Exploring The Potential Of Growth Factors In Chronic Wounds

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Exploring The Potential Of Growth Factors In Chronic Wounds
Daily application of Regranex helped achieve complete wound closure in approximately three months. (Photo courtesy of Gerit Mulder, DPM.)
Post-op pressure on the amputation site of the lower extremity resulted in this chronic non-healing wound for six months. (Photo courtesy of Gerit Mulder, DPM.)
A Comparision Of One- And Five-Year Mortality Rates
Clinical Editor: Lawrence Karlock, DPM

    “Whereas PDGF stimulates fibroblasts, which lay down a collagen matrix, other growth factors such as epidermal growth factor (EGF) and GMCSF could work in conjunction to lay down the epithelium that covers the collagen,” explains Dr. Woods.

   According to Dr. Rosenblum, there has been some promising work with basic fibroblast growth factor (bFGF), the aforementioned EGF and transforming growth factor beta (TGF-beta). Dr. Weber concurs. He notes that researchers have shown EGF enhances the healing of diabetic foot ulcers and TGF-beta promotes wound healing. The FGF family, which contains at least 23 members, is known to regulate angiogenesis, cell growth, cell migration, neurotrophic effects and other aspects of tissue repair, according to Dr. Weber.

   Dr. Weber says other potentially promising growth factors include: vascular endothelial growth factor (VEGF), which induces angiogenesis and endothelial cell proliferation; tumor necrosis factor (TNF), which stimulates fibroblasts and promotes angiogenesis; keratinocyte growth factor-2 (KGF-2), which has been studied in chronic venous ulcers; and insulin growth factor (IGF), which is known to promote tissue growth.

   All of the panelists would like to see more studies on combination therapy with growth factors.

Dr. Weber is an Associate of the American College of Foot and Ankle Surgeons. He is an Attending Podiatric Surgeon at Washington Hospital Center in Washington, D.C.

Dr. Rosenblum is an Assistant Clinical Professor of Surgery at Harvard Medical School and is the Director of Podiatric Residency Training at the Beth Israel Deaconess Medical Center in Boston.

Dr. Serena is the founder and Medical Director of the Penn North Centers for Advanced Wound Care, NewBridge Medical Research and Oxygen-8 Hyperbaric Centers in western Pennsylvania and southern New York. Dr. Serena is also a Professor at Gannon University and serves on the board of the Wound Healing Society.

Dr. Woods is a Fellow of the American Academy of Dermatology and practices in Austintown, Ohio. She is the founder of the Wound Clinic at Forum Health in Youngstown, Ohio.

Dr. Karlock is a Fellow of the American College of Foot and Ankle Surgeons, and practices in Austintown, Ohio. He is a member of the Editorial Advisory Board for WOUNDS, a Compendium of Clinical Research and Practice.

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