Healing of chronic cutaneous wounds by topical treatment with basic fibroblast growth factor

OBJECTIVE: To evaluate the safety and efficacy of topical application of recombinant bovine basic fibroblast growth factor (rbFGF) on the healing of chronic cutaneous wounds. METHODS: Twenty-eight patients with thirty-three chronic cutaneous wounds resulting from trauma, diabetes mellitus, pressure sore and radiation injuries were enrolled in this prospective, open-label crossover trial. Prior to treatment with rbFGF, all wounds failed to heal with conventional therapies within 4 weeks. All wounds were locally treated with rbFGF at a dose of 150 AU/cm(2). Healing time and the quality of wounds were used to evaluate the efficacy of the treatment. RESULTS: Healing of all chronic wounds was expedited. During the study, eighteen wounds completely healed within 2 weeks, four healed within 3 weeks, and another eight completely healed within 4 weeks. Only three wounds failed to heal within 4 weeks, but healed at 30, 40 and 42 days after treatment with rbFGF. Thus, compared with conventional therapies, the effective rate of rbFGF treatment within 4 weeks was 90.9%. Histological assessment showed more abundant capillary sprouts or tubes and that fibroblasts were differentiated in wounds treated with rbFGF. No adverse side effects related to basic fibroblast growth factor were observed. CONCLUSIONS: Our results indicate that rbFGF could be used to accelerate healing in chronic wounds. It is our belief that this may be a more effective method of chronic wound management.

目的 观察重组中碱性成纤维细胞生长因子 (rbFGF)对慢性难愈合创面 (溃疡 )的促修复作用并探讨其促修复机制。方法 本组 2 8例共 33个慢性难愈合创面 ,其中创伤性溃疡 12例 (13个创面 )、压迫性溃疡 9例 (13个创面 ) ,糖尿病溃疡 4例 ,放射性溃疡 3例。所有创面经清创后用rbFGF治疗 (15 0AU/cm2 创面 ,每天 1次 )。结果 所有经rbFGF治疗的创面都产生了明显的愈合 ,其中 2周内愈合为 18例 ,2 - 3周内愈合为 4例 ,3- 4周内愈合为 8例 ,大于 4周愈合的创面为 3例。本组创面 4周内总愈合率为 90 9%。结论 rbFGF可以明显加速慢性难愈合创面愈合 ,其可能的机制涉及外源性bFGF能够补充内源性bFGF的不足或调控内源性bFGF活性。