Randomized controlled trial on collagen/oxidized regenerated cellulose/silver treatment

Collagen/oxidized regenerated cellulose ( ORC )/silver therapy has been designed to facilitate wound healing by normalizing the microenvironment and correcting biochemical imbalances in chronic wounds. The aim of this study was to compare collagen/ ORC /silver therapy to control (standard treatment). Patients with diabetic foot ulcers were randomized to either collagen/ ORC /silver (24) or control treatment (15). Wound area measurements and wound fluid samples were taken weekly. Protease levels were measured in wound fluid samples to investigate differences between responders (≥50% reduction in wound area by week 4) and nonresponders (<50% reduction in wound area by week 4). There were significantly more responders in the collagen/ ORC /silver group compared with the control group (79% vs. 43%, p  = 0.035). There were significantly fewer withdrawals from the study because of infection in the collagen/ ORC /silver group compared with the control group (0% vs. 31%, p  = 0.012). The sum of matrix metalloproteinase‐9 and elastase concentration was higher in nonresponders compared with responders at baseline ( p  = 0.0705) and week 4 ( p  = 0.012). The results suggest that collagen/ ORC /silver normalizes the wound microenvironment and protects against infection, resulting in improved wound healing. It was also demonstrated that measuring a combination of proteases may be a more relevant prognostic healing marker than any individual protease alone.