The use of intralesional epidermal growth factor in the treatment of diabetic foot ulcers

Abstract

Aims: The mitogenic and cell protective effects of epidemal growth factor (EGF) in wound healing stimulate the growth, re-covering the surface of the wound area. In this research we tried to elucidate the effectiveness of intradermal EGF application on wound healing in diabetic foot ulcers regarding the fact that EGF can accelerate the formation of skin cover layer on the infected surface, even in relatively ischemic cases. Methods: The data of 68 patients who applied to our institution’s orthopedics and wound care outpatient clinic with the diagnosis of diabetic foot ulcer, who underwent wound care, debridement and follow-up were retrospectively analyzed. All of the patients included in this study were classified as Wagner Stage III and Stage IV diabetic foot ulcers and were followed up with standard wound care. EGF application was initiated if there was not enough bleeding on the wound borders and defect floor after debridement. Results: The rate of patients with 50% or more granulation in the second week of treatment in the groups was 35.7% (n=10) in the standard treatment group, it was 60% (n=24) in the EGF group (p<0.05). Complete granulation rates at the fourth week of treatment in patients who did not show complete granulation in the second week of treatment was 30.8% (n=8) in the standard treatment and 61.1% (n=22) in the EGF treatment (p<0.05). Similarly, in patients who did not show complete granulation in the fourth week of treatment, complete granulation rates at the sixth week of treatment was found to be 44.4% (n=8) in standard treatment and 85.7% (n=12) in EGF treatment (p<0.05). Conclusion: According to the results of this study, intradermal EGF application in diabetic foot ulcers may positively affect wound healing by accelerating the formation of a skin cover layer.

Keywords

• Diabetic foot ulcer
• EGF
• epidermal growth factor
• diabetic ulcer
• wound care

Diyabetik ayak ülserlerinin tedavisinde intralezyonel epidermal büyüme faktörünün kullanımı

Abstract

Amaç: Epidemal büyüme faktörünün (EGF) yara iyileşmesindeki mitojenik ve hücre koruyucu etkileri büyümeyi uyararak yara bölgesinin yüzeyini yeniden kaplar. Bu araştırmada, EGF'nin nispeten iskemik vakalarda bile enfekte yüzeyde deri örtümü oluşumunu hızlandırabileceği gerçeğinden yola çıkarak diyabetik ayak ülserlerinde intradermal EGF uygulamasının yara iyileşmesi üzerindeki etkinliğini açıklamaya çalıştık. Yöntemler: Kurumumuzun ortopedi ve yara bakım polikliniğine diyabetik ayak ülseri tanısıyla başvuran, yara bakımı, debridmanı ve takibi yapılan 68 hastanın verileri retrospektif olarak analiz edildi. Bu çalışmaya dahil edilen hastaların tamamı Wagner Evre III ve Evre IV diyabetik ayak ülseri olarak sınıflandırıldı ve standart yara bakımı ile takip edildi. Debridman sonrası yara kenarlarında ve defekt tabanında yeterli kanama olmaması durumunda EGF uygulamasına geçildi. Bulgular: Tedavinin ikinci haftasında gruplarda %50 ve üzerinde granülasyon görülen hasta oranı standart tedavi grubunda %35,7 (n=10), EGF grubunda %60 (n=24) idi (p <0,05). Tedavinin ikinci haftasında tam granülasyon göstermeyen hastalarda tedavinin dördüncü haftasındaki tam granülasyon oranları standart tedavide %30,8 (n=8), EGF tedavisinde ise %61,1 (n=22) idi (p< 0.05). Benzer şekilde tedavinin dördüncü haftasında tam granülasyon göstermeyen hastalarda tedavinin altıncı haftasında tam granülasyon oranları standart tedavide %44,4 (n=8), EGF'de %85,7 (n=12) olarak belirlendi (p<0.05). Sonuç: Bu çalışmanın sonuçlarına göre, diyabetik ayak ülserlerinde intradermal EGF uygulaması yara örtümünü hızlandırarak yara iyileşmesi üzerinde olumlu etki gösterebilir.

Keywords

• Diyabetik Ayak Ülseri
• EGF
• Epidermal Büyüme Faktörü
• Diyabetik Ülser
• Yara Bakımı

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