The inhibition of matrix metalloproteinase activity in chronic wounds by a polyacrylate superabsorber

Eming, Sabine A.; Smola, Hans; Hartmann, Berenike; Malchau, Gebhart; Wegner, Ronny; Krieg, Thomas; Smola-Hess, Sigrun

doi:10.1016/j.biomaterials.2008.03.029

Cited by 74 publications

(61 citation statements)

References 32 publications

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“…4,5 In contrast to skin substitutes, 6 wound dressings are temporarily applied to the wound bed, in order to ensure a defined environment in terms of moisture (to minimise the risk of tissue maceration) and exudate management (to retain growth factors, MMPs and specific cells key to healing). 7,8 Furthermore, an ideal wound dressing should (i) provide thermal insulation and oxygen exchange; (ii) protect damaged tissue from secondary infections and bacterial contamination; (iii) display low adherence in situ to enable complete dressing removal without debris formation and integration with the host tissue; (iv) control activity of up-regulated MMPs, such as MMP-9, 9,10,11,12,13,14,15,16,17 in order to promote wound healing; (v) not induce any toxic response to tissue microenvironment. Although these requirements can be individually provided by many existing commercial dressings, such controlled multi-functionality is still challenging to accomplish in a single, soluble factor-free material system.…”

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confidence: 99%

Protease-sensitive atelocollagen hydrogels promote healing in a diabetic wound model

et al. 2016

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mentioning

confidence: 99%

Protease-sensitive atelocollagen hydrogels promote healing in a diabetic wound model

et al. 2016

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“…Polyacrylate-containing dressings were also shown to sequester and remove MMP and elastase activity in vitro. 37,41,49,67,68 Eming et al further reported an indirect effect of SAP particles on MMP activity by binding of essential Ca 2+ and Zn 2+ ions. 37 Protease sequestration capabilities could also been shown for alginates.…”

Section: Correction Of Biochemical Imbalancementioning

confidence: 98%

“…37,41,49,67,68 Eming et al further reported an indirect effect of SAP particles on MMP activity by binding of essential Ca 2+ and Zn 2+ ions. 37 Protease sequestration capabilities could also been shown for alginates. 51 Moreover, alginates and hydrofibers exhibit significant antioxidative capacities.…”

Section: Correction Of Biochemical Imbalancementioning

confidence: 98%

“…4 Polyacrylate-containing wound dressings, also known as superabsorbent polymer (SAP)-containing dressings or just superabsorbent dressings, have been shown to be particularly effective in the treatment of heavily exuding wounds. [37][38][39] The majority of SAPs is of synthetic/petrochemical origin, and most commonly acrylic acid (and its sodium or potassium salts) and acrylamide are used as the starting monomers. There are also polysaccharide-based and poly(amino acid)-based SAPs available that have different properties when compared with synthetic SAPs.…”

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confidence: 99%

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Clinical efficacy of dressings for treatment of heavily exuding chronic wounds

Wiegand¹,

Tittelbach²,

Hipler³

et al. 2015

CWCMR

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Abstract:The treatment of chronic ulcers is a complex issue and presents an increasing problem for caregivers everywhere. This is especially true in Germany, where more than 4 million chronic wounds are treated each year. Therapeutic decisions must be patient-centered and reflect wound etiology, localization, and healing status. The practice of using the same wound dressing during the entire healing period is no longer reasonable. Instead, multiple types of dressings may be needed for a single wound over its healing trajectory. Selection of the most appropriate dressing should be based on wound phase, depth, signs of infection, and level of exudate. Moisture balance is critical in wound care; dryness will hamper epithelial cell migration while excessive generation of fluid causes maceration at the wound margins. Hence, exudate management is a key issue in chronic wound therapy, particularly given that exudate from chronic wounds has a composition different from that of acute wound fluid. Several studies have shown that exudates from non-healing wounds contain significantly elevated levels of protease activity, increased formation of free radicals, and abundant amounts of proinflammatory cytokines, while concentrations of growth factors and protease inhibitors are markedly decreased. Application of dressings that remove and sequester excess amounts of wound fluid may not only help in restoring the correct balance of moisture, but also support the wound healing process by preventing tissue deterioration caused by abundant protease activity. Several types of dressings, such as hydrogels, hydrocolloids, alginates, hydrofibers, foams, and superabsorbent dressings, are reviewed here and evaluated with regard to their efficacy for highly exuding wounds.

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“…In a recent randomized controlled trial, 10 we demonstrated superior debriding efficacy of a proteinase-modulating polyacrylate (PA)-based hydrogel 11 compared to an amorphous hydrogel without known proteinase-modulating activity in the treatment of venous leg ulcers that were covered by .70% fibrin and necrotic tissue. A minimum of 70% of fibrin and necrotic tissue was defined as inclusion criterion because we were particularly interested in identifying the therapy efficiency in terms of its debriding capacity.…”

Section: Introductionmentioning

confidence: 99%

Economic benefit of a polyacrylate-based hydrogel compared to an amorphous hydrogel in wound bed preparation of venous leg ulcers

Kaspar¹,

Linder²,

Zöllner³

et al. 2015

CWCMR

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Objective: To assess the cost-effectiveness of a polyacrylate (PA)-based hydrogel compared to an amorphous hydrogel in wound bed preparation for venous leg ulcers. Method: A cost-effectiveness analysis was undertaken alongside a multicenter, randomized controlled trial performed in France. A total of 75 patients with venous leg ulcers extensively covered with fibrin and necrotic tissue were randomized to a PA-containing hydrogel or an amorphous hydrogel. Wounds were treated for 14 days and costs were estimated from the German payer's perspective. Medical costs included study treatment, wound treatment supply, and labor time. The clinical benefit was expressed as the number of patients with wounds .50% covered with granulation tissue within 14 days. The incremental cost-effectiveness ratio (ICER) was expressed as the additional cost spent with .50% granulation tissue per day per patient within 14 days of leg ulcer care. Results: Because of individual pricing of wound dressings in hospitals, cost data were derived from the outpatient sector. A total of 33 patients were treated using the PA-based hydrogel and 37 patients using the amorphous hydrogel. The estimated total direct costs per patient and per 14 days of therapy were €306 for both treatment groups. However, with the PA-based hydrogel, 2.5 additional days with wounds covered .50% with granulation tissues were gained within 14 days of leg ulcer care compared to the comparator. The ICER was €0 per additional day spent with .50% granulation tissue. Conclusion: Although there were a greater number of dressing changes in the PA-based hydrogel treatment, the total treatment cost for 14 days of leg ulcer care was the same for both the PA-based-hydrogel and amorphous-hydrogel treatment modalities. The cost benefit favored the PA-based hydrogel because of its greater clinical efficiency in producing a viable wound bed.

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The inhibition of matrix metalloproteinase activity in chronic wounds by a polyacrylate superabsorber

Cited by 74 publications

References 32 publications

Protease-sensitive atelocollagen hydrogels promote healing in a diabetic wound model

Protease-sensitive atelocollagen hydrogels promote healing in a diabetic wound model

Clinical efficacy of dressings for treatment of heavily exuding chronic wounds

Economic benefit of a polyacrylate-based hydrogel compared to an amorphous hydrogel in wound bed preparation of venous leg ulcers

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