Preventive effect of polynucleotide on post-thyroidectomy scars: a randomized, double-blinded, controlled trial
Open accessAbstract
Background and Objective: Polynucleotide (PN) provides a structural scaffold to induce anti‐inflammatory and enhanced wound healing properties, and this study aimed to assess the efficacy of PN administration in the prevention of post‐operative scars after conventional open total thyroidectomy. Study Design Materials and Methods: Forty‐two patients with thyroid carcinoma who underwent total thyroidectomy were randomly assigned to the study (PN administration) or control (normal saline) group. All patients underwent a single session of combined ablative and non‐ablative fractional laser. The Vancouver Scar Scale (VSS), global photographic assessment, and objective scar were assessed using three‐dimensional (3D) camera at baseline and at 2, 4, 8, and 16 weeks after surgery. Results: Patients who underwent PN injection demonstrated better surgical scar quality outcome. Participants in the PN administration group had lower VSS scores than the control group (2.09 ± 0.47 vs. 4.01 ± 0.55, respectively) and lower scar height (0.23 ± 0.03 vs. 0.29 ± 0.03, respectively), as measured using 3D imaging. Furthermore, in the PN injected group, the degree of erythema, and pigmentation of the scar were less prominent. No patient developed hypertrophic scar or keloids on the surgical site. No other adverse events, including post‐inflammatory hyperpigmentation, scarring, or infection, were observed. Conclusion: Adjuvant administration of PN along with conventional fractional laser treatment led to more favorable effect in wound healing and post‐operative scar prevention after thyroidectomy. Lasers Surg. Med. 50:755–762, 2018. © 2018 Wiley Periodicals, Inc.
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In Kim et al. 2018, PN significantly improved scar appearance.
“PN significantly improved scar quality, reduced scar height, and improved scar appearance”
No adverse events, including post-inflammatory hyperpigmentation, scarring, or infection, were observed in the postoperative scar study.
“No adverse events, including post-inflammatory hyperpigmentation, scarring, or infection, were observed.”
Vascularity VSS subscale scores decreased significantly in the PN group from 1.41±0.14 to 0.32±0.12 (p<0.05).
“vascularity scores decreased from 1.41±0.14 to 0.32±0.12 (p<0.05)”
Within the PN group, mean scar height decreased from 0.46±0.06 at baseline to 0.23±0.03 at 16 weeks, whereas in the control group it decreased from 0.38±0.04 to 0.29±0.03.
“Within the PN group, the mean scar height decreased from 0.46±0.06 at baseline to 0.23±0.03 at 16 weeks, whereas in the control group, it decreased from 0.38±0.04 to 0.29±0.03.”
Three-dimensional image analysis showed that mean scar height was significantly lower in the PN group at 16 weeks (0.23±0.03) than in the control group (0.29±0.03; p<0.05).
“Three-dimensional image analysis demonstrated that the mean scar height was significantly lower in the PN group at the 16-week assessment (0.23±0.03) compared with the control group (0.29±0.03; p<0.05).”
Pliability VSS subscale scores decreased from 1.73±0.16 to 0.59±0.16 in the PN group, but this did not reach statistical significance (p=0.07).
“Pliability scores decreased from 1.73±0.16 to 0.59±0.16, and height scores decreased from 1.27±0.22 to 0.41±0.16; however, neither reached statistical significance (p=0.07 and p=0.06, respectively).”
In a randomized double-blinded controlled trial of postoperative scar prevention after open total thyroidectomy, PN treatment produced significantly greater improvement in Vancouver Scar Scale (VSS) scores over 16 weeks than control.
“Primary outcome assessment using the Vancouver Scar Scale (VSS) demonstrated significantly greater improvement in the PN group over the 16-week follow-up period.”
In Kim et al. 2018, PN significantly reduced scar height.
“PN significantly improved scar quality, reduced scar height, and improved scar appearance”
The rate of improvement in scar height following the initial combined laser and injection session was significantly more pronounced in the PN group (p<0.05).
“The rate of improvement in scar height following the initial combined laser and injection session was significantly more pronounced in the PN group (p<0.05).”
Patient scar perception scores improved from 2.86±0.18 to 3.27±0.18 in the PN group, compared with minimal change from 2.91±0.16 to 2.90±0.23 in the control group, but between-group differences did not reach statistical significance (p=0.23).
“Patient scar perception scores improved from 2.86±0.18 to 3.27±0.18 in the PN group, compared with minimal change from 2.91±0.16 to 2.90±0.23 in the control group, though between-group differences did not reach statistical significance (p=0.23).”
Pigmentation VSS subscale scores decreased significantly in the PN group from 1.64±0.10 at baseline to 0.77±0.13 at 16 weeks (p<0.05).
“pigmentation scores decreased significantly in the PN group from 1.64±0.10 at baseline to 0.77±0.13 at 16 weeks (p<0.05)”
In Kim et al. 2018, PN significantly improved scar quality.
“PN significantly improved scar quality, reduced scar height, and improved scar appearance”
No patient in either group developed hypertrophic scar or keloid formation during the 16-week follow-up.
“No patient in either group developed hypertrophic scar or keloid formation during the 16-week follow-up.”
The PN group achieved greater than 50% reduction in VSS score, satisfying the predefined criterion for treatment success.
