Paul Soloman, S (2020) A Clinical study on Role of Collagen Dressings in Diabetic Ulcer Management. Masters thesis, Tirunelveli Medical College, Tirunelveli.
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Abstract
INTRODUCTION: Diabetic foot ulcer is the commonest cause of lower-extremity amputation, major source of morbidity, limb loss and mortality. Collagen components such as fibroblast and keratinocytes are fundamental to the process of wound healing. Dressings that contain collagen products act as scaffold that supports the regulation of extracellular components and promotes wound healing. AIM OF THE STUDY: 1. To estimate the efficacy of Collagen dressing in patients with diabetic foot ulcer. 2. To estimate the rate of healing of the diabetic ulcer after collagen dressings and to finally assess whether SSG was required or not. STUDY DESIGN: This is a cross sectional study. The study was carried out at Tirunelveli Medical College Hospital from Sep 2017 to Aug 2019. Sample size: 80 patients with diabetic foot ulcer. TECHNIQUE: The study was conducted on total eighty patients with diabetic foot ulcer, patients who reported at Tirunelveli Medical College Hospital. All diabetic foot ulcer patients, with ulcer size less than 150 sqcm attending the Surgery Department were invited to participate in the study and written informed consent was taken. All patients underwent a standard clinical and laboratory evaluation. Briefly, information about age, known DM duration, smoking habits, arterial blood pressure, and anthropometric measurements were collected. Critically ill patients and patients with underlying bone osteomyelitis or malignancy were excluded. In all patients, wound size was measured before treatment initiation. A collagen dressing was applied to wound, and all patients were followed as per standard post-application treatment protocol. Patients underwent dressing changes every 3 to 4 days until wound healing or for maximum period of 12 weeks. Changes in wound size was recorded when the dressing was removed; and at 4 and 12 weeks. Healing time, follow up period was noted. All patients were followed up for adverse events. All the data was captured in the pre-printed pro-forma. RESULTS: Study shows that there is significant reduction in ulcer size after collagen treatment (p value < 0.0001). In our study 80% of the patients required SSG after collagen dressing. There is no significant difference in healing in both the gender (p value 0.326). Ulcer healing is decreased by the presence of infection (p value <0.0001), in smokers (p value 0.009), and in patients with hypertension (p value < 0.0001). Patients who are having adequate glycemic control had better reduction in ulcer size (p value 0.001). CONCLUSION: There is no evidence to support that collagen products should replace the gold standard of diabetic wound management, which includes etiology identification, infection management, securement of an adequate vascular supply, regular debridement of nonviable tissue, and offloading. However, despite the limited studies, and the need for improved study designs and increased number of randomized controlled trials, wound dressings containing collagen do appear to have some benefit in the treatment of diabetic foot ulcers and should be carefully considered by clinicians that manage wounds.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221711363 |
| Uncontrolled Keywords: | Collagen Dressings, Wound Healing, Skin grafts, Diabetic ulcers, Non healing wounds. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 11 Feb 2021 02:13 |
| Last Modified: | 11 Feb 2021 02:13 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14041 |
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