Protease‐modulating polyacrylate‐based hydrogel stimulates wound bed preparation in venous leg ulcers – a randomized controlled trial. (26th February 2014)

• Record Type: Journal Article
• Authors: Humbert, P.; Faivre, B.; Véran, Y.; Debure, C.; Truchetet, F.; Bécherel, P.‐A.; Plantin, P.; Kerihuel, J.‐C.; Eming, S.A.; Dissemond, J.; Weyandt, G.; Kaspar, D.; Smola, H.; Zöllner, P.; the CLEANSITE study group
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 28:Number 12(2014:Dec.)
• Page Start: 1742
• Page End: 1750
• Publication Date: 2014-02-26
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.12400
• Languages: English
• ISSNs: 0926-9959

Abstract

<abstract abstract-type="main" id="jdv12400-abs-00001"> <title>Abstract</title> <sec id="jdv12400-sec-0001" sec-type="section"> <title>Background</title> <p>Stringent control of proteolytic activity represents a major therapeutic approach for wound‐bed preparation.</p> </sec> <sec id="jdv12400-sec-0002" sec-type="section"> <title>Objectives</title> <p>We tested whether a protease‐modulating polyacrylate‐ (PA‐) containing hydrogel resulted in a more efficient wound‐bed preparation of venous leg ulcers when compared to an amorphous hydrogel without known protease‐modulating properties.</p> </sec> <sec id="jdv12400-sec-0003" sec-type="section"> <title>Methods</title> <p>Patients were randomized to the polyacrylate‐based hydrogel (<italic>n</italic> = 34) or to an amorphous hydrogel (<italic>n</italic> = 41). Wound beds were evaluated by three blinded experts using photographs taken on days 0, 7 and 14.</p> </sec> <sec id="jdv12400-sec-0004" sec-type="section"> <title>Results</title> <p>After 14 days of treatment there was an absolute decrease in fibrin and necrotic tissue of 37.6 ± 29.9 percentage points in the PA‐based hydrogel group and by 16.8 ± 23.0 percentage points in the amorphous hydrogel group. The absolute increase in the proportion of ulcer area covered by granulation tissue was 36.0 ± 27.4 percentage points in the PA‐based hydrogel group and 14.5 ± 22.0 percentage points in the control group. The differences between the groups were significant (decrease in fibrin and necrotic tissue <italic>P</italic> = 0.004 and increase in granulation tissue <italic>P</italic> = 0.0005, respectively).</p> </sec> <sec id="jdv12400-sec-0005" sec-type="section"> <title>Conclusion</title> <p>In particular, long‐standing wounds profited from the treatment with the PA‐based hydrogel. These data suggest that PA‐based hydrogel dressings can stimulate normalization of the wound environment, particularly in hard‐to‐heal ulcers.</p> </sec> </abstract>