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Case Series/Study
Oxidized regenerated cellulose (ORC)/Collagen (C)/Silver (Ag)-ORC dressings* are currently used in the management of chronic wounds. These dressings provide a moist wound environment conducive to granulation tissue formation, epithelization, and wound healing. Wound bed preparation, particularly in anticipation for surgical closure, has been managed using negative pressure wound therapy (NPWT†). Recently, the use of NPWT in combination with ORC/C/Ag-ORC dressings has become available. The combination of NPWT with ORC/C/Ag-ORC dressings may allow for wound bed preparation that utilizes the benefits of both ORC/C/Ag-ORC dressing use and NPWT. Use of NPWT with reticulated open cell foam (ROCF) dressings‡ in tandem with ORC/C/Ag-ORC dressings in 6 patients is presented.
Methods:
ORC/C/Ag-ORC dressings were cut to fit the wound and fenestrated. A non-adherent layer was placed over the ORC/C/Ag-ORC dressing prior to application of NPWT with ROCF dressings. Continuous negative pressure at -125 mmHg was utilized with ROCF dressing changes every 24-72 hours. At dressing changes, ORC/C/Ag-ORC dressings were reapplied.
Results:
Six patients presented for care. Wound types included pressure injury (n=4), surgical dehiscence (n=1), and diabetic foot ulcer (n=1). No complications resulting from NPWT with ORC/C/Ag-ORC dressing use were observed. In all patients, the wound size reduction and development of granulation tissue were noted. Wound healing was observed in 2 patients after a secondary surgery. One wound healed secondarily without the need for additional surgery, and wound closure was obtained through skin grafting in one patient. Wounds in 2 patients were allowed to heal through secondary intention with use of advanced wound dressings once NPWT with ORC/C/Ag-ORC dressings were discontinued.
Discussion: In these 6 patients, the combination of NPWT and ORC/C/Ag-ORC dressings was safe and effective, helping promote wound bed preparation in anticipation of surgical closure or wound healing through secondary intention. More research is needed to better understand the synergy between NPWT and ORC/C/Ag-ORC dressings; though, this therapy combination should be considered for patients with chronic wounds and wound healing delays.
Trademarked Items: *3M™ Promogran Prisma™ Collagen Matrix with ORC and Silver, †3M™ ActiV.A.C.™ Negative Pressure Wound Therapy System; ‡3M V.A.C.® Granufoam™ Dressing (3M Health Care, St. Paul, MN)
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