Title: Clinical Study of Sterile Collagen Particles (Biofil) in the Management of Chronic Non Healing Ulcers

Authors: Dr W.Edwina Vasantha M.S, Dr V.Marimuthu M.S

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i4.224

Abstract

Introduction: Patients who are suffering from non healing ulcers may lead into a significant problems and prolonged stress. Pain and discomfort are the main complaint of chronic non healing ulcer patients1. Pain may be mild or severe, pricking or burning which may exacerbate with frequent changing of dressings. Wound contracture and scar formation is the end result of any wound healing ulcers2. Collagen plays a very important role in the stage of wound healing process. Collagen particles are used in chronic non healing ulcer management. To evaluate their efficacy when compared with conventional method dressings this study was conducted by our department.

Materials & Methods: This study was a non- randomized, prospective type of study evaluated between December, 2014 to November, 2016 in Thanjavur Medical College and Hospital, Thanjavur, Tamilnadu, India. This is the comparative study between collagen particles dressing study group and conventional method dressing control group. Around a total of 104 patients with chronic non healing ulcers in various region and various types were taken in this study. Study group consisting of 52 patients and control group have 52 patients.

Observation: A significant increase in the wound healing rate percentage being 92.3% in the study group when compared to the control group percentage being 42.3% was seen. Collagen particles dressings found to be effective in the management of chronic non healing ulcer patients compared to the conventional method of betadine dressing. Collagen particles plays an important role by forming an early granulation tissue and scar formation and reduces the duration of the hospital stay.

Keywords: Collagen particles, conventional methods, healing, non-healing, amputation, betadine dressing

References

1.      Pudner R, Wound management: The management of patients with a leg ulcer. Journal of Community Nursing,1998. 12(3): 26–33.

2.      Callam MJ, Harper DR, Dale JJ, Ruckley CV. (1987) Chronic ulcer of the leg: clinical history British Medical Journal 294 1389-1391.

3.      3.Heino J. The collagen family members as cell adhesion proteins.  Bioessays.  2007;29:1001–10.

4.      Myllyharju J, Kivirikko KI. Collagens, modifying enzymes and their mutations in humans, flies and worms. Trends in Genetics. 2004;20:33–43.

5.      Collins MN, Birkinshaw C. Hyaluronic acid based scaffolds for tissue engineering: a review. Carbohydrate Polymers 2013;92(2):1262–796. Singer AJ, Clark RA. Cutaneous wound healing. N Engl J Med. 1999;341:738- 746.

6.      Loots MA, Lamme EN, Zeegelaar J, Mekkes JR, Bos JD, Middelkoop E. Differences in cellular infiltrate and extracellular matrix of chronic diabetic and venous ulcers versus acute wounds. J Invest Dermatol. 1998;111:850-857.

7.      Kirketerp-Møller K, Zulkowski K, James C. Chronic wound colonization, infection, and biofilms. In: Bjarnsholt T, Jensen PØ, Moser C, Høiby N editor(s). Biofilm Infections. 1st Edition. New York: Springer-Verlag, 2011:11-24. [DOI: 10.1007/978-1-4419-6084-9]

8.      Chirife J, Herszage L, Joseph A, Kohn ES. In vitro study of bacterial growth inhibition in concentrated sugar solutions: microbiological basis for the use of sugar in treating infected wounds. Antimicrob Agents Chemother. 1983;23(5):766–73.

9.      Peter A. Blume, DPM, Jodi Walters, et al. Comparison of Negative Pressure Wound Therapy Using Vacuum-Assisted Closure with Advanced Moist Therapy in the Treatment of Diabetic Foot Ulcers. A multicenter randomized controlled trial. Diabetes Care. 2008;31(4):631–36.

10.  Mian M, Beghe F, Mian E. Collagen as a pharmacological approach in wound healing. Int J Tissue React. 1992;14 (Suppl):1–9.

11.  Jiwa F. Diabetes in the 1990s - an overview. Stat Bull Metrop Insur Co. 1997;78(1):2–8

12.  Steed DL, Donohoe D, Webster MW, Lindsley L, for the Diabetic Ulcer Study Group. Effect of extensive debridement and treatment on the healing of diabetic foot ulcers. J Am Coll Surg. 1996;183:61-64.

13.  Donaghue VM, Chrzan JS, Rosenblum BI, Giurini JM, Habershaw GM, Veves A. Evaluation of a collagen-alginate topical wound dressing in the management of diabetic foot ulcers.Adv Wound Care. 1998;11:114-119.

14.  Baker SR, Stacey MC, Jopp-McKay AG, Hoskin SE, Thompson PJ. (1991) Epidemiology of chronic venous ulcers British Journal of Surgery 78 864-867.

15.  Cornwall JV Dore CJ, Lewis JD. (1986) Leg ulcer epidemiology and aetiology British Journal of Surgery 73 693-697.

Corresponding Author

Dr W.Edwina Vasantha M.S

Professor, Department of General Surgery

Thanjavur Medical College Hospital