rhEGF-Loaded Hydrogel in the Treatment of Chronic Wounds in Patients with Diabetes: Clinical Cases

Abstract

The aim of the study was to evaluate the healing process of chronic wounds treated with carboxymethylcellulose loaded with recombinant human epidermal growth factor in patients with diabetes. The case series consisted of 10 patients treated at the university hospital for 12 weeks. Data were analyzed using SPSS version 22.0. according to the intention to treat the principle, without the loss or exclusion of the participants. The sample consisted of 70% (7/10) males with a mean age of 61.9 years (±9.4); all (100%) had diabetes mellitus and 70% (7/10) had systolic hypertension associated with diabetes mellitus. Sixty percent (6/10) presented lesions of diabetic etiology and 40% (4/10) presented lesions of venous etiology; 70% (7/10) had had lesions for less than 5 years. The mean glycated hemoglobin was 7.8% (±2.7%), while the mean ankle-arm index (AAI) was 0.94 (±0.21). The mean initial area of all wounds was 13.4 cm², and the mean final area was 7.8 cm2, with a reduction rate of 28.9% over the 12 weeks of treatment. The reduction rate of diabetic ulcers was higher (33.4%) than that of venous ulcers (22.1%). Regarding the type of tissue, there was an increase in granulation and epithelialization, and a decrease in slough and the amount of exudate that were statistically significant (p = 0.021). No participant had severe or local adverse events during the study period. Epidermal growth factor was effective in the treatment of chronic wounds, especially diabetic ulcers, resulting in the reduction of the wound area and the improvement of tissue and exudate quality.

Functional Electrospun Nanofibers Loaded with Plantago Major L. Extract for Potential Use in Cutaneous Wound Healing

“…In order to correlate the absorbance values with extract concentrations in the media, calibration curve of P. major dry extract in PBS solution was plotted. Since the addition of fresh solution alters the P. major extract concentration, it was corrected by using Equation (3).…”

“…It provides a barrier against environmental, chemical, mechanical, and other damages. This is why skin damage can be considered a major health problem [1][2][3]. Although the skin has the capacity for self-healing, wound healing can be affected and/or delayed due to infection, and necessitate the application of antibiotics [4].…”

Recent advances of the nanocomposite hydrogel as a local drug delivery for diabetic ulcers

“…Previous studies have shown that EGF can greatly promote the proliferation and movement of keratinocytes and fibroblasts, granulation tissue formation, and extracellular matrix synthesis. Exogenous recombinant human EGF (rhEGF) is one of the most widely used growth factors in the treatment of diabetic ulcer ( Tsang et al, 2003 ; Jeong et al, 2020 ; de Oliveira et al, 2022 ). A study reported that a chitosan-based composite hydrogel can be produced by compounding EGF-coated nanoparticles with silver ions using nanocapsule technology ( Lee et al, 2021 ).…”