Decellularized pericardium is a type of tissue in which cellular components are removed, leaving only the extracellular matrix [1]. Decellularization uses chemical or mechanical methods. This tissue is commonly referred to as the collagen membrane by physicians and dentists and is utilized as a scaffold in regenerative medicine, such as repair or replacement of damaged heart tissue [2]. Collagen membranes are used in the correction of inguinal hernias, repair of abdominal wall ventral hernias, bladder repair, diaphragm reconstruction, dura mater substitutes, correction of cerebrospinal fluid fistulas, and in dentistry to assist in covering bone grafts to guide osteogenesis [[3], [4], [5]]. The extracellular matrix acts as a template for cell migration and differentiation [6]. These membranes are considered a promising option for tissue engineering and regenerative medicine. However, as with any new technology, there are potential complications that must be considered, including rejection, abnormal tissue remodeling, and infection [7].

The use of antibiotics in decellularized tissues reduces the risk of infection and promotes healing after implantation [8]. Decellularization removes all cells and DNA, leaving behind extracellular matrix scaffold that can be impregnated with antibiotics [9]. Antibiotics can be incorporated into tissues before, during, or after decellularization [10]. There are several advantages to using antibiotic-impregnated decellularized tissues. Antibiotics can prevent bacterial growth and reduce the risk of infection after implantation. They also assist in reducing inflammation and promoting tissue repair, thereby improving healing outcomes [11]. Some antibiotics, such as gentamicin, can remain active in tissues for an extended period, providing prolonged protection against infection. Various antibiotics can be used depending on the specific needs of the patient, and their concentrations can be tailored to achieve the desired effect [12].

Silver nanoparticles (AgNPs) have been studied for their antimicrobial properties and potential for use in decellularized tissues. AgNPs have a high surface-area-to-volume ratio, which makes them highly effective in killing bacteria, viruses, and other microorganisms [13]. The antimicrobial activity of AgNPs is broad-spectrum, providing activity against both gram-negative and gram-positive bacteria, including multidrug-resistant strains [14]. These characteristics make AgNPs versatile for various applications, in addition to the extensive knowledge of Ag interactions within the human body. However, AgNPs exhibit variable levels of cytotoxicity according with concentration and nanoparticle size, necessitating preclinical studies conducted with significant care [15].

In contrast, traditional antibiotics such as vancomycin (VAN) are safe when used at appropriate concentrations, and there is extensive knowledge regarding their clinical and microbiological effects [9,12]. One disadvantage of VAN is its limited spectrum of action, as it primarily targets gram-positive bacteria, such as Staphylococci, Streptococci, and Enterococci [16]. These microorganisms are often associated with surgical infections and are frequently found in oral cavity infections, despite their polymicrobial nature [17,18].

Therefore, the development of a collagen membrane based on decellularized bovine pericardium impregnated with antimicrobial molecules may be of clinical significance. In the present study, we developed a material with these characteristics by impregnation with VAN or AgNPs. We assessed in vitro and in vivo microbiological properties, mechanical characteristics, and cytotoxicity and conducted a pilot study in humans using the collagen membrane to cover bone grafts and guide osteogenesis.