An Innovative Approach in Managing Non-healing Wounds

Purpose:  Chronic wounds often stall and fail to move through the repair process in an orderly and timely manner¹.  Successful wound healing requires the management of various systemic factors as well as the local wound environment. Chronic inflammation secondary to critical colonization or bioburden results in the excessive production of matrix metalloproteinases (MMPs)².  This detrimental effect is often underestimated and may not be easily visualized by the clinician.  Exorbitant MMPs may damage healthy tissue and impede the body’s ability for angiogenesis resulting in delayed wound healing³.  Consequently, the micro environment of the wound should be a fundamental consideration for the clinician.  Inactivating the excessive MMPs will support the returned balance of MMPs to TIMPs (Tissue Inhibitors of MMPs) to restore the repair process^4.  The purpose of this practice innovation is to review the effectiveness of selecting a collagen dermal template composed of 90% collagen and 10% extracellular matrix.

Objective: The objective was to evaluate the effectiveness of a collagen dermal template in chronic wounds that have not responded to other treatments.

Methods:  Clients with chronic non healing wounds of various etiologies that were non responsive to a variety of topical dressings and adjunctive therapies were selected.  The treatment plan included a collagen dermal template dressing as the primary dressing and the secondary dressing was determined by the Certified Wound Ostomy Continence Nurse (CWOCN).  Wound assessments and treatments were performed by the CWOCN one to two times a week.  Any adverse events were monitored and documented.

Outcomes:  Data gathered from clinicians revealed healing was complete with no adverse events.  The collagen dermal template was effective in supporting wound closure.  Our wound center is initiating this product earlier in our treatment plan as a result of these outcomes.