Originally published: (2007) Acta chir belg, 2007, 107, 675-681
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Authors:
A. Pirayesh *
L. A. Dessy **
F. J. Rogge ***
H. J. P. Hoeksema *
Y. M. G. Sinove *
A. Dall’ Antonia ****
M. A. Jawad *****
P. M. Gilbert ******
C. Rubino **
N. Scuderi **
P. Blondeel *
S. Monstrey *
*Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital, Ghent, Belgium
**Department of Plastic Surgery, La Sapienza University Hospital, Rome, Italy
***Department of Plastic Surgery, Mount Vernon Hospital, Northwood, United Kingdom
****Department of Plastic Surgery, University Hospital, Verona, Italy
*****Department of Plastic Surgery, Chelsea and Westminster Healthcare NHS Trust, London, United Kingdom
******Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead, United Kingdom
Summary:
This multi-center pilot study investigated the effectiveness of a polyhydrated ionogen (PHI) impregnated dressing (Dermax®, or Epimax® in the U.S.A.) in treating persistent diabetic foot ulcers (DFUs). The study aimed to determine if the PHI formulation could achieve stable wound closure by restoring the balance of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in chronic wounds, which is often disrupted in DFUs and hinders healing.Twenty patients with DFUs that had not responded to other therapies for at least three months, and were at least 1 cm² in size, were treated with the PHI dressing. In addition to the dressing, patients received weekly wound debridement, digital imaging, wound perimeter tracing, and off-loading with appropriate footwear and crutches.Key findings include:
- High Closure Rate: Stable wound closure was achieved in 16 out of 20 (80%) DFUs.
- Time to Closure: The average time to full wound closure was 18 weeks.
- Long-term Stability: All patients who achieved full closure maintained stable wound epithelization for up to one year of follow-up.
- Patient Satisfaction: Patients reported high satisfaction with the treatment, citing ease of application, reduced pain, and improved mobility, which contributed to a better quality of life.
The study concludes that these encouraging results warrant further investigation of PHI efficacy in DFU treatment through larger, multi-center, randomized controlled trials, ideally with standardized off-loading and dressing change protocols, and tissue-level MMP quantification.
