The use of acellular porcine dermis, hyaluronic acid and polynucleotides in the treatment of cutaneous ulcers: Single blind randomised clinical trial
Open accessAbstract
Reconstruction of chronic ulcers is often hampered by lack of local tissues and poor general conditions. Conservative approaches with debridement and advanced medications, such as polyurethane foam, stand as mainstays. However, the healing process is often slow, thus increasing the risk for infection or other complications. In such cases, porcine dermis (PD) and polynucleotides‐added hyaluronic acid (PAHA) were previously reported to accelerate healing. The aim of the study was to compare the efficacy of PD, PAHA and polyurethane foam in chronic ulcers. Thirty patients were randomly divided into 3 groups: group 1 was treated with advanced medications, group 2 with PD, group 3 with PAHA. Standardised photographs and biopsies were taken before treatment and at 30‐day follow‐up. Photographs were processed to calculate the wound area. Specimens were stained with Haematoxylin/Eosin, Masson trichrome, and immunohistochemically for CD34, alpha‐Smooth Muscle Actin (α‐SMA), Collagen types I and III, Ki67. The re‐epithelialized area was larger in patients treated with PD and PAHA compared with those treated with polyurethane foam (P < .05 and P < .01, respectively). Specimens from patients treated with PD and PAHA showed a higher number of myofibroblasts (α‐SMA+, P < .01), neo‐angiogenesis (CD34+, P < .01), proliferating dermal cells (Ki67+, P < .01), proliferating keratinocytes (Ki67+, P < .01) and collagen type 1 deposition (P < .05). No difference was found between PD and PAHA. PD and PAHA proved to be more effective than polyurethane foam in the treatment of chronic ulcers. These approaches are a versatile and reliable option to address such cases.
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The combination of HA and PN was demonstrated to be more effective than HA alone.
“Segreto et al. reported that the combination of HA and PN was demonstrated to be more effective than HA alone [38].”
From Comparison of Polynucleotide and Polydeoxyribonucleotide in Dermatology: Molecular Mechanisms and Clinical Perspectives (2025) · cites this paper as [38]
The passage labeled F I G U R E 3 reports that HA plus polynucleotides was more effective than HA alone, but specifically for re-epithelialization of venous ulcers. The citing sentence omits that outcome and condition, making the finding sound broader than the source states. (LLM, conf=0.87)
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Research works printed but not linked: 10
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- Segreto F, Carotti S, Marangi GF. The role of angiogenesis, inflammation and estrogen receptors in breast implant cap- sules development and remodeling. J Plast Reconstr Aesthet Surg. 2018;71(5):637-643.
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Cited by
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Kim, S. T. (2025) · Pharmaceutics · doi:10.3390/pharmaceutics17081024 · Cited by 18 · see citing works
- Authors
- Segreto, F., Carotti, S., Marangi, G. F., Francesconi, M., Scaramuzzino, L., Gratteri, M., Caldaria, E., Morini, S., & Persichetti, P.
- Affiliations
- Università Campus Bio-Medico (IT)
- Federico II University Hospital (IT)
- Corresponding author
- Segreto, Francesco
- ORCID
- Venue
- International Wound Journal
- Publisher
- Wiley
- Published
- 2020-07-25
- Volume
- 17
- Issue
- 6
- Pages
- 1702-1708
- ISSN
- 1742-4801 (ISSN-L)
- 1742-481X
- PMC
- PMC7948890
- OpenAlex
- W3043982959
- Cited by
- 17
- References
- 0
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 4 · 2023: 3 · 2022: 2
- FWCI
- 0.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Wound Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rehabilitation › Wound Healing and Treatments
- Health Sciences › Medicine › Surgery › Tissue Engineering and Regenerative Medicine
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Keywords
- chronic cutaneous ulcers, polyurethane foam, wound healing, re-epithelialization, myofibroblasts, neoangiogenesis, collagen deposition, keratinocyte proliferation, advanced wound dressings
- MeSH terms
- Animals, Humans, Hyaluronic Acid, Polynucleotides, Polyurethanes, Skin Ulcer, Swine, Single-Blind Method, Acellular Dermis, Heterografts
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