Burns and donor site treatment using allogeneic type I collagen

Introduction. The search for methods to reduce the time of treatment of burns and wounds of the donor sites currently remains relevant.
Aim. Objective of this retrospective study was to evaluate the effectiveness of local treatment of II–IIIA degree burns and donor site wounds with dressings based on allogeneic type I collagen.
Material and methods. The study included 434 patients hospitalized in 2018–2021. Collagen dressings were used in 280 patients (234 with II–IIIA degree burns and 46 with donor site wounds); 154 patients of the comparison group received traditional treatment in accordance with the standards of care for burns. Patients did not differ statistically significantly in age and the area of burns (general, superficial, deep). Lyophilized, sterile dressings based on type I collagen (RC No. FSR 2009/06370 December 8, 2014) were manufactured in accordance with TU No. 9393-002-01967081-2008 by the Department for Tissue Preservation and Graft Manufacturing of our Institute. We compared the timing of wound epithelialization when using collagen dressings versus the conventional treatment, and the pain intensity in the donor sites as assessed by the visual analogue scale for pain.
Results. The terms of complete epithelialization of II–IIIA degree burn wounds made 10 (7;12) days when collagenbased dressings were used, and 18 (14;20) days without collagen, the difference being statistically significant (p<0.001). Epithelialization of the donor site wounds took 9 (8;10) days with using collagen dressings, and 11 (10;12) days with conventional treatment (p<0.001). The visual analogue scale assessed pain intensity in the donor site wounds after collagen application was statistically significantly lower on days 1, 4, and 7 than in patients on conventional treatment (p<0.001, p<0.001, p=0.003, respectively).
Conclusion. The use of dressings based on type I allogeneic collagen for the treatment of superficial burns and the donor sites reduces the time of re-epithelialization, decreases the pain intensity in the donor site wounds, which proves the greater efficacy of this treatment method.

1. Tenenhaus M, Rennekampff H-O. Treatment of superficial burns requiring hospital admission. Available at: https://www.uptodate.com/contents/treatmentof-superficial-burns-requiring-hospitaladmission/print [Accessed May 5, 2022].

2. Phelan HA, Bernal E. Treatment of deep burns. Available at: https://www. uptodate.com/contents/treatment-ofdeep-burns/print [Accessed May 5, 2022].

3. Deitch EA, Wheelahan TM, Rose MP, Clothier J, Cotter J. Hypertrophic burn scars: analysis of variables. J Trauma. 1983;23(10):895–898. PMID: 6632013

4. Vikhriev BS, Burmistrov VM. (eds.) Ozhogi: rukovodstvo dlya vrachey. 2nd ed. Leningrad: Meditsina Publ.; 1986. (In Russ.).

5. Radharaman, Kumar P, Ajai KS, Kumar Sharma R. The role of recruited minced skin grafting in improving the quality of healing at the donor site of split-thickness skin graft-A comparative study. Burns. 2019;45(4):923–928. PMID: 30661716 https://doi.org/10.1016/j.burns.2018.11.018

6. Chowdhry SA. Use of oxidized regenerated cellulose (ORC)/collagen/silverORC dressings to help manage skin graft donor site wounds. JPRAS Open. 2019;22:33–40. PMID: 32158895 https://doi.org/10.1016/j.jpra.2019.08.001eCollection 2019 Dec.

7. Brölmann FE, Eskes AM, Goslings JC, Niessen FB, de Bree R, Vahl AC, et al.; REMBRANDT study group. Randomized clinical trial of donor-site wound dressings after split-skin grafting. Br J Surg. 2013;100(5):619–627. PMID: 23460253 https://doi.org/10.1002/bjs.9045

8. Greenhalgh DG. Management of burns. N Engl J Med. 2019;380(24):2349– 2359. PMID: 31189038 https://doi.org/10.1056/NEJMra1807442

9. Kolokolchikova EG, Sychevsky MV, Zhirkova EA, Smirnov SV, Bocharova VS. Morphological evaluation of the effect of collagen bandage on grade IIIa burn wound healing. Transplantologiya. The Russian Journal of Transplantation. 2010;(3–4):64–67. (In Russ.).

10. Jabeen S, Clough ECS, Thomlinson AM, Chadwick SL, Ferguson MWJ, Shah M. Partial thickness wound: does mechanism of injury influence healing? Burns. 2019;45(3):531–542. PMID: 30739729 https://doi.org/10.1016/j.burns.2018.08.010

11. Daley WP, Peters SB, Larsen M. Extracellular matrix dynamics in development and regenerative medicine. J Cell Sci. 2008;121(Pt 3):255–264. PMID: 18216330 https://doi.org/10.1242/jcs.006064

12. Singer AJ, Clark RA. Cutaneous Wound Healing. N Engl J Med. 1999;341(10):738–746. PMID: 10471461 https://doi.org/10.1056/NEJM199909023411006

13. Li W, Fan J, Chen M, Guan S, Sawcer D, Bokoch GM, et al. Mechanism of human dermal fibroblast migration driven by type I collagen and plateletderived growth factor-BB. Mol Biol Cell. 2004;15(1):294–309. PMID: 14595114 https://doi.org/10.1091/mbc.e03-050352

14. Ferguson MW, O'Kane S. Scarfree healing: from embryonic mechanisms to adult therapeutic intervention. Philos Trans R Soc Lond B Biol Sci. 2004;359(1445):839–850. PMID: 15293811 https://doi.org/10.1098/rstb.2004.1475

15. Serebrakian AT, Pickrell BB, Varon DE, Mohamadi A, Grinstaff MW, Rodriguez EK, et al. Meta-analysis and systematic review of skin graft donor-site dressings with future guidelines. Plast Reconstr Surg Glob Open. 2018;6(9):e1928. PMID: 30349793 https://doi.org/10.1097/GOX.0000000000001928

16. Civelek B, Inal HI, Ozdil K, Celebioglu S. The effect of sucralfate, an agent for gastroprotection on the healing of split thickness skin graft donor sites. Eur J Plast Surg. 2007;30(1):25–28. https://doi.org/10.1007/s00238-007-0140-z

17. Rotatori RM, Starr B, Peake M, Fowler L, James L, Nelson J, et al. Prevalence and risk factors for hypertrophic scarring of split thickness autograft donor sites in a pediatric burn population. Burns. 2019;45(5):1066–1074. PMID: 30824160 https://doi.org/10.1016/j.burns.2019.02.003

18. Ki SH, Ma SH, Choi JH, Sim SH, Kim HM. Treating skin graft donor sites: a comparative study between remnant skin use and polyurethane foam. J Wound Care. 2019;28(7):469–477. PMID: 31295096 https://doi.org/10.12968/jowc.2019.28.7.469