Adjuvant hydrolyzed collagen powder in high-risk patients with large soft tissue defects undergoing orthoplastic limb preservation surgery

Abstract

Limb preservation in the multi-morbid patient remains a significant challenge. The combination of orthopedic and plastic reconstructive techniques (“Orthoplastics”) is well known to result in limb preservation (“limb salvage”) even in extremely high-risk patients. Despite advances, adjunctive healing techniques remain desirable.

In this case series, we examined the use of hydrolyzed collagen powder in limb salvage in multi-morbid patients undergoing limb preservation surgery. The medical records of ten high-risk patients with multiple co-morbidities undergoing limb preservation reconstruction, who would otherwise have required a major level amputation, were reviewed retrospectively. Of these patients, there was an average of nine varying risk factors, including the presence of infection, diabetes mellitus, renal impairment, vascular disease, smoking, illicit drug or alcohol abuse, or nicotine use. The case review data included patient demographics, risk factors, specific pathophysiology, Orthoplastic procedure, and the volume of adjunctive hydrolyzed collagen during the reconstructive procedures.

All patients achieved limb preservation or the prevention of an anticipated higher-level amputation. On average, two hydrolyzed collagen applications were used per patient with a mean volume of 1.8 g (range 2-4 g). Notably, the presence of an actively treated infection did not appear to diminish the efficacy of hydrolyzed collagen. Additionally, no adverse reactions were identified with the use of hydrolyzed collagen. These findings suggest that use of hydrolyzed collagen is a safe, valuable adjunct in Orthoplastic limb preservation surgery for patients at extreme risk for limb loss.