Venous leg ulcers are characterized by chronic inflammation and in consequence high extracellular matrix turnover, avoiding epithelialization. In this work we evaluated maltodextrin/ascorbic acid powder versus standard care for the topical treatment of noninfected venous leg ulcers, smaller than 25 cm2. All patients received daily micronized diosmin/hesperidin and they were recommended an appropriate diet, an exercise program, cleaning of the ulcer, etc., except for compression stocking, since they are not available in the clinic. Both treatments were administered daily during 12 weeks. Clinically, most of the patients were colonized by Staphylococcus aureus; patients who received maltodextrin/ascorbic acid reported less pain than controls and they improved significantly twice and thrice the lesion size in weeks 8 and 12, respectively, when compared with the standard care, (% wound closure: maltodextrin group 78.7 ± 21.6 vs. standard care 36.7 ± 45.4). In order to know changes in cytokine expression in the wound fluid, ulcers were covered with an impermeable film for 24 h, at the beginning and after 4 and 8 weeks of treatment, and the fluids were tested for IL‐1β, TNF‐α, IL‐10, and PDGF‐AB by ELISA. Important changes in wound closure were observed when TNF‐α and IL‐10 changed, increasing their expression in maltodextrin group, meanwhile those cytokines were diminished in the controls. Finally, histological assessment was performed from the two biopsies taken before and after 8 weeks of treatment to each patient. Type III collagen showed an increase, but type I collagen decreased in the tissues derived from maltodextrin group, opposite to the data obtained from standard care group.
In conclusion, maltodextrin/ascorbic acid powder is an important topical treatment for chronic wounds, and it has demonstrated to improve wound closure when it was compared with the standard of care, even without compression. This work was supported by DeRoyal.
