Abstract

PIP: This study summarizes present knowledge on the use of the collagen sponge (CS) in gynecology. All the properties of collagen are preserved when it is reconstructed into the 3-dimensional matrix of the sponge; fluid binding capacity is much higher than with polyurethane or cellulose sponges, and there is no cytotoxicity when it comes into contact with an epithelial surface; moreover, collagen appears to be a natural substrate for cell attachment, and it is biodegradable. Contraceptive CSs with a diameter of 6-8 cm, a string for removal, and an applicator for insertion have been tested. Contraceptive CSs have a pH 4.5 adjusted with 0.2 M citrate buffer; they produce an extrememly good mechanical barrier in the upper third of the vagina and can be left in place up to 48 hours following coitus without malodor formation. From a total of 41 postcoital tests performed with CS alone in 28 women, 22% showed the presence of 1 or more motile spermatozoa. In 33 postcoital tests performed with the combination of CS and spermicidal cream, there were only 6% positive tests. The use of spermicidal cream alone showed a 14% failure rate. These results certainly favor the combination of a mechanical and a chemical barrier. Zinc medicated CSs (ZnCSs) were tested in 10 patients with primary genital herpes; the patients were treated for 2-3 weeks and were observed for recurrent disease for a total of 6 months. All patients were treated with a ZnCS in the shape of a 2.5 by 10 cm cyclinder containing 40 mg ZnSO4; 30% of patients had a recurrence of the disease within 6 months. It is very possible that a hygienic tampon made of CS may overcome the drawbacks of commercially available hygienic tampons; weight is much lower, while water uptake and water binding capacity are much greater.