Collagen makes good use of an abundant protein
By Liza G. Ovington, PhD
Program Director
Wound and Continence Management
Home Health Care Division, Southeast Florida
Columbia Healthcare Corporation
Ft. Lauderdale, FL
Collagen, a relatively new material becoming available in topical dressings, is offering wound care professionals a new option in the healing process. While new to wound care, collagen has a longer history in soft tissue repair.
Collagen sponges long have been used as hemostatic devices, and injectable collagen is commonly used to treat minor dermatological defects, in cosmetic dermatological applications, and in urologic surgery to treat incontinence. Collagen has been regulated as a medical device by the U.S. Food and Drug Administration since 1976.
The most prevalent protein
The structural, physical, and biochemical properties of collagen are well known. It is the body’s most prevalent protein, accounting for almost 30% of all protein. Collagen is manufactured primarily by the body’s fibroblast cell. This fibroblast-derived collagen plays an important and specific role in the healing process by providing a three-dimensional matrix for cellular attachment and new tissue growth.
External collagen can play an important role in the healing of chronic wounds by performing the same duties. Collagen slowly breaks down into its component amino acids over time and is absorbed by the body. The most common source of external collagen for wound care applications is bovine collagen derived from cow hides. The bovine material is non-antigenic as a result of enzymatic purification methods.
These collagen products are available in a variety of physical formats: freeze-dried sheets, particles, and pastes or gels. One brand of collagen sheet also contains 10% alginate for absorption and structural integrity.
Collagen particles are available in a vial or enclosed in a "sachet" that can be placed into a cavity. The sachet must be removed at dressing changes. A collagen gel or paste is available pre-loaded in a syringe for use in filling tracts and tunnels. The use of all of these collagen products requires a secondary dressing.
Jump-starting the healing process
It is believed that the addition of exogenous collagen to a wound bed accelerates wound repair by providing a collagen matrix for cellular migration, and many clinicians have described the use of collagen as "jump-starting" the wound healing process in chronic wounds or long duration.
The use of collagen materials in a wound can be associated with transient redness and increased drainage, perhaps because of an inflammatory response. Collagen products, therefore, should be covered with an absorbent secondary dressing.
Collagen also works optimally when in contact with healthy tissue rather than slough or necrotic tissue. Therefore, debridement prior to collagen treatment is recommended.
Listed below are the currently available collagen products for wound healing, their manufacturers, and telephone numbers for more information.
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