Objective To review the current condition of growth factors and their application to clinical treatment of acute and chronic wounds. Methods Data from the literature and Medline were analyzed according to their different uses in acute and chronic wounds. Their potential side-effects were studied. Results All data showed that wound healing time in acute and chronic wounds was accelerated and wound healing quality was improved after treatment with growth factors. No sideeffect was observed. Conclusion The efficacy and safety of growth factors in improving wound healing were confirmed. However, some reconsideration aboutpotential problems of growth factors must be made to apply them clinically in the future.
OBJECTIVE This paper aims to explore the new method of continuous delivery of epidermal growth factor to wounds by transfected fibroblasts to promote wound repair. METHODS It was constructed a novel chimeric expression plasmid in which the biologically active portion of the human epidermal growth factor (EGF) gene was fused in-frame to the human granulocyte colony-stimulating factor signal sequence. RESULTS Clonally selected human fibroblasts transfected with this construct could secrete biologically active EGF. After the transplantation of irradiated gene-transfected fibroblasts suspended in fibrin glue to murine full-thickness wounds, EGF could be demonstrated for at least seven days in the wounds, slowly decreasing from initially 470 ng/L to 140 ng/L in 7 days. No EGF was found in the wound at 14 days. CONCLUSION A single application of irradiated EGF gene transfected fibroblasts to wounds can continuously deliver the transgene in vivo and can be used to administer drugs to the wound bed during the crucial first seven days of wound-healing.
ObjectiveTo investigate the mechanism of impeded wound healing by exogenous hyaluronan (HA). Methods Wound healing models were established on 18 adult rabbit ears, which were randomly divided into 3 groups, the 2% HA treated-group (group A), the 1% HA treated-group(group B), and the PBS control-group (group C). The process of wound healing was observed morphologically and histologically. The expression of α-smooth muscle actin in fibroblast was measured by immunohistochemical method. Results ①The mean values of wound healing time of groups A, B and C were (11.7±0.6), (11.3±0.6), and (10.8±1.0) days respectively. Wound contraction was greater in group C than in group A and group B. ②Compared with PBS controls, the collagen fibril was slender and arrayed regularly in HA treated wound. ③ The expression of α-smooth muscle actin was greater in group C than in groups A and B. Conclusion It is one of reasons of impeded wound healing that exogenous HA inhibits the expression of α-smooth muscle protein and wound contraction. There exists dose-dependant effect.
An experiment on the effect of phenytoin onthe healing of wounds of rabbits with the selfcontrol was otiserved from the followingparameters: the reduction of surface area ofwound, the time required for the healing ofwound, examination of the wound tissues bylight and electronic microscope , and the bacterialcounts of the wound. It was noted thatphenytoin was capable to increase the rate ofwound healing, reduce the time of woundhealing, enhance the growth of healthygranulation tissue, enh...
Objective To compare and research the process of woundhealing in occlusive moist environment and dry environment on the skin donor site. Methods The wound healing of adult skin donor site was studied by clinical observation, histological and electromicroscopical examinations on the operative day and the 1st, 2nd, 3rd, 4th, 7th days postoperatively, each skin donor site was divided into two parts: occlusive environment and dry environment. Results The wounds of occlusive moist environment healed faster than those of dry environment; thefibroblasts were more active and activated earlier, revascularization and re-epithelialization happened earlier and more quickly. Conclusion In occlusive environment, more active fibroblasts can accelerate granulation growth; quicker regenerative capillaries bring more nourishment; quicker re-epithelialization accelerates the wound healing.
