The Integrated Use of DACC Technology and a New Bio-Active Native Collagen Scaffold to Treat Chronic Wounds

Introduction:

There are many impediments that can affect the normal acute wound healing cascade and present as a challenge in managing chronic wounds in the clinic setting.  Wound bed preparation has been defined as the management of the wound to accelerate endogenous healing or to facilitate the effectiveness of other therapeutic measures.  Two of the factors that need to be addressed in preparing the wound to heal are 1) addressing inflammation and bacterial bioburden and 2) managing unbalanced protease activity. Controlling wound bacterial levels prevents biofilm formation and reducing excess MMPs creates a conducive environment for the formation of granulation tissue, re-epithelialization and ultimately wound closure. 

Methods/Material: An integrated two step approach with DACC technology and a new bioactive native collagen scaffold was used on three chronic wounds.  The three patients that presented to the clinic with chronic wounds included two poorly controlled diabetics with dehisced 1^stray and hallux amputations and a non-compliant diabetic with PVD and open left TMA. DACC (dialklycarbamoyl chloride) is a fatty acid derivative that manages bacteria through hydrophobic interaction by physically binding to the cell wall, rendering them inert and thus, controlling the bacterial load and reducing infection as well as inflammation. The new bio-active collagen scaffold was used to reduce excess MMP’s by acting as a sacrificial substrate to protect the intact ECM, allow for new collagen deposition and neovascularization (granulation) to proceed.

Results:

All three patients responded to this integrated approach as evidenced by rapid and complete wound healing with no secondary infection. 

Conclusion:

Utilizing DACC to control bacterial burden and inflammation, in conjunction with a bioactive native collagen scaffold to control excess MMPs, addresses two key impediments to chronic wound healing and ultimately provides an optimum environment for wound closure.