Application of collagen powder seems to be as effective as primary closure with non-resorbable sutures for the management of wounds created by skin biopsy. These findings come from a pilot study published in the Journal of Drugs in Dermatology (July 2019; 18(7):667–673). The authors note that collagen plays a pivotal role as a signalling molecule in the regulation of all phases of wound healing. They write that externally applied collagen powder has significant potential for wound healing and care due to its ability to stop bleeding, to recruit immune and skin cells central to wound healing, as well as stimulate new blood vessel formation, and can be left in wounds without causing irritation or facilitating bacterial growth. However, its efficacy has not been compared to sutured wound closure. “During normal wound healing, collagen acts as a scaffold for cellular entry and growth in the wound bed and encourages the deposition of new collagen,” said senior author Dr.Adam Friedman, in a press release. “While collagen has been used as a wound healing adjuvant, a good comparison to the standard of wound care has been lacking.” Dr. Friedman is the interim chair of the department of dermatology at the George Washington School of Medicine and Health Sciences in Washington, D.C. In the pilot study, eight volunteers received two punch biopsies each. For each participant, one wound was treated daily with topical collagen powder and the other with primary closure. After four weeks the wounds were biopsied for analysis and the subjects were asked to rate the itch, pain, and treatment preferences throughout the process. Six out of eight collagen-treated wounds were completely healed four weeks after the initial wounding, and all the wounds were completely healed eight weeks after the second biopsy. Patients reported similar pain and itch for both primary closure and collagen, with most attributing the itch to the adhesive dressings rather than the wound itself.
The team concluded that based on these findings, wounds treated with collagen powder healed at least as well as those treated with primary closure and that the powder can be applied safely for at least four weeks. “Given the cost and time to place and remove sutures and the potential reimbursement for collagen, using topical collagen powder for punch biopsy wounds may be easier on the patient, not requiring an additional visit for suture removal and yielding an equivalent or possibly better wound healing outcome,” Dr. Friedman said. “Moving forward we need to further examine the parameters of collagen use on wounds, including duration of therapy and wound sizes.”