Dynamics of Regenerative Processes in Patients with Trophic Ulcers against the Background of Chronic Venous Hemodynamic Disturbances Using Therapy with Polydesoxyrinobonucleotides

Yelena Yu. Shapovalova, Yuriy G. Baranovskiy, Fedor N. Ilchenko, Tatyana A. Boyko, Pavel V. Vaschenko

 
International Journal of Biomedicine. 2019;9(2):139-143.
DOI: 10.21103/Article9(2)_OA12
Originally published June 15, 2019  

Abstract: 

The aim of this study was to analyze the healing of trophic ulcers (TUs) of the skin against the background of chronic venous insufficiency (CVI) after applying PDRN-therapy in a complex of therapeutic measures.
Materials and Methods: The study included 19 patients with TUs of various sizes and shapes (from 4 to 12 cm2) in the lower extremities with average duration from 4 weeks to 12 months, against the background of CVI. Patients were divided into two groups. Group 1 included 9 patients who received complex treatment along with using desoxyribonucleotide polymers (PDRN-therapy) according to the proposed methodology. Group 2 included 10 patients treated according to standard treatment of TUs. The area of wound defects was determined using the LesionMeter program. Skin thermometry was carried out using a B.Well WF-5000 medical infrared non-contact thermometer.
Results: We found that in patients of Group 1, who received PDRN-therapy in addition to standard treatment, by Day 20 there was a reduction in the TU area to 51.06±0.1% of the initial size; in patients of Group 2, who received only standard treatment, the TU area was 85.56±0.1% of the initial size. The temperature in the center of the ulcer and in its periphery increased in patients of Group 1 compared to patients of Group 2 by 2.79% and 2.74%, respectively, indicating a better blood supply to the skin defect, possibly due to more active angiogenesis
Conclusion: The use of PDRN-therapy in the complex treatment of TUs on the background of CVI is clinically effective. The applied method contributed to accelerating the repair processes of the skin defect and improving vascularization, which reduced the healing time of trophic ulcers.

