Arch Plast Surg.  2017 Nov;44(6):482-489. 10.5999/aps.2017.00801.

Polydeoxyribonucleotide Improves Peripheral Tissue Oxygenation and Accelerates Angiogenesis in Diabetic Foot Ulcers

• Kim S
• Kim J
• Choi J
• Jeong W
• Kwon S

• KMID: 2403948
• DOI: http://doi.org/10.5999/aps.2017.00801

Abstract

BACKGROUND
Polydeoxyribonucleotide (PDRN) is known to have anti-inflammatory and angiogenic effects and to accelerate wound healing. The aim of this study was to investigate whether PDRN could improve peripheral tissue oxygenation and angiogenesis in diabetic foot ulcers.
METHODS
This was a prospective randomized controlled clinical trial. Twenty patients with a non-healing diabetic foot ulcer were randomly distributed into a control group (n=10) and a PDRN group (n=10). Initial surgical debridement and secondary surgical procedures such as a split-thickness skin graft, primary closure, or local flap were performed. Between the initial surgical debridement and secondary surgical procedures, 0.9% normal saline (3 mL) or PDRN was injected for 2 weeks by the intramuscular (1 ampule, 3 mL, 5.625 mg, 5 days per week) and perilesional routes (1 ampule, 3 mL, 5.625 mg, 2 days per week). Transcutaneous oxygen tension (TcPO2) was evaluated using the Periflux System 5000 with TcPO2/CO2 unit 5040 before the injections and on days 1, 3, 7, 14, and 28 after the start of the injections. A pathologic review (hematoxylin and eosin stain) of the debrided specimens was conducted by a pathologist, and vessel density (average number of vessels per visual field) was calculated.
RESULTS
Compared with the control group, the PDRN-treated group showed improvements in peripheral tissue oxygenation on day 7 (P < 0.01), day 14 (P < 0.001), and day 28 (P < 0.001). The pathologic review of the specimens from the PDRN group showed increased angiogenesis and improved inflammation compared with the control group. No statistically significant difference was found between the control group and the PDRN group in terms of vessel density (P=0.094). Complete healing was achieved in every patient.
CONCLUSIONS
In this study, PDRN improved peripheral tissue oxygenation. Moreover, PDRN is thought to be effective in improving inflammation and angiogenesis in diabetic foot ulcers.

Keyword

Polydeoxyribonucleotides; Foot ulcer; Blood Gas Monitoring, transcutaneous; Angiogenesis modulating agents

MeSH Terms

Angiogenesis Modulating Agents
Blood Gas Monitoring, Transcutaneous
Debridement
Diabetic Foot*
Eosine Yellowish-(YS)
Foot Ulcer
Humans
Inflammation
Oxygen*
Polydeoxyribonucleotides
Prospective Studies
Skin
Transplants
Ulcer*
Wound Healing
Angiogenesis Modulating Agents
Eosine Yellowish-(YS)
Oxygen
Polydeoxyribonucleotides