Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1992 Oct;216(4):401–408. doi: 10.1097/00000658-199210000-00002

The safety and effect of topically applied recombinant basic fibroblast growth factor on the healing of chronic pressure sores.

M C Robson 1, L G Phillips 1, W T Lawrence 1, J B Bishop 1, J S Youngerman 1, P G Hayward 1, L D Broemeling 1, J P Heggers 1
PMCID: PMC1242638  PMID: 1417189

Abstract

The first randomized, blinded, placebo-controlled human trials of recombinant basic fibroblast growth factor (bFGF) for pressure sore treatment were performed. Three different concentrations of bFGF in five dosing schedules were tested for safety using hematology, serum chemistries, urinalysis, absorption, antibody formation, and signs of toxicity. Efficacy was evaluated by wound volumes, histology, and photography. No toxicity, significant serum absorption, or antibody formation occurred. In six of eight subgroups, there was a trend toward efficacy with bFGF treatment. When all subgroups were combined, comparison of the slopes of the regression curves of volume decrease over initial pressure sore volume demonstrated a greater healing effect for the bFGF-treated patients (p < 0.05). Histologically, bFGF-treated wound sections demonstrated increased fibroblasts and capillaries. More patients treated with bFGF achieved > 70% wound closure (p < 0.05). Blinded observers were able to distinguish differences in visual wound improvement between bFGF and placebo groups. These data suggest that bFGF may be effective in the treatment of chronic wounds.

Full text

PDF
401

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allman R. M., Laprade C. A., Noel L. B., Walker J. M., Moorer C. A., Dear M. R., Smith C. R. Pressure sores among hospitalized patients. Ann Intern Med. 1986 Sep;105(3):337–342. doi: 10.7326/0003-4819-105-3-337. [DOI] [PubMed] [Google Scholar]
  2. Allman R. M. Pressure ulcers among the elderly. N Engl J Med. 1989 Mar 30;320(13):850–853. doi: 10.1056/NEJM198903303201307. [DOI] [PubMed] [Google Scholar]
  3. Baird A., Walicke P. A. Fibroblast growth factors. Br Med Bull. 1989 Apr;45(2):438–452. doi: 10.1093/oxfordjournals.bmb.a072333. [DOI] [PubMed] [Google Scholar]
  4. Brown G. L., Curtsinger L., Jurkiewicz M. J., Nahai F., Schultz G. Stimulation of healing of chronic wounds by epidermal growth factor. Plast Reconstr Surg. 1991 Aug;88(2):189–196. [PubMed] [Google Scholar]
  5. Brown G. L., Nanney L. B., Griffen J., Cramer A. B., Yancey J. M., Curtsinger L. J., 3rd, Holtzin L., Schultz G. S., Jurkiewicz M. J., Lynch J. B. Enhancement of wound healing by topical treatment with epidermal growth factor. N Engl J Med. 1989 Jul 13;321(2):76–79. doi: 10.1056/NEJM198907133210203. [DOI] [PubMed] [Google Scholar]
  6. DeLisa J. A., Mikulic M. A. Pressure ulcers. What to do if preventive management fails. Postgrad Med. 1985 May 1;77(6):209-12, 218-20. doi: 10.1080/00325481.1985.11698993. [DOI] [PubMed] [Google Scholar]
  7. Disa J. J., Carlton J. M., Goldberg N. H. Efficacy of operative cure in pressure sore patients. Plast Reconstr Surg. 1992 Feb;89(2):272–278. doi: 10.1097/00006534-199202000-00012. [DOI] [PubMed] [Google Scholar]
  8. Fiddes J. C., Hebda P. A., Hayward P., Robson M. C., Abraham J. A., Klingbeil C. K. Preclinical wound-healing studies with recombinant human basic fibroblast growth factor. Ann N Y Acad Sci. 1991;638:316–328. doi: 10.1111/j.1749-6632.1991.tb49042.x. [DOI] [PubMed] [Google Scholar]
  9. Folkman J., Klagsbrun M. Angiogenic factors. Science. 1987 Jan 23;235(4787):442–447. doi: 10.1126/science.2432664. [DOI] [PubMed] [Google Scholar]
  10. Gospodarowicz D., Ferrara N., Schweigerer L., Neufeld G. Structural characterization and biological functions of fibroblast growth factor. Endocr Rev. 1987 May;8(2):95–114. doi: 10.1210/edrv-8-2-95. [DOI] [PubMed] [Google Scholar]
  11. Hayward P., Hokanson J., Heggers J., Fiddes J., Klingbeil C., Goeger M., Robson M. Fibroblast growth factor reserves the bacterial retardation of wound contraction. Am J Surg. 1992 Mar;163(3):288–293. doi: 10.1016/0002-9610(92)90004-b. [DOI] [PubMed] [Google Scholar]
  12. Hebda P. A., Klingbeil C. K., Abraham J. A., Fiddes J. C. Basic fibroblast growth factor stimulation of epidermal wound healing in pigs. J Invest Dermatol. 1990 Dec;95(6):626–631. doi: 10.1111/1523-1747.ep12513528. [DOI] [PubMed] [Google Scholar]
  13. O'Keefe E. J., Chiu M. L., Payne R. E., Jr Stimulation of growth of keratinocytes by basic fibroblast growth factor. J Invest Dermatol. 1988 May;90(5):767–769. doi: 10.1111/1523-1747.ep12560956. [DOI] [PubMed] [Google Scholar]
  14. Resch C. S., Kerner E., Robson M. C., Heggers J. P., Scherer M., Boertman J. A., Schileru R. Pressure sore volume measurement. A technique to document and record wound healing. J Am Geriatr Soc. 1988 May;36(5):444–446. doi: 10.1111/j.1532-5415.1988.tb02385.x. [DOI] [PubMed] [Google Scholar]
  15. Rifkin D. B., Moscatelli D. Recent developments in the cell biology of basic fibroblast growth factor. J Cell Biol. 1989 Jul;109(1):1–6. doi: 10.1083/jcb.109.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Robson M. C., Phillips L. G., Thomason A., Robson L. E., Pierce G. F. Platelet-derived growth factor BB for the treatment of chronic pressure ulcers. Lancet. 1992 Jan 4;339(8784):23–25. doi: 10.1016/0140-6736(92)90143-q. [DOI] [PubMed] [Google Scholar]
  17. Shing Y., Folkman J., Haudenschild C., Lund D., Crum R., Klagsbrun M. Angiogenesis is stimulated by a tumor-derived endothelial cell growth factor. J Cell Biochem. 1985;29(4):275–287. doi: 10.1002/jcb.240290402. [DOI] [PubMed] [Google Scholar]
  18. Shipley G. D., Keeble W. W., Hendrickson J. E., Coffey R. J., Jr, Pittelkow M. R. Growth of normal human keratinocytes and fibroblasts in serum-free medium is stimulated by acidic and basic fibroblast growth factor. J Cell Physiol. 1989 Mar;138(3):511–518. doi: 10.1002/jcp.1041380310. [DOI] [PubMed] [Google Scholar]
  19. Stenberg B. D., Phillips L. G., Hokanson J. A., Heggers J. P., Robson M. C. Effect of bFGF on the inhibition of contraction caused by bacteria. J Surg Res. 1991 Jan;50(1):47–50. doi: 10.1016/0022-4804(91)90008-a. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES