Surgical debridement and type 1 collagen extracellular matrix plus polyhexamethylene biguanide for the management of pressure injuries

Objective: Purified collagen matrix containing a broad-spectrum antimicrobial, polyhexamethylene biguanide (PuraPly Antimicrobial (PCMP); Organogenesis Inc., US) has been shown to be an effective adjunct in managing wounds of different aetiologies. The aim of this study was to show the clinical outcomes of PCMP in the management of pressure injuries (PIs) and its implication on healthcare. Method: This retrospective study included patients managed with PCMP as an adjunct to standard of care procedures, following debridement of stage 3 and stage 4 PIs in the operating room between December 2021–October 2022. Indices from baseline (index surgery) and subsequent visits, including patient demographics, wound presentation and progression were collected and analysed. Results: A total of nine patients with sacral PIs were identified. Of these, six were stage 4 and three were stage 3. Smoking was prevalent in seven patients and five patients had diabetes and were obese. At baseline, the median wound area was 30cm 2 and bioburden was observed in eight wounds. Following either one or two applications of PCMP, the median wound area was reduced to 16cm 2 and the incidence of bioburden decreased to one patient. Conclusion: This case series suggested that PCMP is an effective adjunct in the management of PIs by supporting healing and managing bioburden. Wounds managed with PCMP did not require the surgeon's standard protocol of daily enzymatic wound debridement and this may decrease the workload for hospital staff.