Keywords: 
trophic ulcer • polydesoxyribonucleotides • planimetry • thermometry
References: 
  1. Tolstoy PI, Tamrazova OB, Pavlenko VV, Kuleshov IYu, Tolstoy MP. Prolonged non-healing wounds and ulcers (pathogenesis, clinic, treatment). M.: Deepak; 2009. [In Russian].
  2. Obolensky VN, Rodoman GV, Nikitin VG, Karev MA. Trophic ulcers of the lower extremities - a review of the problem. Russian Medical Journal. 2009;(25):1647–63. [Article in Russian].
  3. Brem H, Tomic-Canic M, Tarnovskaya A, Ehrlich HP, Baskin-Bey E, Gill K, et al. Healing of elderly patients with diabetic foot ulcers, venous stasis ulcers, and pressure ulcers. Surg Technol Int. 2003;11:161-7.
  4. Budgen V. Evaluating the impact on patients of living with a leg ulcer. Nurs Times. 2004;100(7):30-1.
  5. Saltmarche AE. Low level laser therapy for healing acute and chronic wounds- the extendicare experience. Int Wound J. 2008;5(2):351-60. doi: 10.1111/j.1742-481X.2008.00491.x.
  6. Menke NB, Ward KR, Witten TM, Bonchev DG, Diegelmann RF. Impaired wound healing. Clin Dermatol. 2007;25(1):19-25.
  7. Mikhailov AYu, Pronichev VV, Solov'ev AA, Styazhkina SN, Chernenkova LM, Ledneva AL. The effectiveness of stimulating auto-factors for the regeneration of local inflammatory and ulcerative processes. Perm Medical Journal. 2014;33(5): 58-64. [Article in Russian].
  8. Fraccalvieri M, Salomone M, Di Santo C, Ruka E, Morozzo U, Bruschi S. Quantum molecular resonance technology in hard-to-heal extremity wounds: histological and clinical results. Int Wound J. 2017;14(6):1313-1322. doi: 10.1111/iwj.12805.
  9. Pang C, Ibrahim A, Bulstrode NW, Ferretti P. An overview of the therapeutic potential of regenerative medicine in cutaneous wound healing. Int Wound J. 2017;14(3):450-459. doi: 10.1111/iwj.12735
  10. Shin J, Park G, Lee J, Bae H. The effect of polydeoxyribonucleotide on chronic non-healing wound of an amputee: a case report. Ann Rehabil Med. 2018;42(4):630-633. doi.org/10.5535/arm.2018.42.4.630.
  11. Lee JH, Han JW, Byun JH, Lee WM, Kim MH, Wu WH. Comparison of wound healing effects between Oncorhynchus keta-derived polydeoxyribonucleotide (PDRN) and Oncorhynchus mykiss-derived PDRN. Arch Craniofac Surg. 2018;19(1):20-34. doi: 10.7181/acfs.2018.19.1.20.
  12. Kim JY, Pak CS, Park JH, Jeong JH, Heo CY. Effects of polydeoxyribonucleotide in the treatment of pressure ulcers. J Korean Med Sci. 2014;29 Suppl 3:S222-7. doi: 10.3346/jkms.2014.29.S3.S222.
  13. Noh TK, Chung BY, Kim SY, Lee MH, Kim MJ, Youn CS, Lee MW, et al. Novel anti-melanogenesis properties of polydeoxyribonucleotide, a popular wound healing booster. Int J Mol Sci. 2016;17(9):E1448. doi: 10.3390/ijms17091448.
  14. Hwang KH, Kim JH, Park EY, Cha SK. An effective range of polydeoxyribonucleotides is critical for wound healing quality. Mol Med Rep. 2018;18(6):5166-72. doi: 10.3892/mmr.2018.9539.
  15. Danilov RK. Wound process: Histogenetic basis. SPb.:VMedA; 2008. [In Russian].
  16. Fedorov DN, Ivashkin AN, Shinin VV, Vasil'ev AV, Ivanov AA. [Morphological and immunohistochemical characteristics of repar processes in nonhealing wounds]. Arh Patol. 2002;64(1): 8-11. [Article in Russian].
  17. Bitto A, Polito F, Altavilla D, Minutoli L, Migliorato A, Squadrito F. Polydeoxyribonucleotide (PDRN) restores blood flow in an experimental model of peripheral artery occlusive disease. J Vasc Surg. 2008;48(5):1292-300. doi: 10.1016/j.jvs.2008.06.041.
  18. Bitto A, Oteri G, Pisano M, Polito F, Irrera N, Minutoli L, Squadrito F, Altavilla D. Adenosine receptor stimulation by polynucleotides (PDRN) reduces inflammation in experimental periodontitis. J Clin Periodontol. 2013;40(1):26–32. doi: 10.1111/jcpe.12010. 
  19. Shapovalova YeYu, Boyko TA, Baranovskiy YuG, Harchenko SV, Yunsi GA. Influence of polynucleotides on the content of macrophages in regenerating ischemic wound. Modern Problems of Science and Education. 2017;6:URL: http://www.science-education.ru/ru/article/view?id=27352 [Article in Russian].
  20. Shapovalova YeYu, Boyko TA, Baranovskiy YuG, Kolomoyetz TA, Vasilenko SA. The morphological peculiarities of the skin tissue are under the skin of the polydeoxyribonucleotide. Crimea Journal of Experimental and Clinical Medicine. 2017; 7 (4): 85-90. [Article in Russian].
  21. Mufti A, Somayaji R, Coutts P, Sibbald RG. Infrared Skin Thermometry: Validating and Comparing Techniques to Detect Periwound Skin Infection. Adv Skin Wound Care. 2018;31(1):607-611. doi: 10.1097/01.ASW.0000527352.75716.70.
  22. Sibbald RG, Mufti A, Armstrong DG. Infrared skin thermometry: an underutilized cost-effective tool for routine wound care practice and patient high-risk diabetic foot self-monitoring. Adv Skin Wound Care. 2015;28(1):37-44; quiz 45-6. doi: 10.1097/01.ASW.0000458991.58947.6b.
  23. Langemo DK, Spahn JG. A Reliability Study Using a Long-Wave Infrared Thermography Device to Identify Relative Tissue Temperature Variations of the Body Surface and Underlying Tissue. Adv Skin Wound Care. 2017;30(3):109-119. doi: 10.1097/01.ASW.0000511535.31486.bb.

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Received May 11, 2019.
Accepted June 13, 2019.
©2019 International Medical Research and Development Corporation.