{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:41:51Z","timestamp":1792104111863,"version":"4.4.0"},"reference-count":11,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,7,25]],"date-time":"2020-07-25T00:00:00Z","timestamp":1595635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Reconstruction of chronic ulcers is often hampered by lack of local tissues and poor general conditions. Conservative approaches with debridement and advanced medications, such as polyurethane foam, stand as mainstays. However, the healing process is often slow, thus increasing the risk for infection or other complications. In such cases, porcine dermis (PD) and polynucleotides\u2010added hyaluronic acid (PAHA) were previously reported to accelerate healing. The aim of the study was to compare the efficacy of PD, PAHA and polyurethane foam in chronic ulcers. Thirty patients were randomly divided into 3 groups: group 1 was treated with advanced medications, group 2 with PD, group 3 with PAHA. Standardised photographs and biopsies were taken before treatment and at 30\u2010day follow\u2010up. Photographs were processed to calculate the wound area. Specimens were stained with Haematoxylin\/Eosin, Masson trichrome, and immunohistochemically for CD34, alpha\u2010Smooth Muscle Actin (\u03b1\u2010SMA), Collagen types I and III, Ki67. The re\u2010epithelialized area was larger in patients treated with PD and PAHA compared with those treated with polyurethane foam (<jats:italic>P<\/jats:italic> &lt;\u2009.05 and <jats:italic>P<\/jats:italic> &lt;\u2009.01, respectively). Specimens from patients treated with PD and PAHA showed a higher number of myofibroblasts (\u03b1\u2010SMA+, <jats:italic>P<\/jats:italic> &lt;\u2009.01), neo\u2010angiogenesis (CD34+, <jats:italic>P<\/jats:italic> &lt;\u2009.01), proliferating dermal cells (Ki67+, <jats:italic>P<\/jats:italic> &lt;\u2009.01), proliferating keratinocytes (Ki67+, <jats:italic>P<\/jats:italic> &lt;\u2009.01) and collagen type 1 deposition (<jats:italic>P<\/jats:italic> &lt;\u2009.05). No difference was found between PD and PAHA. PD and PAHA proved to be more effective than polyurethane foam in the treatment of chronic ulcers. These approaches are a versatile and reliable option to address such cases.<\/jats:p>","DOI":"10.1111\/iwj.13454","type":"journal-article","created":{"date-parts":[[2020,7,25]],"date-time":"2020-07-25T10:44:47Z","timestamp":1595673887000},"page":"1702-1708","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The use of acellular porcine dermis, hyaluronic acid and polynucleotides in the treatment of cutaneous ulcers: Single blind randomised clinical trial"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1573-1098","authenticated-orcid":false,"given":"Francesco","family":"Segreto","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery \u201cCampus Bio\u2010Medico di Roma\u201d University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Carotti","sequence":"additional","affiliation":[{"name":"Laboratory of Microscopical and Ultrastructural Anatomy \u201cCampus Bio\u2010Medico di Roma\u201d University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni Francesco","family":"Marangi","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery \u201cCampus Bio\u2010Medico di Roma\u201d University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Francesconi","sequence":"additional","affiliation":[{"name":"Laboratory of Microscopical and Ultrastructural Anatomy \u201cCampus Bio\u2010Medico di Roma\u201d University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Scaramuzzino","sequence":"additional","affiliation":[{"name":"Department of General and Emergency Surgery \u201cFederico II\u201d University  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Gratteri","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery \u201cCampus Bio\u2010Medico di Roma\u201d University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Caldaria","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery \u201cCampus Bio\u2010Medico di Roma\u201d University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Morini","sequence":"additional","affiliation":[{"name":"Laboratory of Microscopical and Ultrastructural Anatomy \u201cCampus Bio\u2010Medico di Roma\u201d University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Persichetti","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery \u201cCampus Bio\u2010Medico di Roma\u201d University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2016.12.44"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12623"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2014.1490"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481508100136"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1100\/2012\/727352"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2012.00777.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12214"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2017.12.003"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199101033240101"},{"issue":"11","key":"e_1_2_7_11_1","first-page":"2280","article-title":"The effect of porcine 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