Effect of Oxidized Regenerated Cellulose/Collagen Matrix on Proteases in Wound Exudate of Patients With Diabetic Foot Ulcers

Abstract

The aim of this study was to investigate the influence of oxidized regenerated cellulose/collagen matrix on the concentration and activity of gelatinases, elastase, and plasmin in wound exudate. The study included 32 patients with diabetic foot ulcers. Ten patients with a mean age of 66 ± 9 years (mean ± SD) were treated with hydrocolloid dressings; 22 patients with a mean age of 57 ± 12 years were treated with oxidized regenerated/collagen matrix and hydrocolloid dressings. Wound exudate was collected on days 0, 5, 14, and every 14 days thereafter for 12 weeks. Total protein was determined according to Bradford's technique. The levels of elastase and plasmin were measured spectrofluorometrically. Besides, gelatinase activity and matrix metalloproteinase-2 concentration were analyzed. The surface area of all ulcers was measured by planimetry. Patients treated with oxidized regenerated cellulose/collagen matrix showed a significant decrease in elastase, plasmin, and gelatinase activities in wound exudates. The matrix metalloproteinase-2 concentration was significantly reduced on days 14, 28, 42, and 56 in comparison to day 0. Furthermore, wound size was significantly reduced at days 14 and 28 in oxidized regenerated cellulose/collagen matrix-treated patients (P < .05). Our results showed a significant and immediate reduction in the levels of all tested proteases in the wound exudate of diabetic foot ulcer patients treated with oxidized regenerated cellulose/collagen matrix. These patients also experienced a significantly greater reduction in wound size.