Comparative Effectiveness of Oxidized Regenerated Cellulose (ORC)/collagen/silver-ORC Dressing versus Standard of Care for the Management of Arterial Insufficiency Ulcers

Background: Arterial insufficiency ulcers are ischemic lesions that are generally concomitant with peripheral artery disease as a comorbidity. Management of arterial insufficiency ulcers may entail selective debridement, the application of occlusive dressings and resolving the impairment to circulation. Unless the underlying pathology of the vascular deficiency is addressed, integumentary integrity of the recalcitrant wound may worsen.

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 arterial insufficiency ulcers.  

Methods: Data extracted from the US Wound Registry identified arterial insufficiency ulcers (n = 4550) that were managed with either ORC/collagen/silver-ORC dressing (n = 236) or SOC (n = 4314). Twenty-five variables were considered in propensity score matching to develop a case-matched cohort of 472 arterial insufficiency ulcers (n = 236 in each cohort).

Results: Wound healing outcomes were compared between the two groups using Chi-Square or Fisher’s exact tests. As a result of the propensity score matching, there were not significant differences in baseline patient and wound characteristics. The ORC/collagen/silver-ORC dressing group demonstrated a significantly higher percentage of arterial insufficiency ulcers that healed or improved (77.1% vs. 63.1%; p = 0.0009).  The SOC group yielded a significantly higher percentage of arterial insufficiency ulcers that worsened (29.7% vs. 21.2%; p = 0.0345). Between the treatments, the ORC/collagen/silver-ORC dressing group demonstrated a significantly lower percentage of wounds resulting in amputations relative to the SOC group (1.3% vs. 6.8%; p = 0.0023).

Conclusion: According to our comparative effectiveness study using real world data, ORC/collagen/silver-ORC dressing appears to provide improved healing relative to SOC in the management of arterial insufficiency ulcers.