By Nancy Morgan, RN, BSN, MBA, WOC, WCC, DWC, OMS
Each month, Apple Bites brings you a tool you can apply in your daily practice.
Collagen, the protein that gives the skin its tensile strength, plays a key role
in each phase of wound healing. It attracts cells, such as fibroblasts and keratinocytes, to the wound, which encourages debridement, angiogenesis, and reepithelialization. In addition, collagen provides a natural scaffold or substrate for new tissue growth.
Collagen dressings stimulate new tissue growth and encourage the deposition and organization of newly formed collagen fibers and granulation tissue in the wound bed. These dressings chemically bind to matrix metalloproteinases (MMPs) found in the extracellular fluid of wounds. MMPs normally attackand break down collagen, so it’s thought that wound dressings containing collagen give MMPs an alternative collagen source, leaving the body’s natural collagen available for normal wound healing.
Examples of wounds that may benefit from a collagen dressing include:
• partial- and full-thickness wounds
• wounds with minimal to heavy exudate
• skin grafts and skin donation sites
• second-degree burns
• granulating or necrotic wounds
• chronic nonhealing wounds (to jump-start wounds that are stalled in the inflammatory phase by reducing mediators of inflammation).
Don’t use collagen dressings in the following circumstances:
• third-degree burns
• patient sensitivity to bovine (cattle), porcine (swine), or avian (bird)
• wounds covered in dry eschar.
How to apply
Some collagen products will require a secondary cover dressing. Application technique varies based upon manufacturer recommendations.
Frequency of dressing changes
The frequency of dressing changes varies depending on the brand, but ranges from daily to every 7 days.
A variety of topical formulations of collagen are available, such as freeze-dried sheets, pastes, pads, powder, and gels. Some dressings include alginates or even antimicrobial additives. The collagen source varies—bovine, porcine, or avian.
BGC Matrix®; BIOSTEPu Collagen Matrix; Catrix® Wound Dressing; CellerateRX® Gel or Powder; ColActive® Plus; Excellagen®; FIBRACOL® Plus; Promogran Prisma® Matrix; Puracol® Plus; Stimulen™ Collagen Gel, Lotion, Powder, or Sheets; Triple Helix Collagen Dressing
The HCPCS (Healthcare Common Procedure Coding System) codes for collagen dressings are A6021-A6024.
Nancy Morgan, cofounder of the Wound Care Education Institute, combines her expertise as a Certified Wound Care Nurse with an extensive background in wound care education and program development as a nurse entrepreneur. Read her blog, “Wound Care Swagger.”