Collagens
Action
Collagen, the most abundant protein in the body, is fibrous and insoluble and is produced by fibroblasts. Its fibers are found in connective tissues, including skin, bones, ligaments, and cartilage. During wound healing, collagen encourages the deposition and organization of newly formed collagen fibers and granulation tissue in the wound bed. It also stimulates new tissue development and wound debridement, creating an environment conducive to healing. Collagen dressings are manufactured as sheets, pads, particles, solutions, and gels.
Indications
Collagen dressings may be used as primary dressings for partial- and full-thickness wounds, infected and noninfected wounds, tunneling wounds, wounds with minimal to heavy exudate (depending on the form of collagen dressing), skin grafts, donor sites, and red or yellow wounds.
Advantages
Are absorbent
Maintain a moist, wound-healing environment
May be used in combination with topical agents
Conform well to a wound surface
Are nonadherent
Are easy to apply and remove
Disadvantages
Are not recommended for third-degree burns
Are not recommended for black wounds
Require a secondary dressing
HCPCS code overview
The HCPCS codes normally assigned to collagen dressings are:
A6021—pad size < 16 in2
A6022—pad size > 16 in2 but < 48 in2
A6023—pad size > 48 in2
The HCPCS codes normally assigned to collagen wound fillers are:
A6010—wound filler, dry form, per gram of collagen
A6011—wound filler, gel/paste, per gram of collagen
A6024—wound filler, per 6″ (15 cm)
BGC Matrix Wound Dressing
Brennen Medical, LLC
How supplied
Patch: 2.5″ × 3″; A6021 Sheet: 5″ × 6″; A6022
5″ × 12″; A6023
Action
BGC Matrix is a temporary, multifilament mesh matrix wound dressing. It combines the highly advanced oat beta-glucan technology with collagen, which provides structural support for new cell growth. BGC Matrix provides a moist environment that supports the autolytic debridement of wounds with scattered areas of necrosis and slough.
Indications
To manage partial-thickness burns, ulcers, donor sites, chronic wounds, and other shallow or abrasive wounds
Contraindications
Contraindicated for third-degree burns and for wounds with large amounts of eschar
Contraindicated on patients with a sensitivity to plant extracts or collagen
Contraindicated on patients with a history of multiple serum allergies
Application
Prepare the wound by removing (debriding) dead or necrotic tissue, eschar, or foreign debris. Cleanse the wound with normal saline solution or other noncytotoxic wound cleanser.
Apply the mesh side of the dressing to the wound surface, film side up. (Dressing is labeled “THIS SIDE UP.”) If the wound bed is dry, or to increase dressing pliability, lightly moisten the dressing with sterile saline before application.
Smooth the BGC Matrix into place on the wound surface. Avoid any wrinkling; the BGC Matrix should have intimate contact with the wound bed. If necessary, overlap adjoining pieces of Matrix to provide total wound coverage. Cut edges to fit wound.
For deep wounds, cut the BGC Matrix to fit the size of the wound bed. Push it gently into the wound so dressing is in contact with wound bed. Then lightly pack the wound with dry gauze if wound is heavily exudating, or moist gauze if wound is dry.
If the wound is exudative, apply a nonadherent absorbent secondary dressing over the BGC Matrix, and secure in place. If the wound is nonexudative, apply a secondary dressing to maintain moisture at the wound base, and secure in place.
After 24 hours, remove the secondary dressing and inspect the wound. If the wound is still draining, leave the BGC Matrix in place and reapply a clean absorbent outer dressing. Inspect daily.
If the BGC Matrix is adherent and the film layer is intact, see Removal.
If any signs of infection are present, remove the BGC Matrix dressing, clean the wound site and reapply a new dressing. Treat infection per normal prescribed protocol.
You may see an increase of exudate during the first few days of the BGC Matrix application.
BGC Matrix may be left on the wound for up to 72 hours. Check secondary dressing every 24 hours. If “strikethrough” is evident, or outer dressing is saturated with exudate, remove outer dressing and replace. Note: The Matrix mesh will not dissolve.
Removal
BGC Matrix will occasionally adhere to red, granulating tissue. To remove an adherent BGC Matrix dressing, apply a normal saline moistened gauze, amorphous hydrogel, or topical ointment over the BGC Matrix, then lightly cover with a nonadherent secondary dressing. Leave in place for 24 hours.
After 24 hours, carefully lift the dressing off the wound. To prevent damage to new tissue, never force the dressing from the wound; simply reapply gauze, hydrogel, or topical ointment to remaining adherent dressing, and attempt removal in 12 to 24 hours.
When the outer secondary dressing is removed, you may observe an accumulation of yellow exudate. You may also detect an odor. Yellow exudate and odor may be normal occurrences when using dressings containing hydrocolloid; they’re not necessarily signs of infection.
CellerateRX Gel
Wound Care Innovations, LLC
How supplied
Tube: 28 g: A6011, sterile 6 g: A6011, sterile
Action
A medical hydrolysate of type I collagen, CellerateRX gel (approximately 65% collagen) is appropriate for use on light to moderately exudative or dry wounds. It protects the wound bed and newly formed granulation tissue by the formation of an outer occlusive barrier while maintaining a moist gelatinous wound contact layer. The product conforms to any wound site and is biocompatible, biodegradable, safe and nontoxic. CellerateRX occludes nerve endings to reduce pain, minimizes the potential of scarring, and is effective in all wound phases.
Indications
For management of acute and chronic wounds, including but not limited to pressure ulcers (stages 2 to 4), venous stasis ulcers, ulcers resulting from arterial insuf-ficiency, surgical wounds, diabetic ulcers, traumatic wounds, superficial wounds, and first- and second-degree burns; ideal for tunneling/undermining wounds, skin flaps, and/or grafts
Contraindications
Not for use on patients with known sensitivities to bovine collagen
Application
It is recommended that the wound be debrided of any loose necrotic tissue prior to initial application.
Apply CellerateRX gel directly onto wound. Completely cover the wound bed and the edges of the wound.
Cover the wound with an appropriate secondary dressing if desired.
Reapply every 2 to 3 days or as indicated.
Removal
Remove the secondary dressing and reapply gel as above.
It is not necessary to remove CellerateRX from the wound with subsequent dressing application, just add more.
CellerateRX Powder
Wound Care Innovations, LLC
How supplied
Powder: 1 g; A6010 5 g; A6010
Action
A medical hydrolysate of type I collagen, CellerateRX powder (approximately 95% collagen) interacts with the wound site, forming a gel when it mixes with wound exudate and providing a moist healing environment. The powder absorbs approximately 30 times its weight in exudate and is safe and nontoxic. CellerateRX protects the wound bed and newly formed granulation tissue by forming an occlusive gelatinous barrier. It conforms to any wound site and is biocompatible and biodegradable. CellerateRX occludes nerve endings to reduce pain, minimizes the potential of scarring, and is effective in all wound phases.
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