Bovine-derived collagen matrix as an adjunct in stage 3 pressure injuries: a case series of lower extremity wounds.

IF 1.7 4区医学 Q3 DERMATOLOGY

Journal of wound care Pub Date : 2025-09-02 DOI:10.12968/jowc.2025.0254

Scott R Boynton, Melina Butuci, R Allyn Forsyth, Sara Shahbazi

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引用次数: 0

Abstract

Objective: Hard-to-heal (chronic) stage 3 pressure injuries (PIs) in medically complex patients are often refractory to standard treatments, and pose significant risks of infection, limb loss and diminished quality of life. Adjunctive use of advanced biologic materials, such as bovine-derived collagen matrices, may support more efficient wound resolution in these high-risk populations.

Method: In this retrospective case series, patients with hard-to-heal stage 3 PIs of the lower extremity were treated with a single application of a bovine-derived collagen matrix as part of a multidisciplinary wound care protocol. All patients had significant comorbidities, including diabetes and dementia, as well as mobility impairments, such as peripheral neuropathy and multiple sclerosis with paraplegia. Interventions included debridement, a single application of a bovine-derived collagen matrix, appropriate wound dressings and pressure offloading.

Results: All three patients (each with one PI) had failed to respond to prior standard wound care and their PIs had persisted from four weeks to approximately three years before treatment. Following a single application of the collagen matrix, complete wound closure was achieved within 27-52 days. Early wound responses were notable: one PI showed a 98% area reduction by day 14, another reduced by 76% by day 6, and in Case 2, closed by primary intention, stable closure was observed as early as day 3. No repeat applications of the bovine-derived collagen matrix were required, and no complications or recurrences were observed at follow-up.

Conclusion: This case series highlights the potential of bovine-derived collagen matrix as an effective adjunct to comprehensive wound care in medically complex patients with stage 3 PIs that have persisted for several months to years, despite prior standard treatments. In all cases, complete wound closure was achieved following a single application of collagen matrix, highlighting its potential utility in the management of hard-to-heal PIs. Further prospective studies are warranted to validate these outcomes.

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牛源性胶原基质作为3期压迫性损伤的辅助材料：一系列下肢创伤病例。

目的：在医学复杂的患者中，难以愈合的（慢性）3期压力损伤（PIs）通常难以接受标准治疗，并且存在感染，肢体丧失和生活质量下降的重大风险。辅助使用先进的生物材料，如牛源性胶原基质，可以在这些高风险人群中支持更有效的伤口愈合。方法：在这个回顾性的病例系列中，作为多学科伤口护理方案的一部分，用牛源性胶原基质单次应用治疗下肢难以愈合的3期PIs患者。所有患者都有明显的合并症，包括糖尿病和痴呆，以及活动障碍，如周围神经病变和多发性硬化症伴截瘫。干预措施包括清创，单次应用牛源性胶原基质，适当的伤口敷料和减压。结果：所有三名患者（每个患者有一个PI）对先前的标准伤口护理没有反应，他们的PI持续从治疗前四周到大约三年。单次应用胶原基质后，伤口在27-52天内完全愈合。早期伤口反应明显：一个PI在第14天显示98%的面积缩小，另一个在第6天减少76%，在病例2中，最初的意图闭合，早在第3天就观察到稳定的闭合。不需要重复应用牛源性胶原基质，随访中没有观察到并发症或复发。结论：本病例系列强调了牛源性胶原基质作为医学上复杂的3期pi患者综合伤口护理的有效辅助的潜力，这些患者持续了数月至数年，尽管先前进行了标准治疗。在所有病例中，单次应用胶原基质即可实现伤口完全闭合，这突出了其在治疗难以愈合的pi中的潜在效用。需要进一步的前瞻性研究来验证这些结果。

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来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.