Combining the Benefits of Collagen and Negative Pressure Wound Therapy to Heal a Chronic Diabetic Foot Ulcer: A Case Report

Introduction. Diabetes affects 30 million children and adults in the United States, equivalent to 1 out of every 11 people in the country, and results in costs of $327 billion annually. Interventions that can improve healing rates and/or reduce the size of diabetic ulcers may lower the incidence of infection, rate of amputations, and cost of care. This report is on the use of a collagen wound contact layer in conjunction with negative pressure wound therapy (NPWT) to achieve healing in a chronic diabetic foot ulcer (DFU). Case Report. A known patient with type 1 diabetes presented with a chronic DFU of 6 months' duration. Previous treatment modalities included offloading regimens and topical therapies (ie, clostridial collagenase, human platelet-derived growth factors, and 6 applications of a human amniotic membrane allograft). A collagen wound contact layer was applied to the debrided wound bed with subsequent debridements performed every other week, weekly NPWT dressing changes, and weekly contact layer changes. A 91% reduction in wound area was seen at day 35, with complete healing at day 63, and no recurrence at 18 months. Conclusions. The combination of a collagen wound contact layer and weekly NPWT had a significantly positive effect on healing in this chronic DFU. The regimen was well-tolerated and simple to administer in this case.