What Is a Collagen Dressing? Benefits, Uses, and Best Practices

Editor’s note: This blog has been updated and reviewed by Tara Call Triplett, RN, WCC, CHFN.

For wound care clinicians, staying informed about advanced wound dressings is crucial to providing optimal patient care. Among the many options available, collagen dressings play a significant role in wound healing, especially for wounds that have stalled in the repair process.

Collagen is a component of connective tissue and makes up a substantial portion of the dermis, ligaments, tendons, and cartilage. When applied to wounds, collagen wound dressings encourage tissue growth, support the extracellular matrix, and enhance the body’s natural healing process.

Let’s explore how collagen dressings work, their indications, advantages, disadvantages, and best practices for their use in clinical settings.

Understanding a collagen dressing

Collagen dressings are biological dressings derived from natural collagen sources. They help promote wound healing by:

• Stimulating new tissue growth
• Serving as a scaffold for the migration of fibroblasts and keratinocytes
• Reducing protease activity in wounds with excessive levels of matrix metalloproteinases (MMPs)
• Maintaining a moist wound environment, which is essential for granulation tissue formation

Designed to be biocompatible and non-toxic, collagen wound dressings offer a supportive environment for wound healing without provoking an immune response.

Collagen dressings are most commonly derived from:

• Bovine (cow)
• Porcine (pig)
• Avian (bird)

Though less common, they can also be derived from:

• Ovine (sheep)
• Equine (horse)
• Piscine (fish)

These sources undergo a purification process to minimize allergic reactions and immunogenicity.

Forms of collagen wound dressings

Collagen wound dressings are available in various forms to suit different wound needs. You can find dressings in these forms:

• Sheets: Thin, flexible sheets applied directly to the wound bed
• Gels: Provide hydration and are ideal for dry wounds
• Pads: Thicker versions of sheets for larger wound coverage
• Particles: Granular collagen applied to irregular wound surfaces
• Pastes: Thick, spreadable forms for deep or tunneling wounds
• Powders: Fine collagen particles that integrate with exudate
• Solutions: Liquid collagen formulations for easy application

Dressing indications

A collagen dressing is recommended for wounds that need additional structural support and biochemical stimulation. They’re commonly used for:

• Chronic wounds (e.g., pressure injuries, diabetic foot ulcers, venous leg ulcers)
• Partial- and full-thickness wounds
• Surgical wounds, donor sites, and skin grafts
• Wounds with moderate to heavy exudate
• Infected wounds (when used alongside antimicrobial management)

One key benefit of these dressings is their ability to help kickstart stalled wounds, particularly those that remain in the inflammatory phase due to elevated MMP levels.

Contraindications

Collagen wound dressings shouldn’t be used in these instances:

1. Wounds with necrotic tissue or eschar (These wounds require debridement first.)
2. Third-degree burns
3. Patients with allergies to bovine, porcine, ovine, or avian products

Always assess patient allergies and wound bed conditions before selecting a collagen dressing.

Benefits of a collagen dressing

Collagen dressings offer several advantages that make them a preferred choice for chronic and complex wounds.

These dressings:

• Absorb wound exudate to maintain a moist healing environment.
• Stimulate fibroblast proliferation for granulation tissue formation.
• Help regulate protease activity to support healthy tissue repair.
• Remain non-adherent, meaning they don’t stick to fragile tissue.
• Conform to wound surfaces and are flexible and malleable.
• Work with topical agents like antimicrobials.
• Remain in place for up to seven days, reducing dressing changes.

For wounds that are slow to heal, collagen dressings provide the structural and biochemical support needed for progression toward closure.

Potential drawbacks

While collagen dressings are beneficial, they do have some limitations, such as:

• These often require secondary dressings (such as foam or film) to hold them in place.
• There is a higher cost compared to standard dressings.
• Application can be difficult for some forms (e.g., powders or pastes). However, using the best form of collagen for the characteristics of the specific wound will make application easier.

Despite these drawbacks, clinical benefits often outweigh the challenges, especially for wounds that have stalled in the healing process.

Best practices

To maximize the effectiveness of a collagen dressing, keep these key points in mind:

• Pre-moisten dry wounds with normal saline before applying collagen dressings.
• Follow the manufacturer’s instructions for application and removal.
• Ensure proper storage to maintain the product’s integrity.
• Check expiration dates to prevent using degraded collagen.
• Use a secondary dressing to keep collagen in place and manage exudate.
• Monitor the wound’s progress regularly to assess whether collagen is promoting the expected healing response.

Collagen wound dressings are a powerful tool in wound management, especially for chronic wounds, stalled healing, and complex wound types. Their ability to stimulate new tissue growth, regulate proteases, and support the extracellular matrix makes them an excellent option for clinicians aiming to optimize healing outcomes.

By understanding the indications, benefits, and best practices for collagen dressings, wound care providers can offer evidence-based, patient-centered care for better healing results.