Objective The amniotic carrier complex membrane, which contains bFGF and vitamin C (VitC) and is loaded with BMSCs, is planted into the deeply-partial wounds of rabbits. To explore its influence on the epidermis renascence and regenerating speed in the process of the dermis restore. Methods BMSCs were isolated from the marrows of 24 healthy3-month-old New Zealand rabbits, male or female, weighing 1.0-1.5 kg. The BMSCs were cultured in vitro and purified, and then amniotic carrier complex membrane was prepared, whose size was 4.52 cm2. Three deep-partial wounds, with the area of about 3.14 cm2, were produced on the back of each rabbit. All the wounds were randomly divided into 3 groups: group A, group B and group C. Group A was the experimental group in which the amniotic carrier complex membrane was planted, including 1 ml BMSCs, 10 mL bFGF (0.2 mg/L) and 10 mL VitC (0.02 g/L). In group B, the amniotic carrier complex membrane was planted, including only 1 mL BMSCs. In group C, the amniotic carrier complex membrane alone was planted. After the operation, general observation was conducted. At postoperative 7, 14 and 21 days, respectively, the observation by HE, Masson, Van Giesonr staining and immunohistochemical staining of collagen type I was performed. The ink perfusion method was performed to evaluate the velocity and the qual ity of the wound heal ing after the transplantation. Results All the wounds obtained good heal ing. At 14 days after the operation, the ratio of wound heal ing was 60%, 41% and 23% in groups A, B and C, respectively. At 21 days after the operation, the the ratio of wound heal ing was 99%, 90% and 81% in groups A, B and C, respectively. There were significant differences between any two groups (P lt; 0.05). The depth of the newborn dermis, the number of the active collagen type I mascul ine cells and the number of the blood vessels in group A were better and more than in group B. And those in group B were better and more than in group C. At the exterior area of the newborn dermis, there was lots of regenerated epidermis from the peripheral normal skin, which in group A was better than in group B, and in group B was better than in group C. onclusion The amniotic carrier complex membrane transplanted to deep-partial wounds, which is appended withBMSCs, bFGF and VitC, can accelerate repair and reconstruction of the dermis. There has an optimal time of the renascence and regeneration of the epidermis in the process of dermis repair.
Objective To explore the efficacy and safety of bioactive material(combest) which is combinated with bioglass and hyaluronan on burn wound healing．Methods From March to September 2006, 20 patients were treated; including 16 males and 4 females, aging 18-58 years(40 years on average)．The wounds were classified as deep degrees Ⅱ in 7 cases, granulated wounds in 9 cases and graft site wounds in 4 cases. Twenty wounds in one side were repaired with Combest as the test group and 20 wounds in the other side with blank cream as the control group. The wounds in size ranged from 2.0 cm×1.5 cm to 40.0 cm×20.0 cm. The wound healing rate was observed, and the blood test and the indices of hepatic and renal function were determined on the 1st, 3 rd,6 th, 11 th, 16 th and 21 st days of treatment．Results Wound healed within 3 weeks in 11 cases of the test group (3 cases on the 11 st day, 4 on the 16 th day, and 4 on the 21 st day) , but no wound healing was observed within 3 weeks in the control group. The healing size accounted for 2/3 of wounds in 18 cases of the test group and in 1 case of the control group. The excellent and good rates were 95%(18 cases and 1 case) in the test group and 50% (1 case and 9 cases) in the control group, showing significant difference (Plt;0.01). For all patients, no obvious changes were found in the blood test and hepatic or renal function indices. Conclusion Combest combinated with bioglass and hyaluronan is beneficial to the proliferation of the granulation and wound healing with good safety.
ObjectiveTo study the inhibitory effect of Sommerlad technique on the growth of the maxilla by comparing the wound healing between Sommerlad and Von Langenbeck techniques in repair of isolated cleft palate.
MethodsA retrospective cohort study was conducted on 54 patients with isolated cleft palate who received palatoplasty with levator veli palatini retropositioning according to Sommerlad between June 2005 and August 2011 as trial group;89 cleft patients received Von Langenbeck technique repair between June 2003 and September 2006 as control group.There was no significant difference in gender and age between 2 groups (P>0.05).The operation time,intraoperative blood loss,body temperature,and fever were recorded and compared;the wound healing was observed,and the palatal mucosa was graded according to Karsten standard.
ResultsThe operation time of trial group [(72.2±5.5) minutes] was significantly longer than that of control group [(58.1±6.8) minutes] (t=4.494,P=0.000);the intraoperative blood loss of trial group [(18.6±6.5) mL] was significantly less than that of control group [(34.2±10.2) mL] (t=2.447,P=0.000).Within postoperative 48 hours,the highest body temperature was 36.6-37.6℃(mean,36.9℃) in trial group,and was 36.8-38.2℃(mean,37.3℃) in control group;fever occurred in 5 patients (9.3%) of trial group and 21 patients (23.6%) of control group,showing significant difference (χ2=4.640,P=0.030).The patients were followed up 3-18 months (mean,9 months) in the trial group,and 3-6 years (mean,4 years) in the control group.Scar was rated as level 0,level 1,and level 2 in 38,13,and 3 cases of trial group,and in 6,35,and 48 cases of control group,showing significant difference (Z=-7.785,P=0.000).
