Comparative Effectiveness of Oxidized Regenerated Cellulose (ORC)/collagen/silver-ORC Dressing versus Standard of Care for Flaps and Grafts

Background: Competent management of flaps and grafts can mitigate adverse events such as flap compromise or graft failure. Diminished integumentary integrity associated with flap or graft complications impacts wound resolution and may arise due to a deficient wound bed, incidental flap necrosis, vascular insufficiency, and ischemia/reperfusion injury.

Purpose: Here, we present a comparative effectiveness study to evaluate the application of oxidized regenerated cellulose (ORC)/collagen/silver-ORC dressing versus standard of care (SOC) in matched cohorts of patients requiring the management of flaps and grafts.

Methods: Data extracted from the US Wound Registry included flaps or grafts (n = 2227) that were managed with either ORC/collagen/silver-ORC dressing (n = 194) or SOC (n = 2033) and excluded flaps or grafts that received negative pressure wound therapy. Propensity score matching across 29 variables was conducted to construct a case-matched cohort of 194 flaps or grafts per treatment.

Results: The ORC/collagen/silver-ORC group demonstrated a significantly higher percentage (44.3% vs. 31.4%) of flaps or grafts that survived (p = 0.0089). Flaps or grafts within the SOC group exhibited a higher percentage of worsening flaps or grafts (29.9% vs. 11.9%; p < 0.0001). There was no difference in the median initial area of the defects between the ORC/collagen/silver-ORC group and the SOC group (3.9 cm2 [1.5, 13.5] vs. 4.3 cm2 [1.2, 15]; p = 0.1382). The smaller median final area of the defects of the ORC/collagen/silver-ORC group relative to the SOC group was statistically significant (0.53 cm2 [0.04, 3.0] vs. 1.1 cm2 [0.006, 7.0]; p = 0.0004).

Conclusion: According to our comparative effectiveness study using real world data, ORC/collagen/silver-ORC dressing appears to provide improved flap or graft survival relative to SOC in wound management.