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A Journal on Physiopathology and Therapy of Chronic Cutaneous Ulcers


Official Journal of the Italian Association for Cutaneous Ulcers
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Acta Vulnologica 2013 March;11(1):23-33

language: English, Italian

Chronic wounds treated with photodynamic therapy: analysis of cellular response and preliminary results

Corsi A. 1, Lecci P. P. 2, Bacci S. 2, Cappugi P. 3

1 Ospedale di Santa Maria Nuova, Florence, Italy;
2 Department of Experimental and Clinic Medicine, University of Florence Florence, Italy;
3 Department of Surgery, University of Florence, Florence, Italy


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Aim: A wound is considered chronic if it does not heal timely. Basic processes at work are similar to acute healing, but their persistence leads to abundant granulation tissue and often fibrosis, scar contraction and loss of function. Wounds may become chronic because of local and systemic conditions and are a major concern in clinical dermatology. Photodynamic therapy (PDT) has been proposed for chronic wound treatment, in combination with the administration of aminolevulinc acid (ALA), leading to the synthesis of the photosensitizer protoporphyrin IX (PpIX), followed by illumination with visible light.
Methods: The effects of PDT on the cell infiltrate of chronic wounds was studied on cryosections of biopsies obtained before and after PDT, post-fixed in cold acetone, and stained with hematoxylin and eosin or immunolabeled with antibodies to laminin-5 (for basement membrane), HSP47 (for fibroblasts), and SPM 250 (for granulocytes). Intact adjacent skin was used as control.
Results: As compared to healthy skin, an increase in cellular infiltrate, epidermal thickness, vascularisation, and the number of fibroblasts was seen in the chronic wounds. After completion of PDT, fibroblasts appeared further increased in number.
Conclusion: PDT seemed to stimulate the connective tissue cells responsible for tissue repair rather than inflammatory infiltrate.

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