Brown G L, Nanney L B, Griffen J, Cramer A B, Yancey J M, Curtsinger L J, Holtzin L, Schultz G S, Jurkiewicz M J, Lynch J B
Department of Surgery, Emory University, Atlanta.
N Engl J Med. 1989 Jul 13;321(2):76-9. doi: 10.1056/NEJM198907133210203.
Experimental studies in animals have demonstrated that the topical application of epidermal growth factor accelerates the rate of epidermal regeneration of partial-thickness wounds and second-degree burns. We conducted a prospective, randomized, double-blind clinical trial using skin-graft-donor sites to determine whether epidermal growth factor would accelerate the rate of epidermal regeneration in humans. Paired donor sites were created in 12 patients who required skin grafting for either burns or reconstructive surgery. One donor site from each patient was treated topically with silver sulfadiazine cream, and one was treated with silver sulfadiazine cream containing epidermal growth factor (10 micrograms per milliliter). The donor sites were photographed daily, and healing was measured with the use of planimetric analysis. The donor sites treated with silver sulfadiazine containing epidermal growth factor had an accelerated rate of epidermal regeneration in all 12 patients as compared with that in the paired donor sites treated with silver sulfadiazine alone. Treatment with epidermal growth factor significantly decreased the average length of time to 25 percent and 50 percent healing by approximately one day and that to 75 percent and 100 percent healing by approximately 1.5 days (P less than 0.02). Histologic evaluation of punch-biopsy specimens taken from the centers of donor sites three days after the onset of healing supported these results. We conclude that epidermal growth factor accelerates the rate of healing of partial-thickness skin wounds. Further studies are required to determine the clinical importance of this finding.
对动物的实验研究表明,局部应用表皮生长因子可加快部分厚度伤口和二度烧伤的表皮再生速度。我们进行了一项前瞻性、随机、双盲临床试验,以皮肤移植供区为对象,确定表皮生长因子是否能加快人类表皮再生速度。为12例因烧伤或整形手术需要进行皮肤移植的患者创建了配对的供区。每位患者的一个供区局部用磺胺嘧啶银乳膏治疗,另一个供区用含表皮生长因子(每毫升10微克)的磺胺嘧啶银乳膏治疗。每天对供区进行拍照,并采用面积测量分析法评估愈合情况。与仅用磺胺嘧啶银治疗的配对供区相比,在所有12例患者中,用含表皮生长因子的磺胺嘧啶银治疗的供区表皮再生速度加快。表皮生长因子治疗使达到25%和50%愈合的平均时间显著缩短约1天,使达到75%和100%愈合的平均时间显著缩短约1.5天(P<0.02)。对愈合开始三天后从供区中心获取的打孔活检标本进行的组织学评估支持了这些结果。我们得出结论,表皮生长因子可加快部分厚度皮肤伤口的愈合速度。需要进一步研究以确定这一发现的临床重要性。