title: Effect of oxidized regenerated cellulose/collagen matrix on proteases in wound exudate of patients with diabetic foot ulcers.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Erasmus University Hospital, Rotterdam, The Netherlands.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Ulrich
authors.forename: Ralf
authors.initials: R
authors.lastname: Smeets
authors.forename: Frank
authors.initials: F
authors.lastname: Unglaub
authors.forename: Michael
authors.initials: M
authors.lastname: Wöltje
authors.forename: Norbert
authors.initials: N
authors.lastname: Pallua
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000379:methods; D047070:Bandages, Hydrocolloid; D002483:Cellulose, Oxidized / Q000494:pharmacology* / Q000627:therapeutic use; D015331:Cohort Studies; D017719:Diabetic Foot / Q000175:diagnosis / Q000451:nursing / Q000628:therapy*; D010450:Endopeptidases / Q000032:analysis / Q000378:metabolism; D005122:Exudates and Transudates / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000032:analysis / Q000378:metabolism; D008875:Middle Aged; D012038:Regeneration / Q000187:drug effects / Q000502:physiology; D018570:Risk Assessment; D012720:Severity of Illness Index; D012869:Skin Absorption / Q000187:drug effects*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology
chemical_list: D002483:Cellulose, Oxidized; D010450:Endopeptidases; D020778:Matrix Metalloproteinase 2