Leg Ulcer Treatment Outcomes with New Ovine Collagen Extracellular Matrix Dressing

Bohn, Gregory; Gass, K

doi:10.1097/01.asw.0000453728.12032.6f

Cited by 17 publications

(13 citation statements)

References 28 publications

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“…Data from preliminary case series suggest that clinicians may achieve better outcomes in chronic wound healing in a shorter timeframe using a broad-spectrum ovine-based CECM dressing compared to previous available treatments. 17,34 Controlled clinical trials are needed to further analyze the comparative and cost-effectiveness of ovine-based CECM dressings in various wound types.…”

Section: Discussionmentioning

confidence: 99%

“…3,34 In a study, including venous ulcers, diabetic foot wounds, and incisional wounds, Liden and May 35 reported 50% closure at 12 weeks with ovine-based CECM dressings with an average surface area reduction of 73.4%. Bohn and Gass 17 reported a healing rate of 97% of VLUs at 12 weeks with weekly application of CECM dressing and compression; 50% of wounds were closed by 7-8 weeks using CECM dressings. Authors suggested that compared with other collagen dressings requiring at least twice weekly application, the once weekly application of CECM dressings saved healthcare system dollars in terms of reduced facility fees, material costs, and home nursing visits.…”

Section: Effectiveness Of Collagen Dressings In Treating Vlusmentioning

confidence: 99%

“…Earlier, MMPtargeted treatment may reduce the need for advanced wound therapies later in the course of care, and lead to reduced costs and healing times. 17 …”

Section: Early Application Of Collagenmentioning

confidence: 99%

“…Authors suggested that compared with other collagen dressings requiring at least twice weekly application, the once weekly application of CECM dressings saved healthcare system dollars in terms of reduced facility fees, material costs, and home nursing visits. 17 In addition to compression, application of a CECM dressing with broad-spectrum activity to modulate MMP activity may translate into improved healing rates for patients with VLUs. Once degradation is normalized, other cellular processes can proceed.…”

Section: Effectiveness Of Collagen Dressings In Treating Vlusmentioning

confidence: 99%

“…Collagen dressings have been used effectively to modify the wound environment, control bacterial bioburden, protect growth factors from degradation, and stimulate cell growth and cell infiltration into the wound area. 3,17,18 Collagen has been shown to reduce MMP levels, acting as a sacrificial substrate for excessive proteases in a chronic wound. 1,2,19 As such, collagen can reduce the excessive protease activity in a wound to a level that may allow healing to proceed.…”

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confidence: 99%

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Ovine-Based Collagen Matrix Dressing: Next-Generation Collagen Dressing for Wound Care

Bohn¹,

Liden²,

Schultz

et al. 2016

Advances in Wound Care

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Significance: Broad-spectrum metalloproteinase (MMP) reduction along with inherent aspects of an extracellular matrix (ECM) dressing can bring about improved wound healing outcomes and shorter treatment duration. Initial reports of clinical effectiveness of a new ovine-based collagen extracellular matrix (CECM) dressing demonstrate benefits in chronic wound healing. Recent Advances: CECM dressings are processed differently than oxidized regenerated cellulose/collagen dressings. CECM dressings consist primarily of collagens I and III arranged as native fibers that retain the three-dimensional architecture present in tissue ECM. As such, ovine-based ECM dressings represent a new generation of collagen dressings capable of impacting a broad spectrum of MMP excess known to be present in chronic wounds. Critical Issues: While MMPs are essential in normal healing, elevated presence of MMPs has been linked to wound failure. Collagen has been shown to reduce levels of MMPs, acting as a sacrificial substrate for excessive proteases in a chronic wound. Preserving collagen dressings in a more native state enhances bioactivity in terms of the ability to affect the chronic wound environment. Clinical observation and assessment may not be sufficient to identify a wound with elevated protease activity that can break down ECM, affect wound fibroblasts, and impair growth factor response. Future Directions: Collagen dressings that target broad-spectrum excessive MMP levels and can be applied early in the course of care may positively impact healing rates in difficult wounds. Next-generation collagen dressings offer broader MMP reduction capacity while providing a provisional dermal matrix or ECM. SCOPE AND SIGNIFICANCESelecting treatment based on a scientific understanding of the pathological condition of a chronic wound is important in addressing cost and patient needs. Harmful effects of excessive metalloproteinase (MMP) activity in chronic wound healing should be a consideration of wound care decision making. Collagen dressings have been shown to reduce MMP levels, acting as a sacrificial substrate for excessive proteases in chronic wounds. 1-3New ovine-based collagen extracellular matrix (CECM) dressings (EndoformÔ dermal template; Hollister Wound Care, Libertyville, IL) exhibit broad-spectrum MMP inhibition and can serve as a provisional matrix to affect cellular signaling and differentiation that may enhance wound healing. 2 TRANSLATIONAL RELEVANCEDegradation of collagen is important for the physiological remodeling of connective tissues during wound healing. Extracellular degradation of collagen fibers is mediated by MMPs and is a multistep process. A collagen dressing with a preserved structural component can serve as a provisional ECM dermal template and influence cellular interaction necessary to encourage keratinocyte migration. 4 CECM dressings have been shown to retain the complex collagen architecture of native tissue ECM as well as the ECM-associated secondary molecules, including laminin, fibronectin, and glycosam...

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Section: Discussionmentioning

confidence: 99%

Section: Effectiveness Of Collagen Dressings In Treating Vlusmentioning

confidence: 99%

“…Earlier, MMPtargeted treatment may reduce the need for advanced wound therapies later in the course of care, and lead to reduced costs and healing times. 17 …”

Section: Early Application Of Collagenmentioning

confidence: 99%

Section: Effectiveness Of Collagen Dressings In Treating Vlusmentioning

confidence: 99%

mentioning

confidence: 99%

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