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Surgical wound management aims to protect and heal a patient’s wound quickly and without complications. In the healing process, collagen is a component of normal wound healing in which native collagen is broken into collagen fragments. Hydrolyzed collagen, for which the breakdown process is started, provides a “head start” to wound healing. However, the published literature has scattered articles addressing benefits of hydrolyzed collagen in the healing process of acute surgical wounds. To consider research on hydrolyzed collagen in acute surgical wound management, we reviewed literature from 2018 to 2023 in PubMed to find research that addresses hydrolyzed collagen in acute wound management. The literature search uncovered 15 articles that address the numerous benefits of hydrolyzed collagen in acute surgical wound management. In the management of acute surgical wounds, hydrolyzed collagen provides benefits that help with a timely inflammatory response and resolution, epithelialization, wound appearance, and tensile strength. Based on existing data, we encourage surgeons to utilize hydrolyzed collagen powder as an effective tool in acute surgical wound management and suggest that additional research, particularly large focused studies, would benefit patient care.

Background: Patients undergoing spinal surgery are at risk of surgical site complications. Type 1 hydrolyzed collagen powder has been shown to aid in wound healing. Purpose: The objective of this case series was to evaluate the effect of using type 1 hydrolyzed collagen on the incidence of surgical site complications (infection and dehiscence) following spinal surgeries. Methods: Electronic medical records were queried for patients who had previously undergone spinal surgery to correct spinal deformity or to treat spinal fracture, received type 1 hydrolyzed collagen for wound application during surgery, and who had returned for at least one follow up visit between two and six weeks after surgery. All consecutive patients meeting these criteria were included for analysis. Pre-operative, operative, and post-operative data were collected on electronic case report forms. Surgical site infection was documented as per the Centers for Disease Control and Prevention definitions. Results: Fifty-four (54) patients who met the inclusion criteria were included in the study. None of the patients that received type 1 hydrolyzed collagen powder at the time of wound closure experienced wound dehiscence or surgical site infection. Conclusion: These results provide evidence that surgical site wound healing is safely supported by application of type 1 hydrolyzed collagen powder.

Wound healing remains a concern in primary total joint arthroplasty, given the risk of deep infections arising from hematomas, wound separations, and superficial infections. If wound additives can prevent these early complications, their universal application would be cost-effective. This study examined whether 2 wound additives, platelet-rich plasma (PRP) and activated collagen, would improve postoperative wound healing and reduce complications in primary total joint arthroplasty. A prospective, randomized controlled study was conducted using 3 cohorts with 30 patients each (group 1: PRP; group 2: activated collagen; and group 3: control). These patients were examined at 2 and 6 weeks postoperatively, at which time the following data were recorded: 6 wound measurements, total postoperative blood loss, complications of superficial infections, and reoperations. The PRP and the activated collagen groups showed early improvement in 3 of the 6 wound scores at 2 weeks, but these early results were not present at 6 weeks. In addition, there was a statistically significant reduction in blood loss in both the PRP and the activated collagen groups, as compared with the control group. Furthermore, high-risk patients had a statistically significant reduction in total complication rates in both the PRP and the activated collagen groups, as compared with the control group. On the basis of this study, these additives are not recommended for routine primary joint arthroplasty; however, the data suggest possible benefits for high-risk patients and those for whom blood loss may be an issue

Objective: Hydrolyzed collagen-based matrices are widely used as wound care dressings. Information on the mechanism of action of such dressings is scanty. The objective of this study was to test the effect of a specific hydrolyzed collagen powder (HCP), which is extensively used for wound care management in the United States. Approach: The effects of HCP on resolution of wound inflammation, perfusion, closure, and breaking strength of the repaired skin were studied in an experimental murine model. Results: In early (day 7) inflammatory phase of wound macrophages, HCP treatment boosted phagocytosis and efferocytosis of wound-site macrophages. In these cells, inducible reactive oxygen species were also higher on day (d) 7. HCP treatment potentiated the expression of anti-inflammatory interleukin (IL)-10 cytokine and proangiogenic vascular endothelial growth factor (VEGF) production. Excisional wounds dressed with HCP showed complete closure on day 21, while the control wounds remained open. HCP treatment also demonstrated improved quality of wound healing as marked by the improved breaking strength of the closed wound tissue/repaired skin. Innovation: These data represent first evidence on the mechanism of action of clinically used HCP. Conclusion: HCP dressing favorably influenced both wound inflammation and vascularization. Improved breaking strength of HCP-treated repaired skin lays the rationale for future studies testing the hypothesis that HCP-treated closed wounds would show fewer recurrences.

