2016, Number 1
<< Back Next >>
Med Int Mex 2016; 32 (1)
Results of the treatment of chronic venous ulcers with a polymer polysaccharide with zinc oxide
Cueto-García J, Moreno-Eutimio MA, Ibáñez-González VT, Rodríguez-Ayala E, Moreno-Rodríguez J
Language: Spanish
References: 30
Page: 48-57
PDF size: 826.90 Kb.
ABSTRACT
Background: Chronic varicose vein ulcers continue to represent a
challenge to the health systems worldwide mainly due to the fact that
they are very difficult to treat and that at the present time there is no
product or method really effective that improves healing, avoids complications
and improves the quality of life patients.
Objective: To evaluate the clinical and molecular results of the application
of a polymer polysaccharide with zinc oxide in the treatment
of chronic ulcers.
Material and Method: A clinical, open, experimental, longitudinal,
prospective, random study was done making a comparative evaluation
in two arms, in patients with chronic varicose vein ulcers, phase
III, during seven months. One group received polymer polysaccharide
with zinc oxide and control group was given conventional treatment
(external venous compression and simple bandage).
Results: Healing process of chronic varicose vein ulcers in the two
groups showed important differences: in group treated with polymer
polysaccharide with zinc oxide, chronic varicose vein ulcers showed
a significantly higher reduction of the area of the ulcer than that observed
in control group. In control group five unsatisfied patients with
the treatment abandoned the study during weeks 5 to 8, which was
not observed in group treated with polymer polysaccharide with zinc
oxide. These clinical findings showed a parallel course to the serum
levels of cytokines IL-8 and IL-6, lower of CD 45+ cells and increased
CD 31+ cells in group treated with polymer polysaccharide with zinc
oxide compared to control group.
Conclusions: Polymer polysaccharide with zinc oxide showed having
a very favorable effect on healing of chronic varicose vein ulcers,
accompanied by an evident improvement of life quality. It also produces
changes on serum levels of cytokines IL-8 and IL-6, lower of CD 45+
cells and increased CD 31 + cells.
REFERENCES
Samuel N, Carradice D, Wallace T, Smith GE, Chetter IC. Endovenous thermal ablation for healing venous ulcers and preventing recurrence. Cochrane Database Syst Rev. 2013 Oct 4; 10:CD009494. Disponible en:10.1002/14618 58. CD009494.pub2.
Wittens AH, Davies N, Bækgaard, et al. Editor’s Choice - Management of chronic venous disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2015;49:678-737.
World Medical Association, Declaration of Helsinki: Principios Éticos en la Investigación Utilizando Seres Humanos. JAMA 2013;310:2191-2194. Disponible en:10.1001/ jama.2013.281053. PMID 24141714.
Vilagut G, Ferrer M, Rajmil L, Rebollo, P, et al. Health Questionnaire SF-36: Experience in a decade and new developments. Gac Sanit 2005;19:135-150.
Danielsson G, Eklof B, Grandinetti A, Kistner R. The influence of obesity on chronic venous disease. Vasc Endovascular Surg 2002;36:271-276.
Hodde JP, Allam R. Extracellular wound matrices: small intestinal submucosa wound matrix for chronic wound healing. Wounds 2007;19:157-162.
Rice JB, Desai U, Cummings AK, Birnbaum HG, et al. Burden of venous leg ulcers in the United States. J Med Economics 2014;17:347-356.
Fife CE, Carter MJ. Wound care outcomes and associated cost among patients treated in US outpatient wound centers: data from the US wound registry. Wounds 2012;24:10-17.
Ruckley CV. Socioeconomic impact of chronic venous insufficiency and leg ulcers. Angiology 1997;48:67-69.
Beebe HG, Bergan JJ, Berqvist D, Eklof B, et al. Classification and grading of chronic venous disease in the lower limbs consensus statement. Organizado por la Fundación Straub con la Cooperación del Foro Venoso Americano. 6o Congreso anual. 1995;24:313-318. February 22-25, 1994, Maui, Hawaii.
Zenilman J, Valle MF, Malas MB, Maruthur N, et al. Chronic venous ulcers: A comparative effectiveness review of treatment modalities. Rockville, MD Agency for Healthcare Research and Quality 2013;13:1-77.127.
