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CC BY-NC 4.0 · Arch Plast Surg 2017; 44(06): 482-489
DOI: 10.5999/aps.2017.00801
Original Article

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

Seoyoung Kim
Department of Plastic and Reconstructive Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
,
Junhyung Kim
Department of Plastic and Reconstructive Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
,
Jaehoon Choi
Department of Plastic and Reconstructive Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
,
Woonhyeok Jeong
Department of Plastic and Reconstructive Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
,
Sunyoung Kwon
Department of Pathology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
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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.

Keywords

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

This article was presented at the 74th Congress of the Korean Society of Plastic and Reconstructive Surgeons on November 17—20, 2016 in Seoul, Korea.




Publication History

Received: 27 April 2017

Accepted: 10 October 2017

Article published online:
20 April 2022

© 2017. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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