(CS-051) Pre- and Post-operative Use of Oxidized Regenerated Cellulose (ORC) Dressings in Conjunction With Negative Pressure Wound Therapy for Pressure Injury

krista Bauer, RN, WCC, OMS – Abrazo Arrowhead Hospital & Wound Center; Ashley Wardman, LPN; Jody Wolfe, BSN, MBA, RN, CWOCN

Introduction: Oxidized regenerated cellulose (ORC)/Collagen /Silver -ORC dressings (silver collagen ORC dressings)* are currently used to  manage chronic wounds. These dressings provide a moist wound environment conducive to granulation tissue formation, epithelization, and wound healing. Wound bed preparation, particularly in anticipation for surgical closure and following incisional dehiscence has been managed using negative pressure wound therapy (NPWT)^† with reticulated open cell foam (ROCF) dressings^‡. Recently, the use of NPWT with ROCF dressings in combination with silver collagen ORC dressings has become available. This therapy combination may allow for wound bed preparation that utilizes the benefits of both silver collagen ORC dressing use and NPWT. NPWT with ROCF dressings use in tandem with silver collagen ORC dressings in 6 patients with pressure injuries is presented.

Methods:

Silver collagen ORC dressings were cut to fit the wound and fenestrated. A non-adherent layer was placed over the silver collagen ORC dressings prior to application of NPWT with ROCF dressings. Continuous negative pressure at -125 mmHg was utilized with ROCF dressing changes every 24-72 hours. At dressing changes, silver collagen ORC dressings were reapplied.

Results: Six patients presented with pressure injury and secondary ulceration presented for care. Pressure injury location included right buttock (n=2), left buttock (n= 2) and sacrum (n=1). One patient presented with multiple ulcers. No complications resulting from NPWT in combination with silver collagen ORC dressing use were observed. In all patients, wound size reduction and granulation tissue development in the wound bed were noted. Wound healing was observed in 3 patients after a secondary surgery. Two wounds healed secondarily without the need for additional surgery. The remaining patient with multiple ulcers has shown some wound healing while awaiting nutritional improvement prior to surgical intervention.

Discussion: In these 6 patients, the combination of NPWT and silver collagen ORC dressings was safe and effective, helping to promote wound bed preparation in anticipation of surgical closure or wound healing through secondary intention. More research is needed to understand the synergy between NPWT and silver collagen ORC dressings; though, this therapy combination should be considered for patients with chronic wounds and wound healing delays.