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Protease-modulating polyacrylate-based hydrogel stimulates wound bed preparation in venous leg ulcers--a randomized controlled trial.

Humbert P, Faivre B, Véran Y, Debure C, Truchetet F, Bécherel PA, Plantin P, Kerihuel JC, Eming SA, Dissemond J, Weyandt G, Kaspar D, Smola H, Zöllner P, CLEANSITE study gro - J Eur Acad Dermatol Venereol (2014)

Bottom Line: 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 differences between the groups were significant (decrease in fibrin and necrotic tissue P = 0.004 and increase in granulation tissue P = 0.0005, respectively).These data suggest that PA-based hydrogel dressings can stimulate normalization of the wound environment, particularly in hard-to-heal ulcers.

View Article: PubMed Central - PubMed

Affiliation: Research and Studies Center on the Integument (CERT), Clinical Investigation Center (CIC BT506), Department of Dermatology, University Hospital, Besançon, France; INSERM UMR, University of Franche-Comté, Besançon, France.

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Absolute decrease in fibrin and necrotic tissue (a). Cumulative distribution of the absolute change in the amount of fibrin and necrotic tissue at day 14 after treatment with either the PA-based hydrogel or the amorphous hydrogel (b). The graph representing the wounds treated with PA-based hydrogel is clearly shifted to the left compared to the graph representing wounds treated with the amorphous hydrogel. Each point represents one wound.
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fig03: Absolute decrease in fibrin and necrotic tissue (a). Cumulative distribution of the absolute change in the amount of fibrin and necrotic tissue at day 14 after treatment with either the PA-based hydrogel or the amorphous hydrogel (b). The graph representing the wounds treated with PA-based hydrogel is clearly shifted to the left compared to the graph representing wounds treated with the amorphous hydrogel. Each point represents one wound.

Mentions: Both the PA-based and amorphous hydrogel dressings reduced the proportion of slough and necrotic tissue within 14 days. The proportion of ulcer area covered by slough and necroses decreased by 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 compared to the baseline, (P = 0.004) (Fig.3a). These changes corresponded to a relative decrease of 43.4 ± 36.7% in the PA-based hydrogel group and of 21.9 ± 39.4 percentage points in the amorphous hydrogel group (P = 0.018) (Table3). According to the cumulative distribution, PA-based hydrogel-treated wounds displayed a larger reduction in fibrin and necrotic tissue compared to wounds treated with the amorphous hydrogel at day 14 (Fig.3b). On day 14, 17 of 34 (50.0%) ulcers treated with PA-based hydrogel had < 50% of their surface covered by slough compared to 11 of 41 (26.8%) in the amorphous hydrogel group (P = 0.0389; χ2- test). In the two treatment groups, the probability of reducing the amount of fibrin and necrotic tissue to < 50% of the total wound area was 2.7 times higher for wounds treated with the PA-based hydrogel (OR = 2.72; 95% CI = 1.31–9.66) (Fig. 5).


Protease-modulating polyacrylate-based hydrogel stimulates wound bed preparation in venous leg ulcers--a randomized controlled trial.

Humbert P, Faivre B, Véran Y, Debure C, Truchetet F, Bécherel PA, Plantin P, Kerihuel JC, Eming SA, Dissemond J, Weyandt G, Kaspar D, Smola H, Zöllner P, CLEANSITE study gro - J Eur Acad Dermatol Venereol (2014)

Absolute decrease in fibrin and necrotic tissue (a). Cumulative distribution of the absolute change in the amount of fibrin and necrotic tissue at day 14 after treatment with either the PA-based hydrogel or the amorphous hydrogel (b). The graph representing the wounds treated with PA-based hydrogel is clearly shifted to the left compared to the graph representing wounds treated with the amorphous hydrogel. Each point represents one wound.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4263240&req=5

fig03: Absolute decrease in fibrin and necrotic tissue (a). Cumulative distribution of the absolute change in the amount of fibrin and necrotic tissue at day 14 after treatment with either the PA-based hydrogel or the amorphous hydrogel (b). The graph representing the wounds treated with PA-based hydrogel is clearly shifted to the left compared to the graph representing wounds treated with the amorphous hydrogel. Each point represents one wound.
Mentions: Both the PA-based and amorphous hydrogel dressings reduced the proportion of slough and necrotic tissue within 14 days. The proportion of ulcer area covered by slough and necroses decreased by 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 compared to the baseline, (P = 0.004) (Fig.3a). These changes corresponded to a relative decrease of 43.4 ± 36.7% in the PA-based hydrogel group and of 21.9 ± 39.4 percentage points in the amorphous hydrogel group (P = 0.018) (Table3). According to the cumulative distribution, PA-based hydrogel-treated wounds displayed a larger reduction in fibrin and necrotic tissue compared to wounds treated with the amorphous hydrogel at day 14 (Fig.3b). On day 14, 17 of 34 (50.0%) ulcers treated with PA-based hydrogel had < 50% of their surface covered by slough compared to 11 of 41 (26.8%) in the amorphous hydrogel group (P = 0.0389; χ2- test). In the two treatment groups, the probability of reducing the amount of fibrin and necrotic tissue to < 50% of the total wound area was 2.7 times higher for wounds treated with the PA-based hydrogel (OR = 2.72; 95% CI = 1.31–9.66) (Fig. 5).

Bottom Line: 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 differences between the groups were significant (decrease in fibrin and necrotic tissue P = 0.004 and increase in granulation tissue P = 0.0005, respectively).These data suggest that PA-based hydrogel dressings can stimulate normalization of the wound environment, particularly in hard-to-heal ulcers.

View Article: PubMed Central - PubMed

Affiliation: Research and Studies Center on the Integument (CERT), Clinical Investigation Center (CIC BT506), Department of Dermatology, University Hospital, Besançon, France; INSERM UMR, University of Franche-Comté, Besançon, France.

Show MeSH
Related in: MedlinePlus