Intralesional epidermal growth factor treatment on diabetic foot ulcers: one centre experience

Abstract

Introduction: The intralesional injection of recombinant human epidermal growth factor (EGF-IL) is a new approach for reducing amputations. In this study we aimed to show efficacy of EGF-IL with cases.
Material and Method: EGF-IL 75 μg application to 8 diabetic foot ulcers (6 males, 2 females; mean age: 60.3±9.3 years) was evaluated. Patients had history of prior standard treatments.
Results:  In all eight patients’ completely healing was observed diabetic foot ulcers after the intralesional EGF treatment.

Conclusion: In our experience our patients’ wounds wish priorly have healing problems, improved with intralesional EGF. This treatment is expensive and caused of some allergic reactions. Relation with malignancies are not known for long-term.

Keywords

• Diabetes,foot ulcer,EGF,wound healing

Diyabetik ayakta intralezyonel epidermal growth faktör kullanımı: bir merkezin deneyimi

Abstract

Giriş: Rekombinant insan epidermal büyüme faktörü (EGF-IL) intralezyonel enjeksiyonu amputasyonları azaltmak için yeni bir yaklaşımdır. Bu çalışmada EGF-IL'nin olgularla etkinliğini göstermeyi amaçladık.

Gereç ve Yöntem: Sekiz diyabetik ayak ülserine (6 erkek, 2 kadın; ortalama yaş: 60.3 ± 9.3 yıl) EGF-IL 75 μg uygulandı. Hastalar daha önce standart tedaviler geçmişi vardı.

Bulgular: Sekiz hastanın tamamında, intralezyonel EGF tedavisinden sonra diyabetik ayak ülserleri iyileşti.

Sonuç: Tecrübelerimize göre, hastalarımızın yaraları önceden intralezyonal EGF ile iyileşen iyileşme problemlerine sahip olmak istemektedir. Bu tedavi pahalıdır ve bazı alerjik reaksiyonlara neden olur. Malignitelerle olan ilişki uzun süredir bilinmemektedir.

Keywords

• Diyabet,ayak ülseri,EGF,yara iyileşmesi

References

1. 1. Satman I, Yilmaz T, Sengül A, et al. Population-based study of diabetes and risk characteristics in Turkey. Diabetes Care 2002;25(9):1551-6.
2. 2. Boulton AJ. The diabetic foot: grand overview, epidemiology and pathogenesis. Diabet/Metabol Research Rev 2008;24 (S1).
3. 3. Löndahl M, Katzman P, Nilsson A, Hammarlund C. Hyperbaric oxygen therapy facilitates healing of chronic foot ulcers in patients with diabetes. Diabetes Care 2010;33(5):998-1003.
4. 4. Faglia E, Favales F, Aldeghi A, et al. Adjunctive systemic hyperbaric oxygen therapy in treatment of severe prevalently ischemic diabetic foot ulcer: a randomized study. Diabetes Care 1996;19(12):1338-43.
5. 5. Aktaş Ş, Baktıroğlu S, Demir L, ET AL. Intralesional application of epidermal growth factor in limb-threatening ischemic diabetic foot ulcers. Acta Orthopaed Traumatol Turcica 2016;50(3):277-83.
6. 6. Armstrong DG, Lavery LA, Consortium DFS: Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial. The Lancet 2005, 366(9498):1704-1710.
7. 7. Ubbink DT, Westerbos SJ, Evans D, Land L, Vermeulen H. Topical negative pressure for treating chronic wounds. Cochrane Database Syst Rev 2008: 3.
8. 8. Acosta JB, Savigne W, Valdez C, et al. Epidermal growth factor intralesional infiltrations can prevent amputation in patients with advanced diabetic foot wounds. Int Wound J 2006;3(3):232-9.

9. 9. Loots MA, Kenter SB, Au FL, et al. Fibroblasts derived from chronic diabetic ulcers differ in their response to stimulation with EGF, IGF-I, bFGF and PDGF-AB compared to controls. Eur J Cell Biol 2002;81(3):153-60.
10. 10. Zhou L, Liao Z, Zhang Q, Luo M, Lu G, Zhang W. Bio-inductive effects of inorganic elements on skin wound healing. Zhonghua shao shang za zhi= Zhonghua shaoshang zazhi= Chinese J Burns 2005;21(5):363-6.
11. 11. Al-Delaimy WK, Merchant AT, Rimm EB, Willett WC, Stampfer MJ, Hu FB. Effect of type 2 diabetes and its duration on the risk of peripheral arterial disease among men. Am J Med 2004;116(4):236-40.
12. 12. Fernández‐Montequín JI, Valenzuela‐Silva CM, Díaz OG, Savigne W, et al. Intra‐lesional injections of recombinant human epidermal growth factor promote granulation and healing in advanced diabetic foot ulcers: multicenter, randomised, placebo‐controlled, double‐blind study. Int Wound J 2009;6(6):432-43.
13. 13. Velázquez W, Valles A, Curbelo W. Impact of epidermal growth factor on the treatment of diabetic foot ulcers. Biotecnol Apl (Revista en Internet) 2010:136-41.