DOI: http://dx.doi.org/10.18203/2349-2902.isj20205868

A comparative study on topical recombinant human epidermal growth factor vs conventional betadine dressing in management of diabetic wounds

Ajay Kundal, Manu Kohli, Sudershan Kapoor

Abstract


Background: Major complications of diabetes mellitus include cardio vascular disease, chronic kidney disease, diabetic foot ulcers and non-healing wounds. Lack of knowledge and awareness has led to worsening of wounds which can involve deeper tissues and bones also. If treated on time majority of patients can be prevented from undergoing major debilitating surgical procedures such as amputation of toes, foot etc.

Methods: In this proposed study, 60 cases of diabetic wounds were studied for healing who were randomly allocated into two groups of 30 patients each. Group A included topical recombinant epidermal growth factor (EGF) application and group B included conventional Betadine dressing for wound healing.

Results: Anaemia had a significant role in delaying wound healing in group B patients. Blood sugars had no significant role in delaying wound healing in this study as patients in group A had mean FBS more than group B and still the wound healing was observed better in group A patients. Topical recombinant EGF resulted in faster wound healing than conventional dressings in diabetic wounds. 90% wound healing rates were seen with topical EGF dressings in comparison to 36.67% in conventional betadine dressings. Signs of wound healing i.e., early granulation, decreased discharge, early wound closure were seen faster in group A. Moreover, all patients in group A showed healthy granulation tissue by the end of our study.

Conclusions: We concluded that topical recombinant EGF resulted in faster and better wound healing than conventional betadine dressing.


Keywords


EGF, Betadine, Diabetic wounds, Human recombinant EGF, Granulation, Wound discharge

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References


Shea KW. Antimicrobial therapy for diabetic foot infections: a practical approach. Postgraduate Medicine. 1999;106(1):85-94.

Caputo GM, Cavanagh PR, Ulbrecht JS, Gibbons GW, Karchmer AW. Assessment and management of foot disease in patients with diabetes. N Eng J Med. 1994;331(13):854-60.

Ghotaslou R, Memar MY, Alizadeh N. Classification, microbiology and treatment of diabetic foot infections. J Wound Care. 2018;27(7):434-41.

Djahmi N, Messad N, Nedjai S, Moussaoui A, Mazouz D, Richard JL et al. Molecular epidemiology of Staphylococcus aureus strains isolated from inpatients with infected diabetic foot ulcers in an Algerian University Hospital. Clin Microbiol Inf. 2013;19(9):E398-404.

Teterycz D, Ferry T, Lew D, Stern R, Assal M, Hoffmeyer P et al. Outcome of orthopedic implant infections due to different staphylococci. Int J Infect Dis. 2010;14(10):e913-8.

Reiber GE. Epidemiology and health care costs of diabetic foot problems. In: Veves A, Giurini JM, LoGerfo FW, editor(s). The Diabetic Foot. New Jersey: Humana Press. 2002;35-58.

Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293:217-28.

Dumville JC, O'Meara S, Deshpande S, Speak K. Hydrogel dressings for healing diabetic foot ulcers. Cochrane Database Systematic Reviews. 2013(7):151-8.

Harding KG, Jones V, Price P. Topical treatment: which dressing to choose. Diab Metabol Res Rev. 2000;16(S1):S47-50.

Morton LM, Phillips TJ. Wound healing update. In seminars in Cutaneous Medicine and Surgery. 2012;31(1):33-7.

Morin RJ, Tomaselli NL. Interactive dressings and topical agents. Clin Plast Surg. 2007;34(4):643-58.

Wittaya-areekul S, Prahsarn C. Development and in vitro evaluation of chitosan–polysaccharides composite wound dressings. Int J Pharma. 2006;313(1-2):123-8.

Cohen S. Isolation of a mouse submaxillary gland protein accelerating incisor eruption and eye-lid opening in new-born animal. J Biol Chem. 1962;237:1555-62.

Carpenter G, King L, Cohen S. Epidermal growth factor stimulates phosphorylation in membrane preparations in vitro. Nature. 1978;276 409-10.

Carpenter G, Cohen S. Epidermal Growth factor. J Biol Chem. 1990;265:7709-12.

Dawson JP, Berger MB, Lin CC, Schlessinger J, Lemmon MA, Ferguson KM. Epidermal growth factor receptor dimerization and activation require ligand-induced conformational changes in the dimer interface. Mol Cell Biol. 2005;25(17):7734-42.

Staff BN. British national formulary (BNF 69). British Medical Association. Available at: https://rudiapt.files.wordpress.com/2017/11/british-national-formulary-69.pdf. Accessed on 10 Oct, 2020.

Kapoor VS, Evans JR, Vedula SS. Interventions for preventing ophthalmia neonatorum. Coch Database Syst Rev. 2020(9):12-5.

Martí‐Carvajal AJ, Gluud C, Nicola S, Simancas‐Racines D, Reveiz L, Oliva P et al. Growth factors for treating diabetic foot ulcers. Cochrane Database Systematic Reviews. 2015(10):178-80.

Mendoza CB, Postlethwait RW, Johnson WD. II. Incidence of Wound Disruption Following Operation. Arch Surg. 1970;101(3):396-8.

Holt DR, Kirk SJ, Regan MC, Hurson M, Lindblad WJ, Barbul A. Effect of age on wound healing in healthy human beings. Surg. 1992;112(2):293-8.

Reed III JF. An audit of lower extremity complications in octogenarian patients with diabetes mellitus. Int J Lower Extremity Wounds. 2004;3(3):161-4.

Morley JE, Mooradian AD, Rosenthal MJ, Kaiser FE. Diabetes mellitus in elderly patients: Is it different? The Am J Med. 1987;83(3):533.

Hong JP, Jung HD, Kim YW. Recombinant human epidermal growth factor (EGF) to enhance healing for diabetic foot ulcers. Ann Plastic Surg. 2006;56(4):394-8.

Singla S, Singla S, Kumar A, Singla M. Role of epidermal growth factor in healing of diabetic foot ulcers. Ind J Surg. 2012;74(6):451-5.