Made EasyCollagen dressings Made Easy

Collagen dressings Made Easy

Complex wounds, Products, Surgical wounds | Westgate S, Cutting KF, DeLuca G, Asaad K

What is piscean collagen?
Piscean collagen is a protein extracted from fish waste, including the scales, skin or air bladders, which is predominantly sourced from fresh water carp, Labeo rohita (Pati et al, 2010). Purifying collagen from fish involves: alkaline hydrolysis, returning the collagen to a neutral pH and subjecting it to acid hydrolysis to stabilise it. The collagen is freeze-dried into particles, sponge and sheets that can be cut into the required shape and size (Basha et al, 2011). The film membrane preparation is cast onto slabs and is not freeze-dried.

The extraction process for piscean collagen preserves its triple-helix structure. Dressings containing piscean collagen have demonstrated a high level of biocompatibility, while animal studies have found that collagen extracted from fish did not produce an immunological response or allergic reactions and was comparable to type I bovine collagens (Pati et al, 2010).

AVAILABILITY OF type I PISCEAN collagen products
In the UK a number of fish-derived collagen products are available (Table 1). These products are non-toxic, non-allergenic, non-immunogenic and non-pyrogenic.

To choose the most appropriate piscean collagen dressing, selection should be approached with care. All dressings are biodegradable, although there may be some variation in the time they take to degrade in the wound. Variation also applies to the absorption capacity of the dressings and in their ability to mould to the contours of the wound. A particle method of delivery (Helisorb® Particles, Medira Ltd) increases the activity of the collagen by providing an increased surface area and allowing intimate contact with the contours of the wound bed. The particles may be used in infected wounds in combination with appropriate antimicrobial or systemic treatment. All other available piscean products can be used once infection has resolved.  

Tip:  The particles may be mixed with saline to form a paste for ease of use and to maintain a moist wound environment

 

WHEN AND HOW to USE  type I PISCEAN collagen dressings
Piscean collagen dressings are currently used as second-line dressings in non-healing wounds that have failed to respond to other treatment approaches or split skin grafting. They are haemostatic and may provide relief from pain.  Other indications are described in Table 1. Collagen products should not be used on patients sensitive to collagen from any source.

How to apply the dressings
First ensure the wound bed is thoroughly prepared according to local protocols. Apply to the wound bed and keep the area moist. A secondary non-adherent dressing (e.g. paraffin gauze, TelfaTM [Kendall] or MepitelTM [MÖlynlycke]) should be applied over the collagen dressing. An absorbent layer (e.g. gauze) is then placed on top. Finally the dressing should be secured using an appropriate film or crepe dressing.

Tip: When applying Neuskin-FTM, it can curl up at the edges. Simply wet the sheet edges with saline on the fingertips to improve the contact area

How frequently should dressings be changed?
Exudate levels may increase due to healing and the inflammatory response. The authors recommend initial dressing changes two to three times per week, depending on the exudate level. Remaining particles in the wound should be rinsed off. Overgranulation may occur with collagen dressings. If this is present, the collagen product can be discontinued and the overgranulation tissue treated for two weeks using a 1% hydrocortisone cream.

 

 

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