Abstract: BACKGROUND: Nano-silver antibacterial dressings and hydrogels are both new types of dressings used for the treatment of infected wounds. Recombinant human basic fibroblast growth factor is an active peptide drug commonly used for open wounds.
OBJECTIVE: To explore the application of topical recombinant human basic fibroblast growth factor and nano-silver antibacterial hydrogel dressing in wound healing of patients with open ankle fracture after debridement. 
METHODS: A total of 99 patients scheduled for debridement due to open ankle fracture were randomly divided into control group, test group A and test group B, with 33 patients in each group. Vaseline gauze and sterile gauze were applied in the control group. Test group A was treated with recombinant human basic fibroblast growth factor and wounds were covered with sterile gauze. Test group B was treated with recombinant human basic fibroblast growth factor, and wounds were covered with nano-silver antibacterial hydrogel dressing. Dressing in each group was changed every 2 days. The therapeutic measures related to the study should be terminated if one of the following conditions occurs: (1) after debridement, the incision and skin lesions are converted to meet the requirements of elective surgery with regard to skin and soft tissue; (2) wound infections are confirmed and requires further debridement, skin flap transplantation, vacuum negative pressure suction and other measures. After treatment, time of blood supply recovery, time of wound healing, joint swelling score, Visual Analogue Scale score, serum inflammatory factors, oxidative stress index (malondialdehyde, superoxide dismutase) and postoperative incision complications were compared and analyzed. The study protocol was approved by the Medical Ethics Committee of Shengjing Hospital Affiliated to China Medical University, and each patient signed an informed consent form.
RESULTS AND CONCLUSION: Compared with the control group, the total clinical response rate and superoxide dismutase level were significantly higher in the two test groups, and the joint swelling score, Visual Analogue Scale score, levels of interleukin-6, C-reactive protein, tumor necrosis factor-α, D-dimer, and malondialdehyde were significantly lower in the two test groups (P < 0.05). After treatment, the above-mentioned indexes were all lower in the test group B than the test group A (P < 0.05). The blood supply recovery time and wound healing time were also shorter in the test group B than the test group A (P < 0.05). Compared with the test group A and control group, the incidence of postoperative incision complications was lower in the test group B; however, there were no significant difference (P > 0.05). Findings of the present study reveal that topical application of human recombinant basic fibroblast growth factor combined with nano-silver antibacterial hydrogel dressings can relieve swelling and pain, promote wound healing, relieve inflammatory responses and oxidative stress, and effectively reduce postoperative incision complications.

Key words: nano-silver antibacterial hydrogel dressing, recombinant human basic fibroblast growth factor, open ankle fracture, wound healing