title: Randomized controlled trial on collagen/oxidized regenerated cellulose/silver treatment.
abstract: Collagen/oxidized regenerated cellulose (ORC)/silver therapy has been designed to facilitate wound healing by normalizing the microenvironment and correcting biochemical imbalances in chronic wounds. The aim of this study was to compare collagen/ORC/silver therapy to control (standard treatment). Patients with diabetic foot ulcers were randomized to either collagen/ORC/silver (24) or control treatment (15). Wound area measurements and wound fluid samples were taken weekly. Protease levels were measured in wound fluid samples to investigate differences between responders (≥50% reduction in wound area by week 4) and nonresponders (<50% reduction in wound area by week 4). There were significantly more responders in the collagen/ORC/silver group compared with the control group (79% vs. 43%, p = 0.035). There were significantly fewer withdrawals from the study because of infection in the collagen/ORC/silver group compared with the control group (0% vs. 31%, p = 0.012). The sum of matrix metalloproteinase-9 and elastase concentration was higher in nonresponders compared with responders at baseline (p = 0.0705) and week 4 (p = 0.012). The results suggest that collagen/ORC/silver normalizes the wound microenvironment and protects against infection, resulting in improved wound healing. It was also demonstrated that measuring a combination of proteases may be a more relevant prognostic healing marker than any individual protease alone.
authors: Copenhagen Wound Healing Center, Department of Dermatology, Bispebjerg University Hospital, Copenhagen.
authors: Finn
authors: F
authors: Gottrup
authors: Breda Mary
authors: BM
authors: Cullen
authors: Tonny
authors: T
authors: Karlsmark
authors: Morten
authors: M
authors: Bischoff-Mikkelsen
authors: Lorraine
authors: L
authors: Nisbet
authors: Molly Camilla
authors: MC
authors: Gibson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D015415:Biomarkers / Q000378:metabolism; D002483:Cellulose, Oxidized / Q000627:therapeutic use*; D003094:Collagen / Q000627:therapeutic use*; D017719:Diabetic Foot / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism; D005122:Exudates and Transudates / Q000201:enzymology; D005260:Female; D005339:Fibrin Foam; D006801:Humans; D007249:Inflammation; D008297:Male; D020781:Matrix Metalloproteinase 1 / Q000378:metabolism; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000378:metabolism; D012834:Silver / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D015415:Biomarkers; D002483:Cellulose, Oxidized; D005339:Fibrin Foam; D012834:Silver; D003094:Collagen; D010196:Pancreatic Elastase; D020780:Matrix Metalloproteinase 9; D020781:Matrix Metalloproteinase 1