[Objective]
During wound healing process, chronic wounds display higher level of protease expression than acute wound healing. Relevant proteases include matrix metalloproteinases (MMPs) that degrade extracellular matrix (ECM) components, which lead to impaired wound healing. Recently, collagen dressings that contain receptors for extracellular matrix (ECM) or tyrosine kinase may help cells to achieve adhesion, proliferation, migration, and survival, as well as provide nutrition and are protease modulating agents leading to improved healing outcomes. Therefore, wound management with collagen dressing may facilitate chemotaxis to accelerate the undermining wound healing process.
The purpose of this study was to present undermining wounds closure outcomes under the treatment of collagen dressing.

[Material and Methods]
This retrospectively study conducted at Kaohsiung Medical University Hospital included 7 undermining wounds in 7 patients who were treated with Life Fusion Collagen Wound Dressing (Life Fusion Inc., Taiwan) from September 2019 to July 2021. Prior to applying the collagen dressing, adequate debridement with essential antibiotic treatment, wound culture and antibiofilm dressing were indicated. Using aseptic technique, a dry sheet of collagen dressing was trimmed to just into the wound opening and placed beneath the wound tunnel. Covered secondary dressing on collagen dressing. The healing time and related clinical variables were analyzed.

[Results]
The collagen dressing treated 7 patients with 7 undermining wounds successfully. There were no adverse event. The mean healing time was 14.2 days and the mean treatment course was 20.8 days. Compared to frequent surgical debridement and traditional wound dressing, collagen dressings reduced the frequency of dressing change, perceived smooth healing, and reduced dressing application frequency.

[Conclusions]
Collagen dressing restore balance at the microenvironment level through inactivation of excess MMPs, and protect the biologic activity of endogenous growth factors to promote wound healing. In this study, we treated difficult undermining wound with collagen dressing successfully without repeated surgical debridements.

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