{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T07:27:23Z","timestamp":1767598043307},"reference-count":20,"publisher":"Mark Allen Group","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:sec><jats:title>Objective:<\/jats:title><jats:p> To compare the efficacy and safety of negatively-charged polystyrene microspheres (NCM) with controls (saline soaks) in the treatment of hard-to-heal wounds of various aetiologies. <\/jats:p><\/jats:sec><jats:sec><jats:title>Method:<\/jats:title><jats:p> Patients with one or more hard-to-heal wounds, defined as refractory to healing for at least 4 weeks, or those with exposed bone, tendon or ligament, were eligible for inclusion and were randomised to either NCM (PolyHeal; MediWound Ltd.) or controls, both applied twice daily for 4 weeks. Patients were monitored bi-weekly for an additional 8 weeks, while treated by standard wound care, at the investigators' discretion, and were re-evaluated 2 years after inclusion. The primary endpoint was defined as coverage of &gt; 75% of the wound area by light-red granulation tissue after 4 weeks of treatment. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Fifty-eight patients completed the study, 32 in the NCM group and 26 in the control group. The two most common wound types were those with primary etiologies of venous insufficiency and post operative\/post trauma. In the NCM group 47% of patients achieved &gt; 75% light red granulation tissue after 4 weeks compared with 15% of patients in the control group (p=0.01). The mean wound surface area in the NCM group was reduced by 39.0% after 4 weeks compared with 14.9% in the control group (p=0.02). The achievement of &gt; 75% light red granulation tissue and reduction of mean wound surface area was also observed in the two main sub-groups (venous insufficiency and postoperative\/post trauma), although it was not statistically significant, possibly due to the small sample size in each sub-group. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> This study demonstrates that compared to control treatment, NCM treatment of hard-to-heal and chronic wounds improves formation of healthy granulation tissue and reduces wound size thus in fact \u2018kick-starting\u2019 the healing process and \u2018dechronifying\u2019 chronic wounds. <\/jats:p><\/jats:sec><jats:sec><jats:title>Declaration of interest:<\/jats:title><jats:p> This study was conducted with financial support from Polyheal Ltd. D. Vigoda and Y. Barnea received honorarium for their contribution to the study. Y. Shoham and Y. Barnea are paid consultants for MediWound Ltd. and Polyheal Ltd., respectively. J. Govrin-Yehudain is a board member of MediWound Ltd. and Polyheal Ltd. <\/jats:p><\/jats:sec>","DOI":"10.12968\/jowc.2013.22.3.144","type":"journal-article","created":{"date-parts":[[2014,5,23]],"date-time":"2014-05-23T13:00:29Z","timestamp":1400850029000},"page":"144-155","source":"Crossref","is-referenced-by-count":14,"title":["Wound \u2018dechronification\u2019 with negatively-charged polystyrene microspheres: a double-blind RCT"],"prefix":"10.12968","volume":"22","author":[{"given":"Y.","family":"Shoham","sequence":"first","affiliation":[{"name":"Plastic Surgery Department, Soroka University Medical Center, Be'er Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Kogan","sequence":"additional","affiliation":[{"name":"Plastic Surgery and Burns Unit, Western Galilee Hospital, Naharia, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Plastic Surgery Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Tamir","sequence":"additional","affiliation":[{"name":"Maccabi Health Services, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Krieger","sequence":"additional","affiliation":[{"name":"Plastic Surgery Department, Soroka University Medical Center, Be'er Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Barnea","sequence":"additional","affiliation":[{"name":"Plastic Surgery Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Regev","sequence":"additional","affiliation":[{"name":"Sheba Medical Center, Tel Hashomer, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Vigoda","sequence":"additional","affiliation":[{"name":"Clalit Health Services, Southern District, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Haikin","sequence":"additional","affiliation":[{"name":"Plastic Surgery and Burns Unit, Western Galilee Hospital, Naharia, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Inbal","sequence":"additional","affiliation":[{"name":"Plastic Surgery Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Arnon","sequence":"additional","affiliation":[{"name":"Plastic Surgery Unit, Barzilai Medical Center, Ashkelon, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Bogdanov-Berezovsky","sequence":"additional","affiliation":[{"name":"Plastic Surgery Department, Soroka University Medical Center, Be'er Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Silberstein","sequence":"additional","affiliation":[{"name":"Plastic Surgery Department, Soroka University Medical Center, Be'er Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Plastic Surgery Department, Soroka University Medical Center, Be'er Sheva, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Govrin-Yehudain","sequence":"additional","affiliation":[{"name":"Bait Harofeem Medical Center, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Zeilig","sequence":"additional","affiliation":[{"name":"Clalit Health Services, Southern District, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5130","reference":[{"key":"B1","volume-title":"Cutaneous Wound Healing","author":"Falanga V.","year":"2001"},{"key":"B2","author":"Rockville M.D.","year":"1994","journal-title":"Clinical Practice Guideline: Pressure Ulcer Treatment"},{"key":"B4","volume-title":"Cutaneous Wound Healing","author":"Cho M.","year":"2001"},{"key":"B5","volume-title":"Hard-to-heal Wounds","author":"Vowden P.","year":"2008"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1006\/jsre.1999.5354"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000049451.38505.45"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-475X.1996.40314.x"},{"key":"B9","first-page":"52","volume":"6","author":"Govrin G.","year":"2010","journal-title":"Wounds UK"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199806000-00012"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1086\/424846"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(96)80125-6"},{"key":"B13","author":"International Consensus on the Diabetic Foot &amp; 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