Chronic wounds remain a persistent challenge in clinical practice, often necessitating advanced therapeutic interventions to facilitate healing and mitigate infection risks. QuoroGel, a topical formulation incorporating Natural Bovine Collagen, Nano-Silver, EDTA and Vitamin C, represents an innovative approach to wound care. 

Bovine collagen provides a structural matrix that promotes cellular proliferation and collagen deposition, supporting tissue regeneration. Nano-silver, meanwhile, offers broad-spectrum antimicrobial properties, effectively controlling bacterial colonisation, while Vitamin C plays a pivotal role in collagen synthesis and tissue repair.

This case report examines the clinical application of QuoroGel in the management of chronic wounds, assessing its efficacy in accelerating wound closure, reducing infection rates and optimising patient outcomes.

The findings presented aim to underscore the therapeutic value of collagen-based, antimicrobial gels in enhancing chronic wound care.

Methodology 

Participants were selected via convenient sampling that fulfilled the criteria for the suggested protocol for the usage of the product, from patients that attended as outpatients at the Hospital Kuala Lumpur Wound Clinic from May 2024 to August 2024, including five patients who underlying diabetes, hypertension and chronic wounds.

This case series involved patients with one diabetic foot ulcer case, one surgical wound carbuncle case, one venous ulcer case, and two plantar ulcer cases for a period of 3 months period. Patients who came to the unit during weekdays, from 8am until 1pm.

At the time of recruitment, every wounds was evaluated using TIMES framework (Tissue, Infection or Inflammation, Moisture balance, Edges of the wound, Surrounding skin; Nair, 2017)

Each wound was washed with distilled water and debrided if necessary. In accordance with the wound evaluation, QuoroGel was utilised in the dressing. Subsequently the peri wound area was protected with a generous amount of barrier cream during each visit to the wound clinic. All patients with plantar wounds were also treated with offloading shoes.

Discussion

The majority of healthy wounds should heal in a 4-week period, depending on the size and underlying medical conditions of the patient; however, if appropriate care is not provided, chronic wounds that are difficult to heal may take longer to heal or remain stagnant. Hard-to-heal wounds are challenging for medical experts to treat because of their intricate nature, which includes factors like moisture regulation, the presence of tunneling or undermining, and/or the predominance of infection, particularly biofilm. Healthcare providers assess and treat chronic wounds using wound bed preparation and the TIME tool. It provides the medical practitioner treating the patient with a systematic approach to managing chronic wounds, including the use of suitable therapies and the tracking and proper management of responses. Systemic issues need to be addressed before the wound bed is ready in order to increase a patient’s ability to recover.

In this study, each of the five cases showed was assessed using the T.I.M.E concept for wound bed preparation as shown in the . Wound was cleaned with superoxide solution (SOS), thin layer of QuroGel dressing applied over the wound bed and barrier cream was applied to wound periphery for protect the surrounding skin against from irritation and maceration of peri wound skin, secondary dressing was done with low adherent absorbent applied over the wound bed and secured with crepe bandage. Patients were also advised for proper offloading for example diabetic foot wear for patient which having diabetic foot ulcer or pressure ulcer. These methods were repeated twice a week with 3-5 days interval based on exudate. Marked improvement of the exudate, epithelialisation and granulation tissue could be seen as early as 2-4 weeks of treatment shown in picture above. The dressings were continued to maintain an optimum environment for wound healing to ensure skin integrity is restored.

Quorogel contains Bovine collagen, nano-silver, Vitamin C and EDTA, which all play important roles in wound healing. 

Bovine collagen plays a crucial role in wound healing due to its structural role in the extracellular matrix (ECM), by promoting cellular proliferation and tissue formation. Recent studies have demonstrated its effectiveness in accelerating healing times, reducing scarring, and improving tissue repair outcomes. Its high biocompatibility makes it a favoured choice for enhancing wound healing. 

Vitamin C is essential for collagen synthesis and wound healing, as it stabilises collagen structure and protects cells from oxidative stress. Studies show it improves healing outcomes, especially in pressure ulcers. However, larger studies are needed to establish its role in tissue regeneration. Adequate vitamin C levels support faster healing and reduce infection risk. 

Nano-silver’s antimicrobial efficacy in wound care is well-documented, inhibiting bacterial growth and preventing biofilm formation. Its small size allows deep penetration into wound tissues, providing sustained antimicrobial activity without cytotoxic effects. Recent studies highlight its broad-spectrum efficacy against antibiotic-resistant strains. Additionally, nano-silver’s anti-inflammatory properties help modulate the immune response, reducing excessive inflammation and promoting tissue regeneration, creating an optimal environment for faster and more effective wound healing.

EDTA in QuoroGel plays a crucial role in wound healing by acting as a chelating agent that binds to metal ions, such as calcium, magnesium, and iron, which bacteria need to thrive. 

By sequestering these ions, EDTA disrupts bacterial biofilms, structures that protect bacteria from antibiotics and the immune system, making infections harder to treat. In QuoroGel, EDTA enhances the effectiveness of antimicrobial agents by weakening biofilms and promoting antibiotic penetration. This helps reduce bacterial load, prevent infections and autolytic debridement and create an optimal environment for wound healing, particularly in chronic or non-healing wounds where biofilm formation is a significant barrier.

The use of Quorogel demonstrated a multifaceted approach to wound care, addressing several key factors that promote healing: inflammation control, bacterial management and tissue regeneration. The natural bovine collagen scaffold helped to accelerate tissue regeneration, while the nano-silver prevented infection — a critical factor in diabetic wound management. Vitamin C played a supportive role in enhancing collagen production and protecting cells from oxidative damage.

Limitation

• Patient may have sensitivities or allergic reactions to bovine collagen, although such reaction are relatively rare
• Prolonged or excessive use of silver-based products may lead to silver toxicity, though the nano-silver used in QuoroGel is designed to be effective at low concentrations, reducing this risk
• Advance wound care products such as QuoroGel may be more expensive than traditional wound dressings, which could impact accessibility particularly in low-resource settings
• This study lacks a control or active comparison, patient and physician blinding, and standardised procedures. In addition, this report is based solely on a small sample size of five case series. Therefore, it is suggested to conduct a randomised clinical trial to investigate the wound-healing rate with increased sample size.

Conclusion

The combination of natural bovine collagen, vitamin C, nano-silver, EDTA represents a comprehensive approach to optimising chronic wound healing. Each element plays a distinct role, yet their integration offers synergistic effects, enhancing the overall healing process. Bovine collagen provides the structural foundation for tissue regeneration, while vitamin C ensures effective collagen synthesis. 

Nano-silver’s antimicrobial properties prevent infection. EDTA enhance autolytic debridement facilitates clean wound beds, essential for healing and not only maintain an optimal environment but also enhance the bioavailability of these therapeutic agents.

Future research should focus on the clinical application of these combined treatments, particularly in randomised controlled trials, to establish standardised protocols and further validate the therapeutic potential of these agents in various wound care settings. The development of innovative wound care products that integrate these components will likely lead to improved outcomes for patients suffering from chronic wounds, significantly reducing healing times and improving quality of life.