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Case Study/Series
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TREATMENT OF HARD TO HEAL CHRONIC VENOUS ULCERATIONS WITH AMELOGENIN. THE NORWEGIAN EXPERIENCE First Author: THEIS HULDT-NYSTRØM Authors: Theis Huldt-Nystrym, MD Healing in Chronic Venous Ulcers is problematic, 20% do not heal successfully after compression therapy. It has been shown that non-healing ulcers which have not healed in six months, or measure 10cm2 and larger, are associated with a reduced ability to heal (1,2). A possible reason for this might be damage to the ulcer connective tissue matrix that prevents the fibroblasts from receiving proper stimulus to migrate and produce growth factors. Amelogenin is an extra cellular matrix (ECM) protein which is though to act as a surrogate scaffold and aid in the growth of granulation tissue when applied regularly to a wound. Clinical studies on CVU'S using amelogenin as an advanced therapeutic agent have established positive effects and stimulation of healing (3). In this survey 12 patients (15 CVU's) received weekly amelogenin therapy. Throughout the treatment period, the progress of each patient's wounds were measured as follows, wound size, exudate level, fibrin content, patient satisfaction and pain (VAS). The results showed that a large proportion of the ulcers healed or showed a reduction in size, and that 2 ulcers continued to heal after their treatment had been completed. Only a small proportion (2 ulcers) remained unchanged or deteriorated (2 ulcers). |
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