Collagen regeneration template in the management of full-thickness wounds: a prospective multicentre study
Abstract
Objective:
To evaluate the tolerance and healing rate of a collagen regeneration template in covering full-thickness wounds, including rate of adverse events.
Method:
In this prospective, multicentre study, patients with a fullthickness wound underwent two-stage surgery consisting of implantation of a collagen regeneration template followed by a split-thickness skin graft (STSG). Patients were followed-up for 12 months. Adverse events arising from either the implantation or STSG were evaluated.
Results:
Of the 33 patients included in the study, 29 completed the full follow-up period. During the study, 13 adverse events occurred at the treated wound site, as reported by 11 patients during follow-up. These included local infection (n=5), a diffuse infection (n=1) and non-infectious seroma under the silicon layer (n=1). The mean percentage of take of the collagen template at 21±7 days after implantation was 81.2% of the treated surface. The mean percentage of take of STSG at 28 days after grafting was 84.4% of grafted surface. STSG was successful in 28 patients, but was completely rejected at 12 months for one patient. Mean functional score at 12 months, as evaluated by the treating surgeons, was 76.8/100 and mean aesthetic score was 62.7/100.
Conclusion:
This study found use of a collagen regeneration template to be a safe procedure for the coverage of full thickness-wounds.
The coverage of full-thickness wounds is a major challenge and the aim of dermal regeneration treatment is to restore skin function following trauma, surgical procedure or deep (third degree) burn.1,2 Full coverage of the wound must be achieved in order to: protect the major subdermal structures (bones, muscles, nerves, tendons, ligaments, vessels); restore normal mechanical function; restore thermal regulation and immunologic functions; and restore aesthetic appearance.
There has been increasing interest in the use of collagen regeneration templates. Primarily developed for use in burn management, their indications have widened due to their reported advantages including lower levels of morbidity or infection at the donor site and ease of application.3–5 The formation of the collagen layer provides a supple and non-adherent tissue which can support a split-thickness skin graft (STSG).6,7 The functional and aesthetic results are usually better than using only a STSG.8
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