Surgical site infections in neurosurgery patients are increasing due to the high rates of trauma cases, increase in patient comorbidities, and the prevalence of multi-resistant drug organisms. Recent reports have demonstrated that topical antibiotic powder used during wound closure significantly decreases rates of wound infections in spine cases. The authors present a prospective study of 102 consecutive cranial or spinal neurosurgery cases. A mixture of 1 gram Vancomycin powder mixed with 1 gram of hydrolyzed or activated collagen powder (CellerateRX Surgical) was then placed within the incision. This was followed by skin closure with either staples or subcuticular sutures. Patients were seen at approximately 2 weeks postoperatively for incision check and subsequent removal of sutures or staples. In conclusion, this study demonstrated that the combination of activated collagen (CellerateRX Surgical) and Vancomycin powder resulted in no infections or wound dehiscence. The hygroscopic nature of the activated collagen bound the aqueous vancomycin to the activated collagen retaining and prolonging the antimicrobial environment in the surgical site.

Objective: Surgical Site Infections (SSI) are common hospital infections resulting in morbidity, mortality, and cost. Activated Collagen (AC) has been shown to promote wound healing, preventing wound dehiscence with decrease in SSIs. We evaluated the impact of AC on SSI rates in elective surgery patients. Methods: We conducted a retrospective review of surgery patients from 1-1-2018 to 12-1-2021. Comorbidities, demographics and surgical specialties were collected. All patients had chlorhexidine wipes day prior and on day of surgery; appropriate prophylactic antibiotics; and ChloraPrep or DuraPrep. AC was applied prior to skin closure. Cases were stratified by wound class. AC group patients were compared to case matched 1:3 non-AC patients. SSI rates were compared. Results: 5,335 cases were performed, 76% (4,068) clean, 24% (1,287) Clean Contaminated (CC). Overall, the mean age was 63.8+/-0.9 years, mean BMI was 28.8+/-0.44; 87% male, 56% white, 31% with DM, 13% with CKD, and 7% with COPD. The AC and Non-AC groups were well matched with no significant differences in age, BMI, demographics, comorbidities or surgical specialty. AC was used in 28% (Total=1489; Clean=1,089; CC=400) of cases. There was a significant decrease in overall SSI rate with use of AC (AC SSI=0.63%, Non-AC SSI= 1.52%, p=.012). There was a significant decrease in SSI rate in clean cases (AC SSI=0.30%, Non-AC SSI=0.97%, p=.027) and trend towards decreased SSI rate in clean contaminated cases (AC SSI=1.54%, Non-AC SSI=3.36%, p=.064) Conclusions: AC in patients undergoing elective surgery resulted in a significant 59% reduction in SSI rate; most pronounced in clean cases (69% decrease). Activated collagen can be safely used in elective cases to promote wound healing of incisions and decrease SSI rates.

Surgical site infection (SSI) and wound dehiscence are among the most common postoperative spinal surgery complications. Treatment can be complex, costly, and may require hospital readmission. Type 1 Hydrolyzed Collagen (T1HC) powder can be used during surgery to support the healing environment of the surgical wound. This study is a retrospective review of 154 patients who underwent spinal surgery using CellerateRX ® Surgical powder. A total of three (1.9%) high-risk patients developed postoperative wound complications (SSI or dehiscence). All complications resolved with local wound care and oral antibiotics; no hospital readmissions were required. This low incidence of surgical complications further supports the use of TIHC as an effective wound therapy agent in spinal surgery.