ConclusionThe isolated cleft palate repair using Sommerlad technique has the advantages of less injury and less scar tissue,indicating no inhibitory effect on the growth of the maxilla.
OBJECTIVE: To investigate the effect of nerve growth factor(NGF) on the burn wound healing and to study the mechanism of burn wound healing. METHODS: Six domestic pigs weighting around 20 kg were used as experimental animals. Twenty-four burn wound, each 2.5 cm in diameter, were induced on every pigs by scalding. Three different concentrations of NGF, 1 microgram/ml, 2.5 micrograms/ml, 5 micrograms/ml were topically applied after thermal injury, and saline solution used as control group. Biopsy specimens were taken at 3, 5 and 9 days following treatment and immunohistochemistry method was used to detect the epidermal growth factor(EGF), EGF receptor (EGF-R), NGF, NGF receptor (NGF-R), NGF, NGF-R, CD68 and CD3. RESULTS: The expression of EGF, EGF-R, NGF, NGF-R CD68 and CD3 were observed in the experimental group, especially at 5 and 9 days, no expression of those six items in the control group. CONCLUSION: NGF can not only act directly on burn wound, but also modulate other growth factors on the burn wound to accelerate the healing of burn wound.
Objective To investigate the effect of topical external administration of recombinant human epidermal growth factor (rhEGF) when controll ing blood sugar on expression of epidermal growth factor receptor (EGFR) and EGFR mRNA of wound in diabetes mell itus (DM) combined with scald. Methods A total of 136 male Wistar rats weighing (188.57 ± 6.59) g were randamly divided into 4 groups (groups A, B, C, and D, n=34). The rats was made DM model by intraperitoneal injected 60 mg/kg streptozocin in groups A, B, and C; rats were injected buffer alone in group D as control group. After 8 weeks, the rats of 4 groups were placed in 80℃ hot water for 6 seconds for preparation of the back deep II degree scald model. In group A, the blood sugar level was controlled at the level of group D 1 week before scald model; within 24 hours after models preparation, rhEGF was sprayed on wound at 150 U/cm2 . In group B, the rats were given the same treatment as group A except not controll ing blood sugar. In group C, the blood sugar was controlled as group A and wound was suture fixation with 1% silver sulfadiazine cream at 24 hours after the model. In group D, the same treatment as group A was given after injury. The heal ing rate of the wound was detected at 3, 7, 11, 15, and 21 days after injury; the EGFR mRNA expression was determined by mRNA hybridization in situ, and the EGFR protein expression was deterimined by immunohistochemistry and Western blot at 1, 3, 5, 7, 11, 15, and 21 days. Results? All the rats survived at the end of experiment. There was no significant difference in the heal ing rate of the wound among the 4 groups at 3 days (P gt; 0.05). The heal ing rate of the wound was significantly higher in groups A and D than in groups B and C (P lt; 0.05) at 7, 11, 15, and 21 days. The expession of EGFR mRNA in 4 groups was observed by hybridization in situ, which mainly distributed in the dermal fibroblasts, capillary endothel ial cells and remnants of skin and wound edge epithel ium of the subsidiary; the expessions reached the peak at 5 days in group A, at 7 days in groups B and C, and at 11 days in group D; and the peak level was significantly higher in groups A and D than in groups B and C (P lt; 0.05). Immunohistochemistry and Western blot showed that the expession of EGFR protein was observed in 4 groups and reached the peak level at 7 days in groups A and B, and at 11 days in groups C and D; showing significant difference between groups B, C and groups A, D (P lt; 0.05). Conclusion External appl ication of rhEGF when controll ing blood sugar can accelerate obviously the wound heal ing in DM combined with scald. After controll ing blood sugar, external appl ication of rhEGF can boost obviously the expressions of EGFR mRNA, EGFR, and the extending process of signal conduction.
