Tiaka Elisavet K, Papanas Nikolaos, Manolakis Anastassios C, Georgiadis George S
Democritus University of Thrace, Alexandroupolis, Greece.
Perspect Vasc Surg Endovasc Ther. 2012 Mar;24(1):37-44. doi: 10.1177/1531003512442093. Epub 2012 Apr 11.
Management of diabetic foot ulcers remains a rather challenging task. Epidermal growth factor (EGF) plays a central role in wound healing. It acts on epithelial cells and fibroblasts promoting restoration of damaged epithelium. However, its bioavailability is impaired in chronic diabetic foot ulcers. Current evidence suggests that application of human recombinant EGF in addition to standard treatment is able to achieve both partial and complete healing and to prevent foot amputations. Its efficacy has been tested at various concentrations and by various administration routes (topical application and intralesional injection). Intralesional injection has better availability on the deep wound layers, but pain at the injection site is a common complaint. Generally, adverse events have been minor to mild. Finally, numerous issues need to be further clarified before widespread use of EGF becomes possible in everyday practice. Such issues include optimal dosage and administration route, characteristics of the ulcers most likely to heal (severity and ischemic/neuropathic or both), and cost-effectiveness.
糖尿病足溃疡的管理仍然是一项颇具挑战性的任务。表皮生长因子（EGF）在伤口愈合中起着核心作用。它作用于上皮细胞和成纤维细胞，促进受损上皮的修复。然而，在慢性糖尿病足溃疡中其生物利用度受损。目前的证据表明，除标准治疗外应用人重组EGF能够实现部分和完全愈合，并预防足部截肢。已经在不同浓度和通过不同给药途径（局部应用和病灶内注射）对其疗效进行了测试。病灶内注射在深部伤口层具有更好的可用性，但注射部位疼痛是常见的问题。一般来说，不良事件轻微。最后，在EGF能够在日常实践中广泛使用之前，许多问题需要进一步阐明。这些问题包括最佳剂量和给药途径、最有可能愈合的溃疡的特征（严重程度以及缺血性/神经性或两者皆有）以及成本效益。
