Use of silver with a collagen microscaffold with native collagen dressing with silver in wound care in spinal cord injury

Research Objectives: To describe the use of 3-D extracellular matrix, and silver dressings with collagen microscaffolding as an effective options in complicated wound care to promote granulation tissue and help prevent bone exposure.

Design: Case Report, during an inpatient long term acute care admission

Setting: Long Term Acute Care Hospital inpatient stay

Participants: A 70 year old gentleman with history of fall and subsequent tetraplegia  developed a pressure injury to his right foot with osteomyelitis. His wound care included incision and drainage, and debridement in the acute care setting, and he received six week of intravenous antibiotics.  Oasis, a porcine derived  3-D extracellular matrix, was provided, as well as Puracol, a silver dressing with collagen microscaffolding was provided to assist granulation tissue growth after debridement, and the products were used until the nonviable bone was removed, and the skin was primarily closed.

Interventions: Oasis, a porcine derived  3-D extracellular matrix, was provided, as well as Puracol, a silver dressing with collagen microscaffolding was provided

Main Outcome Measures: Assessment of wound healing

Results: Treatment of complicated pressure injuries can be a challenge in the LTACH setting. When the typically applied products either do not work, or are not appropriate, consideration for the use of an extracellular matrix product, and a product with micro scaffolding, can bring added healing options for the difficult to heal wound.
The products aided in healthy granulation tissue that helped with ultimately with surgical closure, and optimized healing.

Conclusions: 3-D extracellular matrix, and silver dressings with collagen microscaffolding, offer effective options in complicated wound care . They can promote granulation tissue and help prevent bone exposure. The principles of wound care, and- specifically- the advantages and potential side  effects of silver dressing with collagen as well as using an extracellular matrix, are reviewed. Their indications, technique and precautions are highlighted.

Author(s) Disclosures: none