Archives of Plastic Surgery

  • 제44권6호
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  • Pages.482-489
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  • 2017
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Polydeoxyribonucleotide Improves Peripheral Tissue Oxygenation and Accelerates Angiogenesis in Diabetic Foot Ulcers

  • Kim, Seoyoung (Department of Plastic and Reconstructive Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Kim, Junhyung (Department of Plastic and Reconstructive Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Choi, Jaehoon (Department of Plastic and Reconstructive Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Jeong, Woonhyeok (Department of Plastic and Reconstructive Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Kwon, Sunyoung (Department of Pathology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine)
  • 투고 : 2017.04.27
  • 심사 : 2017.10.10
  • 발행 : 2017.11.18
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초록

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 ($TcPO_2$) was evaluated using the Periflux System 5000 with $TcPO_2/CO_2$ 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.

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참고문헌

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