Short-contact topical tretinoin therapy to stimulate granulation tissue in chronic wounds

Dana Paquette, Evangelos V Badiavas, Vincent Falanga

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: The use of retinoids in wound healing is increasing. It has been shown that retinoic acid reverses the inhibitory effects of glucocorticoids on wound healing and accelerates the formation of healthy granulation tissue. Pretreatment with tretinoin before epidermal injury such as chemical peeling and dermabrasion has shown accelerated wound healing. Enhanced healing of full-thickness skin wounds has also been demonstrated in early wound healing studies. However, tretinoin therapy can be quite irritating. Objective: Our purpose was to observe the clinical and histologic effects of topical tretinoin solution 0.05% applied directly to the wound beds of chronic leg ulcerations. Methods: We report on the cases of 5 patients with long-standing leg ulcerations. All were treated with topical tretinoin solution 0.05% applied directly to the wound bed. The tretinoin solution was left in contact with the ulcer bed for a maximum of 10 minutes daily and then rinsed with normal saline. Punch biopsy specimens were obtained from the wound beds at baseline and mid therapy. Standard wound care was continued throughout the study. Results: In this study we found that as early as 1 week after treatment with topical tretinoin solution 0.05%, there was increased granulation tissue first noted at the wound's edge. After 4 weeks of therapy with tretinoin, there was further stimulation of granulation tissue, new vascular tissue, and new collagen formation. Conclusion: Short-contact tretinoin therapy is a novel modality in which to treat chronic ulcers and stimulate the formation of granulation tissue.

Original languageEnglish
Pages (from-to)382-386
Number of pages5
JournalJournal of the American Academy of Dermatology
Volume45
Issue number3
DOIs
StatePublished - Sep 11 2001
Externally publishedYes

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Granulation Tissue
Tretinoin
Wounds and Injuries
Wound Healing
Therapeutics
Ulcer
Leg
Dermabrasion
Retinoids
Glucocorticoids
Blood Vessels
Collagen
Biopsy
Skin

ASJC Scopus subject areas

  • Dermatology

Cite this

Short-contact topical tretinoin therapy to stimulate granulation tissue in chronic wounds. / Paquette, Dana; Badiavas, Evangelos V; Falanga, Vincent.

In: Journal of the American Academy of Dermatology, Vol. 45, No. 3, 11.09.2001, p. 382-386.

Research output: Contribution to journalArticle

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abstract = "Background: The use of retinoids in wound healing is increasing. It has been shown that retinoic acid reverses the inhibitory effects of glucocorticoids on wound healing and accelerates the formation of healthy granulation tissue. Pretreatment with tretinoin before epidermal injury such as chemical peeling and dermabrasion has shown accelerated wound healing. Enhanced healing of full-thickness skin wounds has also been demonstrated in early wound healing studies. However, tretinoin therapy can be quite irritating. Objective: Our purpose was to observe the clinical and histologic effects of topical tretinoin solution 0.05{\%} applied directly to the wound beds of chronic leg ulcerations. Methods: We report on the cases of 5 patients with long-standing leg ulcerations. All were treated with topical tretinoin solution 0.05{\%} applied directly to the wound bed. The tretinoin solution was left in contact with the ulcer bed for a maximum of 10 minutes daily and then rinsed with normal saline. Punch biopsy specimens were obtained from the wound beds at baseline and mid therapy. Standard wound care was continued throughout the study. Results: In this study we found that as early as 1 week after treatment with topical tretinoin solution 0.05{\%}, there was increased granulation tissue first noted at the wound's edge. After 4 weeks of therapy with tretinoin, there was further stimulation of granulation tissue, new vascular tissue, and new collagen formation. Conclusion: Short-contact tretinoin therapy is a novel modality in which to treat chronic ulcers and stimulate the formation of granulation tissue.",
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