“The PN group achieved greater than 50% reduction in VSS score, satisfying the predefined criterion for treatment success.”
Both groups demonstrated improvement in Melanin Index (MI), but the reduction was less prominent in the PN group (PN: 148.06±10.04 to 134.76±8.57; control: 147.56±9.79 to 113.41±9.37; p<0.05).
“Although both groups demonstrated improvement in the Melanin Index (MI), the reduction was less prominent in the PN group (PN group: 148.06±10.04 to 134.76±8.57; control group: 147.56±9.79 to 113.41±9.37; p<0.05).”
Spectrophotometric assessment showed a significant decrease in Erythema Index (EI) in the PN group compared with the control group after 12 weeks (PN: 381.09±10.68 to 367.47±11.48; control: 400.03±21.69 to 400.05±23.71; p<0.05).
“Spectrophotometric assessment demonstrated a significant decrease in the Erythema Index (EI) in the PN group compared with the control group after 12 weeks (PN group: 381.09±10.68 to 367.47±11.48; control group: 400.03±21.69 to 400.05±23.71; p<0.05).”
Height VSS subscale scores decreased from 1.27±0.22 to 0.41±0.16 in the PN group, but this did not reach statistical significance (p=0.06).
“Pliability scores decreased from 1.73±0.16 to 0.59±0.16, and height scores decreased from 1.27±0.22 to 0.41±0.16; however, neither reached statistical significance (p=0.07 and p=0.06, respectively).”
Mean VSS scores decreased from 6.05±0.52 at baseline to 2.09±0.47 at 16 weeks in the PN group, compared with a reduction from 6.25±0.59 to 4.01±0.55 in the control group (p<0.05).
“The mean VSS scores decreased from 6.05±0.52 at baseline to 2.09±0.47 at 16 weeks in the PN group, compared with a reduction from 6.25±0.59 to 4.01±0.55 in the control group (p<0.05).”
Low-risk judgments were assigned to Yogya et al. [7], Jeon et al. [12], and Kim et al. [13].
“Low-risk judgments were assigned to Yogya et al. [7], Jeon et al. [12], and Kim et al. [13].”
Additional improvements were observed in skin surface evenness, including reduction in pores, wrinkles, and acne scars.
“Additional improvements were observed in skin surface evenness, including reduction in pores, wrinkles, and acne scars [168,169].”
From Comparison of Polynucleotide and Polydeoxyribonucleotide in Dermatology: Molecular Mechanisms and Clinical Perspectives (2025) · cites this paper as [169]
HPT and similar innovations have been adapted for PN-based products.
“More recently, HPT and similar innovations have also been adapted for PN-based products.”
From Comparison of Polynucleotide and Polydeoxyribonucleotide in Dermatology: Molecular Mechanisms and Clinical Perspectives (2025) · cites this paper as [169]
DNA fragment Optimizing Technology (DOTTM), developed by PharmaResearch Co. Ltd., has been used in the production of both PN and PDRN formulations.
“DNA fragment Optimizing Technology (DOT™), developed by PharmaResearch Co. Ltd., has been used in the production of both PN and PDRN formulations [24,169,170,171].”
From Comparison of Polynucleotide and Polydeoxyribonucleotide in Dermatology: Molecular Mechanisms and Clinical Perspectives (2025) · cites this paper as [169]
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Kim, S. T. (2025) · Pharmaceutics · doi:10.3390/pharmaceutics17081024 · Cited by 18 · see citing works
Alhussain, A. M., Turki M. Albusayys, S., Alfhadi, M. A., Bu Mozah, S. A., AlShammari, S. S. S., Alanazi, H. A. M., Adil Alqazanli, S., Nouruldeen Alabdullah, A., M. ALrashidi, N., Almazrou, A. A., et al. (2026) · Cureus · doi:10.7759/cureus.112403 · Cited by 1 · see citing works
- Authors
- Kim, J. H., Jeong, J. J., Lee, Y. I., Lee, W. J., Lee, C., Chung, W. Y., Nam, K., & Lee, J. H.
- Affiliations
- Department of Dermatology and Cutaneous Biology Research Institute Yonsei University College of Medicine Seoul Korea
- Yonsei University (KR)
- Department of Surgery Institute of Endocrine Research Yonsei University College of Medicine Seoul Korea
- Corresponding author
- Lee, Ju Hee
- Venue
- Lasers in Surgery and Medicine
- Publisher
- Wiley
- Published
- 2018-03-25
- Volume
- 50
- Issue
- 7
- Pages
- 755-762
- ISSN
- 0196-8092 (ISSN-L)
- 1096-9101
- OpenAlex
- W2793486521
- Cited by
- 32
- References
- 0
- Citations by year
- 2026: 12 · 2025: 6 · 2024: 5 · 2023: 3 · 2022: 3 · 2021: 1 · 2018: 2
- FWCI
- 0.81
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Lasers in Surgery and Medicine (publishedVersion)
- PubMed (publishedVersion)
- YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Dermatology › Dermatologic Treatments and Research
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Rehabilitation › Wound Healing and Treatments
- Keywords
- polynucleotides, total thyroidectomy, thyroid cancer, fractional laser, scar prevention, wound healing, hypertrophic scars, scar quality, Vancouver Scar Scale, post-inflammatory hyperpigmentation
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