epidermal-growth-factor and Leg-Ulcer

This rare ulcer was treated with a human recombinant epidermal growth factor-based formulation and antihypertensive drugs. Full granulation was achieved in 49 days and complete wound closure in 79 days. No adverse events were reported.

Topics: Aged; Chemistry, Pharmaceutical; Debridement; Epidermal Growth Factor; Female; Granulation Tissue; Humans; Hypertension; Leg Ulcer; Rare Diseases; Treatment Outcome; Wound Healing

Topics: Administration, Topical; Blood Physiological Phenomena; Epidermal Growth Factor; Fibroblast Growth Factors; Growth Substances; Humans; Leg Ulcer; Leukocytes, Mononuclear; Platelet-Derived Growth Factor; Transforming Growth Factor beta; Wound Healing

To investigate whether the addition of human recombinant epidermal growth factor (h-EGF) to 2% carboxymethyl cellulose gel is more effective in diabetic wound healing than standard treatment, a pilot, double-blind, randomized and controlled clinical trial with therapeutic intervention was performed at a university hospital. The sample consisted of 25 patients (14 in the intervention group that used rh-EGF and 11 in the control group that used 2% carboxymethyl cellulose gel). Data were tabulated in SPSS and analysed by intention to treat, without loss or exclusion of participants. Twenty-five subjects participated with a mean age of 60.6 years, a predominance of males in both groups and 100% prevalence of type-2 diabetes. Within 12 weeks, complete wound healing occurred in three ulcers in the intervention group versus one ulcer in the control group. The percent reduction in the wound area was significantly higher in the intervention group than in the control group (p = 0.049). Concerning the types of tissue, an increase in granulation and epithelial tissue and a reduction in exudate levels were observed in both groups. Decreased slough occurred only in the intervention group. No participant experienced serious or local adverse events during the study period. This study shows that h-EGF is effective, with a statistically significant reduction in wound area, improvement of tissue quality, and safe treatment of chronic wounds. In addition, this study demonstrated that blinding of participants during research using h-EGF is feasible.

Topics: Diabetes Mellitus, Type 2; Double-Blind Method; Epidermal Growth Factor; Humans; Leg Ulcer; Male; Middle Aged; Wound Healing

The effects of growth factors on wound healing have been studied extensively; however epidermal regeneration is not fully understood. We treated eight patients with leg ulcers with recombinant human epidermal growth factor (rhEGF) and compared biopsies of regenerating epidermis with those of controls who did not receive rhEGF. We used immunohistochemistry to identify cells expressing keratin 19 and beta1 integrin in regenerated epidermis from patients and controls. Patients treated with rhEGF had stem cells in the spinous and granular layers of regenerated epidermis. Histological analysis showed that these stem cells had reverted from differentiated to undifferentiated stem cells. Our findings provide evidence for epidermal cell reversion.

Topics: Adult; Case-Control Studies; Cell Differentiation; Epidermal Growth Factor; Humans; Integrin beta1; Keratins; Leg Ulcer; Skin; Stem Cells; Wound Healing

Topics: Aged; Chronic Disease; Cytokines; Epidermal Growth Factor; Female; Humans; Leg Ulcer; Risk Factors; Wound Healing