Collagen-ECM and Dehydrated Human Amnion Chorion Membrane (dHACM) used for Closure of Non-Healing Lower Extremity Wounds (LEW)

Abstract Body: Introduction:  Collagen is an essential component of the ECM and required for wound healing (1) Collagen-ECM has been used successfully to prepare the wound bed for a dermal regenerative matrix in patients with LEW (2). In this Case Series, we evaluated a Collagen-ECM and dHACM for closure of non-healing LEW. Objective: Time to wound closure of non-healing LEWS were evaluated in three groups of patients who were treated with Collagen-ECM or dHACM or Collagen-ECM + dHACM. Method: This case series consisted of three cohorts of patients that received 1) Collagen-ECM alone, 2) patients that received dHACM alone, and 3) patients that received Collagen-ECM + dHACM.  Patients were evaluated for up to 20 weeks for wound closure.  Some patients received NPWT along with 1-3 applications of their respective treatments. Results: Patients treated with Collagen-ECM alone or with dHACM alone had wound closure at half the number of weeks compared to those patients treated with Collagen-ECM + dHACM.  Some patients in the Collagen-ECM + dHACM experienced accelerated wound closure then switched to dHACM only during the later weeks of treatment.   Conclusion: We conclude that Collagen-ECM alone and dHACM alone may be equally effective for closure of non-healing LEWs.  Collagen-ECM + dHACM does not appear to accelerate wound closure. The cost per patient for dHACM is approximately 10x more than treatment with Collagen-ECM.  Therefore, the extra cost should also be taken into consideration for use of dHACM in the treatment of non-healing LEW.