(CS-019) Bovine-Derived Collagen Matrix as an Adjunct for Post-Amputation Diabetic Foot Wound Dehiscence: A Two-Case Review

Friday, April 10, 2026

Melina Butuci, PhD; sara shahbazi, PhD

Introduction: Post-operative wound dehiscence following partial foot amputation is a common and challenging complication in patients with diabetes and peripheral arterial disease (PAD), occurring in approximately 29% of cases according to a recent meta-analysis. These wounds often present with depth, tunneling, impaired tissue quality, and early chronicity, contributing to delayed healing and increased risk for infection and higher-level amputation. Bovine-derived collagen matrices have emerged as adjunctive therapies to support wound progression; however, evidence describing their use specifically in post-amputation dehiscence remains limited.

Methods: A retrospective review was conducted of two medically complex patients who presented with dehisced post-amputation diabetic foot wounds. Both wounds demonstrated significant depth and impaired tissue quality, and one exhibited deep tunneling. Standardized assessment was performed at presentation, followed by surgical sharp debridement and application of a single 500 mg bovine-derived collagen matrix. Mechanical offloading was maintained using a Charcot Restraint Orthotic Walker (CROW) or Controlled Ankle Motion (CAM) boot, with standard wound care continued throughout follow-up.

Results:

Both wounds demonstrated rapid improvement following a single collagen matrix. application. In Case 1 (Chopart stump dehiscence), the wound achieved approximately 83% reduction by Day 6, complete granulation and resolution of tunneling by Day 27, and full epithelial closure by Month 4. In Case 2 (right transmetatarsal stump dehiscence), ~99% reduction was observed by Day 12 and ~99.9% by Day 19, with full epithelial closure later documented at follow-up. No infections, adverse events, or recurrences were noted.

Discussion: This two-case series suggests that a single application of bovine-derived collagen matrix may serve as an effective adjunct to debridement and standard wound care in complex dehisced post-amputation diabetic foot wounds, including those with depth and tunneling. Both cases showed rapid wound progression despite significant comorbidities and chronic wound characteristics. Further prospective evaluation in larger cohorts is warranted to better define the role of collagen matrices in managing postoperative wound dehiscence.