Aims: To assess the cost-effectiveness of hydrolyzed collagen as an adjunct to standard care for reducing postoperative complications in high-risk spinal surgery patients. Methods: A decision tree model was developed from the U.S. healthcare sector perspective to compare hydrolyzed collagen with standard care alone over a one-year time horizon. The model followed a cohort of high-comorbidity patients undergoing complex spinal procedures, capturing postoperative infections, seromas, hematomas, readmissions, and revision surgeries. Clinical inputs were derived from published evidence, and costs were reported in 2025 U.S. dollars. Outcomes included direct medical costs, QALYs, and net monetary benefit (NMB) at a willingness-to-pay threshold of $100,000/QALY. Univariate, probabilistic, and threshold sensitivity analyses assessed parameter uncertainty. Results: Hydrolyzed collagen dominated no treatment, generating $3,853 in cost savings and a 0.007 QALY gain per patient over one year, yielding an NMB of $4,542. Avoided readmissions and revision procedures were the primary contributors to cost savings. Baseline complication rates, relative risk reduction, and complication persistence rates were the most influential parameters. In probabilistic analysis, hydrolyzed collagen was cost-effective in more than 99% of simulations. Limitations: The analysis applies simplifying assumptions, a one-year time horizon, and heterogeneous clinical inputs, factors that may limit the generalizability of the findings. Conclusions: Compared to standard care alone, hydrolyzed collagen demonstrated a dominant strategy associated with cost savings and improved health outcomes for high-risk spinal surgery patients. These findings support its consideration as a value-enhancing component of the spine surgery care pathway, particularly for patients with elevated complication risk.

Surgical site infections in gynecologic procedures significantly contribute to health care costs, prolonged hospital stays, and patient morbidity. Patients undergoing vulvectomy are at a higher risk of postoperative wound complications due to the location of the surgical incision and the prevalence of comorbidities, such as obesity, diabetes, and smoking. The successful use of topical collagen, specifically, hydrolyzed type 1 bovine, in other surgical specialties has led clinicians to explore its use in gynecologic surgery. This case series reports on patients receiving topical hydrolyzed collagen after a vulvectomy. Hydrolyzed collagen was applied directly to the surgical wound. Patients were monitored for postoperative complications during routine follow up visits. This case series highlights the ease of application and clinical efficacy of topical collagen powder when applied to the wound bed following a vulvectomy. Treated surgical sites exhibited reduced inflammation, minimal exudate, and no signs of dehiscence. These findings indicate that hydrolyzed collagen may serve as a valuable adjunct in enhancing postoperative wound healing in vulvectomy patients. The preliminary results underscore the need for larger, randomized clinical trials to further evaluate this novel therapeutic approach.

Limb preservation in the multi-morbid patient remains a significant challenge. The combination of orthopedic and plastic reconstructive techniques (“Orthoplastics”) is well known to result in limb preservation (“limb salvage”) even in extremely high-risk patients. Despite advances, adjunctive healing techniques remain desirable. In this case series, we examined the use of hydrolyzed collagen powder in limb salvage in multi-morbid patients undergoing limb preservation surgery. The medical records of ten high-risk patients with multiple co-morbidities undergoing limb preservation reconstruction, who would otherwise have required a major level amputation, were reviewed retrospectively. Of these patients, there was an average of nine varying risk factors, including the presence of infection, diabetes mellitus, renal impairment, vascular disease, smoking, illicit drug or alcohol abuse, or nicotine use. The case review data included patient demographics, risk factors, specific pathophysiology, Orthoplastic procedure, and the volume of adjunctive hydrolyzed collagen during the reconstructive procedures. All patients achieved limb preservation or the prevention of an anticipated higher-level amputation. On average, two hydrolyzed collagen applications were used per patient with a mean volume of 1.8 g (range 2-4 g). Notably, the presence of an actively treated infection did not appear to diminish the efficacy of hydrolyzed collagen. Additionally, no adverse reactions were identified with the use of hydrolyzed collagen. These findings suggest that use of hydrolyzed collagen is a safe, valuable adjunct in Orthoplastic limb preservation surgery for patients at extreme risk for limb loss.