Open AccessEpidermal growth factor intralesional infiltrations can prevent amputation in patients with advanced diabetic foot wounds
Author(s) -
Acosta Jorge Berlanga,
Savigne William,
Valdez Calixto,
Franco Neobalis,
Alba Jose S,
Rio Amaurys del,
LópezSaura Pedro,
Guillén Gerardo,
Lopez Ernesto,
Herrera Luís,
FérnandezMontequín José
Publication year - 2006
Publication title -
international wound journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 63
eISSN - 1742-481X
pISSN - 1742-4801
DOI - 10.1111/j.1742-481x.2006.00237.x
Subject(s) - medicine , granulation tissue , amputation , surgery , diabetic foot , wound healing , diabetes mellitus , endocrinology
This study examined if a series of epidermal growth factor (EGF) local infiltrations can enhance the healing process of complicated diabetic wounds. Twenty‐nine in‐hospital patients with diabetic neuropathic or ischaemic lesions with high risk of amputation were treated in a non controlled pilot study conducted at the National Institute of Angiology, Havana. Lesions, classified as Wagner’s grade 3 or 4, included ulcers ≥20 cm 2 for ≥25 days or amputation residual bases ≥30 cm 2 for ≥15 days, healing refractory despite comprehensive wound care. EGF (25 μg) intralesional infiltrations (≈250 μl of a 25 μg/ml solution/injection point) were performed thrice weekly up to the eighth week. Wound closure was monitored during the treatment and recurrence examined for a year following discharge from hospital. Eighty‐six per cent of the patients treated showed a productive granulation at infiltration session 8. Histological examination at this point indicated a substantial wound matrix transformation, granulation tissue cell repopulation and angiogenesis. Of the 29 patients treated, amputation was prevented in 17 (58·6%) of them who completed 24 infiltration sessions. They averaged 71·1 ± 18·3% of reepithelisation during a mean in‐hospital period of 66·5 ± 4·9 days. Wound recurrence after 1 year of follow‐up appeared in only one patient. Preliminary evidences suggest that EGF intralesional infiltrations may be effective in reducing diabetic lower limb amputation.