Use of Oxidized Regenerated Cellulose (ORC)/Collagen/Silver-ORC Dressings Alone or In Conjunction with Advanced Wound Therapies in Complex Wounds

Introduction: Complex wounds are difficult to treat and often require several different interventions before wound healing is achieved. This may be mitigated by optimizing the wound for healing. Oxidized regenerated cellulose (ORC)/collagen/silver-ORC dressings have been shown to help optimize the wound environment and promote development of granulation tissue. Additionally, these dressings have been used to prepare the wound bed prior to skin grafting with positive results. Use of ORC/collagen/silver-ORC dressings alone or in conjunction with advanced wound therapies in 4 patients is presented.

Methods: Oral or intravenous antibiotics were given, as necessary. Each wound underwent sharp debridement. Patients received either ORC/collagen/silver-ORC dressings with a secondary dressing alone or in conjunction with negative pressure wound therapy (NPWT). One patient underwent a fifth ray amputation due to osteomyelitis. The wound was first treated with NPWT and then with ORC/collagen/silver-ORC dressings until the wound was ready for epidermal grafting. The second patient received ORC/collagen/silver-ORC dressings until the wound was ready for epidermal grafting. The third patient only received ORC/collagen/silver-ORC dressings. The final patient received wound irrigation, NPWT, and ORC/collagen/silver-ORC dressings. Dressing changes occurred every 2-3 days. Two patients required the use of epidermal grafting to promote wound closure. In these patients, an epidermal harvesting system was utilized. Off-loading was recommended for all patients.

Results: Four patients with an average age 57.75 years (range: 49-64) were treated. Patient medical histories noted diabetes, coronary heart disease, obesity, tobacco use, gout and hypertension. Wound types included were diabetic foot ulcers, thermal burns, and ulcer secondary to chronic gout with tophi. All wounds were fully closed in all patients.

Conclusions: In these patients, use of ORC/collagen/silver-ORC dressings alone or in conjunction with advanced wound therapies led to full wound closure. In 2 patients, this treatment plan contributed to successful limb/toe preservation.