Oxygenation Status in Chronic Leg Ulcer After Topical Hemoglobin Application May Act as a Surrogate Marker to Find the Best Treatment Strategy and to Avoid Ineffective Conservative Long-term Therapy.

Purpose: Chronic leg ulcers can be a challenge to treat and long-term therapy a significant cost factor in western public health budgets. Objective wound assessment assays enabling selection of appropriate wound therapy regimes would be desirable. Oxygenation status in ulcer tissue has obtained incr...

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Publicado en:Molecular Imaging & Biology Vol. 20; no. 1; pp. 124 - 131
Autores principales: Petri, Maximilian, Stoffels, Ingo, Griewank, Klaus, Jose, Jithin, Engels, Peter, Schulz, Andrea, Pötzschke, Harald, Jansen, Philipp, Schadendorf, Dirk, Dissemond, Joachim, Klode, Joachim
Formato: clinical trial pictorial research tables/charts Journal Article
Publicado: Springer Nature Feb2018
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Oxygenation Status in Chronic Leg Ulcer After Topical Hemoglobin Application May Act as a Surrogate Marker to Find the Best Treatment Strategy and to Avoid Ineffective Conservative Long-term Therapy.
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        au:
          Petri, Maximilian
          Stoffels, Ingo
          Griewank, Klaus
          Jose, Jithin
          Engels, Peter
          Schulz, Andrea
          Pötzschke, Harald
          Jansen, Philipp
          Schadendorf, Dirk
          Dissemond, Joachim
          Klode, Joachim
        affil: Department of Dermatology, Venerology and Allergology, University-Hospital Essen, University of Duisburg-Essen, Essen, Germany
      sug:
        subj:
          Hemoglobins Administration and Dosage
          Leg Ulcer Drug Therapy
          Oxygen Metabolism
          Hemoglobins Therapeutic Use
          Adult
          Human
          Acoustics
          Female
          Administration, Topical
          Aged, 80 and Over
          Aged
          Chronic Disease
          Male
          Carboxyhemoglobin Metabolism
          Middle Age
          Wound Healing
          Biopsy
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Clinical Trials
          Adult: 19-44 years
          Aged, 80 & over
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Purpose: Chronic leg ulcers can be a challenge to treat and long-term therapy a significant cost factor in western public health budgets. Objective wound assessment assays enabling selection of appropriate wound therapy regimes would be desirable. Oxygenation status in ulcer tissue has obtained increased attention as a relevant factor in wound healing. To increase oxygenation in wounds, a topical hemoglobin spray was developed. Although favorable results have been noted, the link between clinical efficacy and the mode of action has not been demonstrated. The aims were to determine if changes in tissue oxygenation can be measured after topical application of hemoglobin on chronic wounds and to evaluate the findings in terms of therapy strategies.Procedures: Photoacoustic imaging was used to measure the local oxygen saturation (StO2) in leg ulcers before and after hemoglobin spray treatment. Sclerosis of the leg ulcers was histopathologically graded and the change in wound size was documented in a follow-up examination.Results: Measuring 49 patients, an increase in StO2 after topical hemoglobin application from on average 66.1 to 71 % (p = 0.017) after 20 min was observed. Depending on the increase in StO2 (>10 % or <10 %) patients were stratified into a Responder and a Non-Responder group. Wound size significantly decreased in the Responder Group (p = 0.001), while no significant difference in the Non-Responder group (p = 0.950) was noted.Conclusion: Our findings suggest that the likelihood of wound healing under conservative therapy can be predicted by measuring changes in StO2 after topical hemoglobin application. This assay may reduce treatment time and costs by avoiding ineffective conservative long-term therapy.Trial Registration: German Clinical Trials Register: DRKS00005993.
      pubtype: Academic Journal
      doctype:
        clinical trial
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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