Beam JW. Topical silver for infected wounds. J Athl Train 2009;44:531-533. Disponible en: 10.4085/1062-6050- 44.5.531.
O’Meara S, Cullum N, Nelson EA, Fletcher AW, Sheldon TA. Compression for venous leg ulcers. Cochrane Database Syst Rev. 2012 Nov 14;11:CD000265. Disponible en: 10.1002/14651858. CD000265.pub.3.
Callam MJ, Harper DR, Dale JJ, Ruckley CV. Chronic ulcer of the leg: clinical history. Br Med J (Clin Res Ed). 1987;294:1389-1391. PMID: 3109669.
Barwell JR, Davies CE, Deacon J, Harvey K, et al. Comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR study): randomised controlled trial. Lancet 2004;363:1854-1859.
Margolis D, Berlin J, Strom B. Which venous leg ulcers will heal with limb compression bandages? Am J Med 2000;109:15-19.
Cueto J, Moreno M, Bahena Z, Rodríguez E, et al. Tratamiento de las úlceras venosas varicosas, complicadas y refarctarias con un polímero polisacárido con óxido de zinc. Reporte preliminar. Revista Mexicana de Angiología 2015;43:102-108.
Moreno M, Nieto N, Espinosa L, Torres Y, et al. Potent antiinflammatory activity of carbohydrate polymer with oxide of zinc. Bio Med Research International 2014. Article ID712312;1- 8. Disponible en: http://dx.doi.org/10.1155/2014/712312.
Moreno M, Espinosa L, Orozco T, Orozco T, et al. Enhanced healing and anti-inflammatory effects of a carbohydrate polymer with zinc oxide in patients with chronic venous leg ulcers: preliminary results. Archives of Medical Science (aceptado para publicación. Agosto 2015).
Lars K, Thomas W. Wound bed preparation: The impact of debridement and wound cleansing. Wound Medicine, Medicine 2013;1:44-50.
Kahn SR, M’lan CE, Lamping DL, Kurz X, et al; VEINES Study Group. Relationship between clinical classification of chronic venous disease and patient-reported quality of life: results from an international cohort study. J Vasc Surg 2004;4:823-828.
Smith JJ, Guest MG, Greenhalgh RM, Davies AH. Measuring the quality of life in patients with venous ulcers. J Vasc Surg 2000;31:642-649.
Krahwinkel DJ, Boothe HW. Topical and systemic medications for wounds. Vet Clin Small Anim Pract 2006;36:739-757.
Hajipour M, Fromm K, Ashkarran A, de Aberasturi DJ, et al. Antibacterial properties of nanoparticles. Trends in biotechnology 2012;30:499-511.
Xie Y, He Y, Irwin P, Jin T, Shi X. Antibacterial activity and mechanism of action of zinc oxide nanoparticles against Campylobacter jejuni. Appl Environ Microbiol 2011;77:2325-2331.
Sirelkhatim A, Mahmud S, Seeni A, Kaus NHM, et al. Review on zinc oxide nanoparticles: antibacterial activity and toxicity mechanism. Nano-Micro Lett 2015;7:219- 242.
Martinez M, Martí A, Solà I, Expósito JA, et al. Autologous platelet-rich plasma for treating chronic wounds. Cochrane Database Syst Rev. 2012 Oct 17;10:CD006899. Disponible en: 10.1002/14651858.CD006899.pub2.
Kirsner R, Marston W, Snyder R, Lee T, et al. Spray-applied cell therapy with human allogeneic fibroblasts and keratinocytes for the treatment of chronic venous leg ulcers: a phase 2, multicentre, double-blind, randomised, placebocontrolled trial. Wound Repair Regen 2013;21:682-687. Disponible en: 10.1111/wrr.12076. Epub 2013 Aug 8.
Wille JJ, Burdge JJ, Pittelkow MR. Rapid healing of chronic venous stasis leg ulcers treated by the application of a novel serum-free cultured autologous epidermis. Wound Repair Regen 2011;19:464-474. Disponible en: 10.1111/j.1524- 475X.2011.00702.x. Epub 2011 Jun 7.
Snyder DL, Sullivan N, Schoelles KM. Skin substitutes for treating chronic wounds. Technology Assessment Report Project ID: HCPR0610 December 18, 2012.