title: The Use of Bovine Collagen-glycosaminoglycan Matrix for Atypical Lower Extremity Ulcers.
abstract: The primary purpose of this study was to evaluate the use of bovine collagen-glycosaminoglycan matrix on atypical lower extremity ulcers. A retrospective chart review was performed on patients who underwent application of bovine collagen matrix to a lower extremity ulcer with an atypical etiology including autoimmune disease, sickle cell anemia, radiation therapy, connective tissue disease, vasculitis, or coagulopathy from January 2009 to October 2014. The following outcomes were evaluated: rate of ulcer healing and closure, number of ulcers that received a split-thickness skin graft, improvement in pain, and complications related to the ulcer. Thirty-eight patients with 71 lower extremity ulcers were analyzed. The most common ulcer etiolo- gies included rheumatoid arthritis, sickle cell anemia, and coagulopa- thy. After application of the bovine collagen matrix, 30 (42.3%) ulcers healed at a mean of 220.9 days. Of the 71 ulcers, 26 (36.6%) re- ceived a split-thickness skin graft after application of the matrix and 17 (65.4%) of those went on to complete healing. Ten patients had a local infection noted during follow-up, and 5 patients had dehiscence or dissociation of the matrix. Atypical lower extremity ulcers, such as those caused by autoimmune diseases and sickle cell anemia, proved difficult to heal. This case series shows that bovine collagen matrix can be a successful adjunctive therapy for the treatment of these challenging ulcers.
authors.affiliation: MedStar Georgetown University Hospital, Washington, DC.
authors.forename: Caitlin S
authors.initials: CS
authors.lastname: Garwood
authors.affiliation: Department of Plastic Surgery, Georgetown University School of Medicine, Center for Wound Healing and Hyperbaric Medicine, Washington, DC.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Kim
authors.affiliation: MedStar Washington Hospital Center Podiatric Residency, Washington, DC.
authors.forename: Vinay
authors.initials: V
authors.lastname: Matai
authors.affiliation: MedStar Washington Hospital Center Podiatric Residency, Washington, DC; and Codirector, Center for Wound Healing and Hyperbaric Medicine, MedStar Georgetown University Hospital, Washington, DC.
authors.forename: John S
authors.initials: JS
authors.lastname: Steinberg
authors.affiliation: Department of Plastic Surgery, Georgetown University School of Medicine, Center for Wound Healing and Hyperbaric Medicine, Washington, DC.
authors.forename: Karen K
authors.initials: KK
authors.lastname: Evans
authors.affiliation: MedStar Georgetown University Hospital, Washington, DC.
authors.forename: Carol Deane B
authors.initials: CD
authors.lastname: Mitnick
authors.affiliation: Department of Plastic Surgery, Georgetown University School of Medicine, Center for Wound Healing and Hyperbaric Medicine, Washington, DC; and Codirector, Center for Wound Healing and Hyperbaric Medicine, MedStar Georgetown University Hospital, Washington, DC.
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Attinger
mesh_terms: D000755:Anemia, Sickle Cell / Q000150:complications* / Q000473:pathology; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000473:pathology; D001458:Bandages; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D006025:Glycosaminoglycans / Q000627:therapeutic use*; D006801:Humans; D007871:Leg Ulcer / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D006025:Glycosaminoglycans; D003094:Collagen