Negative Pressure Wound Therapy Use in Conjunction with Oxidized Regenerated Cellulose/Collagen/Silver Dressings: Expert Panel Consensus Recommendations

Introduction: With an increase in patients requiring wound care, development of new wound care options has also intensified. Advanced wound dressings and negative pressure wound therapy (NPWT*) are some of the more commonly utilized products.1-5  Recently, the use of oxidized regenerated cellulose (ORC)/collagen/silver-ORC (ORC/C/Ag-ORC†) dressings in conjunction with NPWT and reticulated open cell foam (ROCF) dressings has become available. An in-person panel meeting with seven US based health care providers was held to identify clinical care settings and appropriate use of ORC/C/Ag-ORC dressings in conjunction with NPWT and ROCF dressings.Methods:A modified Delphi technique was used. An additional 25 participants were invited to complete an anonymous survey on the consensus statements. Consensus was defined as a ≥80% agreement among survey respondents. The panel members and survey participants included podiatrists, surgeons, physician assistants, registered nurses, and nurse practitioners.Results:Panel members recommended use of ORC/C/Ag-ORC dressings with NPWT and ROCF dressings in both inpatient and outpatient healthcare settings. Use in traumatic wounds, surgical wounds, diabetic ulcers, venous leg ulcers, and pressure injuries was supported. Use of ORC/C/Ag-ORC dressings in combination with NPWT and ROCF dressings at the earliest point possible in the wound care plan was also advised. The therapy combination was not recommended in the presence of exposed unprotected organs or exposed unprotected vessels, inadequate wound hemostasis, acutely ischemic wounds, surgically closed incisions, third degree burns, or in patients with hypersensitivity to therapy components.Discussion: Limited evidence exists on the use of NPWT in conjunction with ORC/C/Ag-ORC dressings. A panel was convened to develop guidance for the use of this therapy combination. A total of 12 consensus statements were created to help educate clinicians on the recommended and contraindicated uses of NPWT in conjunction with ORC/C/Ag-ORC dressings.References:1. Zhang L, Wang S, Tan M, Zhou H, Tang Y, Zou Y. Efficacy of Oxidized Regenerated Cellulose/Collagen Dressing for Management of Skin Wounds: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2021;2021:1058671. 2. Chowdhry SA, Nieves Malloure Y, Camardo M, Robertson JM, Keys J. Use of oxidised regenerated cellulose/collagen dressings versus standard of care over multiple wound types: A systematic review and meta-analysis. Int Wound J. 2022;19(2):241-252. 3. Chen L, Zhang S, Da J, et al. A systematic review and meta-analysis of efficacy and safety of negative pressure wound therapy in the treatment of diabetic foot ulcer. Annals of palliative medicine. 2021;10(10):10830-10839. doi:10.21037/apm-21-2476 4. Song YP, Wang L, Yuan BF, et al. Negative-pressure wound therapy for III/IV pressure injuries: A meta-analysis. Wound Repair Regen. 2021;29(1):20-33. 5. Suissa D, Danino A, Nikolis A. Negative-Pressure Therapy versus Standard Wound Care: A Meta-Analysis of Randomized Trials. Plast Reconstr Surg. 2011;128(5):498e-503e.