Enhancement of Wound Healing by Topical Treatment with Epidermal Growth Factor

TLDR

Animal studies show that topical epidermal growth factor accelerates epidermal regeneration of partial‑thickness wounds and second‑degree burns, but further research is needed to assess its clinical significance. The study aimed to determine whether epidermal growth factor accelerates epidermal regeneration in human skin‑graft donor sites. Twelve patients received paired donor sites, one treated with silver sulfadiazine alone and the other with silver sulfadiazine plus 10 µg/mL epidermal growth factor, and daily photographs were planimetrically analyzed to assess healing. All 12 donor sites treated with epidermal growth factor healed faster, shortening time to 25% and 50% healing by about one day and to 75% and 100% by 1.5 days (P < 0.02), with histology confirming accelerated regeneration. Citation: N Engl J Med 1989; 321:76–9.

Abstract

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 μg 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<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. (N Engl J Med 1989; 321:76–9.)