Is there an alternative to acellular dermal matrix for wound management? Revisiting the role of a bioactive collagen and hyaluronic acid-based dressing hyaluronic acid

Wound healing is a complex process, which involves a lot of synergistic interactions between several cell lines, cytokines, enzymes, and growth factors. In the last few years several biomaterials and bioactive dressings, which are considered to play an active role in wound healing have been introduced. Both collagen and Hyaluronic Acid (HA) have been largely adopted for wound management and its combined used as bioactive dressing have been studied. We reported our clinical experience with an advanced wound dressing consisting of HA plus heterologous collagen type I applied on acute and chronic wounds of different aetiology in in a retrospective cohort of 30 patients. All patients included have cutaneous open wounds completely healed by only second intention, and all wounds were treated by using Bionect Pad® (BP). If necessary, some cases were managed with combined treatments in order to obtain an adequate wound bed preparation before the application of BP. Thirty patients with an average age of 60,2 years were treated for wounds of different aetiology. Wound types included venous ulcers, posttraumatic wounds, surgical wound complications, pressure sores, burns, peristomal ulcerations and skin ulcerations after radiation therapy. The average healing time was 31 days (range: 21-76 days). Basing on our encouraging results, we believe that such bioactive dressings may be considered as a useful and reliable alternative to other wellknown and established treatment methods such as acellular dermal matrices or advanced wound dressings in selected cases.