External use of recombinant human granulocyte-macrophage colony stimulating factor hydrogel to repair thick skin graft donor sites

doi:10.3969/j.issn.2095-4344.2015.34.010

Abstract

Abstract:

BACKGROUND: There are less reports about the external use of recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) hydrogel to repair thick skin graft donor sites. By now, relevant self-control studies have not been retrieved.

OBJECTIVE: To observe the effect of rhGM-CSF on the repair of thick skin graft donor sites.

METHODS: Sixty patients with burns and scar hyperplasia undergoing autologous thick skin grafting were enrolled, 47 males and 13 females, aged 18-65 years. The thigh was selected as donor sites. According to the depth of donor sites, the patients were divided into 0.4 mm and 0.55 mm groups, with 30 cases in each group. Wounds on the symmetric areas with equal area and same depth were selected or wounds with same depth were selected and divided equally. The wounds were randomly assigned into treatment group and control group. The treatment group was treated with rhGM-CSF hydrogel externally; the control group was only given vaseline dressing. At postoperative 3, 7, 10, 14 days, the fresh dressing was changed. Then, the wound appearance, healing time, healing rate and adverse effects were observed in the two groups.

RESULTS AND CONCLUSION: At 14 days after operation, the wound surface was smoother and the pigmentation was relatively less in the treatment group compared with the control group; the degree of wound pain was less in the treatment group than the control group during dressing change (P < 0.05). At 10 and 14 days after operation, the healing rate and healing time were better in the treatment group than the control group (P < 0.05). No general malaise or hypersensitivity cases were reported, and local issue hyperplasia was also not found. All the above indicate that the external use of the rhGM-CSF hydrogel can evidently shorten the healing time and improve the healing condition when it is applied in the thick skin graft donor sites.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Granulocyte Macrophage Colony-Stimulating Factors, Recombinant, Gels, Surgical Sponges

CLC Number:

R318

Li Chao, Li Shou-ju, Li Yong-tao, Fu Zi-yang, Ren Chang-yin. External use of recombinant human granulocyte-macrophage colony stimulating factor hydrogel to repair thick skin graft donor sites [J]. Chinese Journal of Tissue Engineering Research, 2015, 19(34): 5458-5462.

Figures/Tables 2

References

[1] 刘艺,李叶扬.高压氧加速供皮区创面愈合的探讨[J].伤残医学杂志,1997,5(4):22-24.
[2] 陈宝国,乔群,黄渭清,等.高压氧治疗促进供皮区创面愈合的临床研究[J].中国美容医学,2010,19(5):627-628.
[3] 张放,唐洪泰,王广庆.含银亲水纤维敷料封闭中厚皮供皮区创面的临床观察[J].第二军医大学学,2013,34(11):1206-1209.
[4] 杨苓山,王光毅,江榕,等.三种敷料应用于供皮区的临床对照研究[J].华南国防医学杂志,2014,28(10):955-957.
[5] 张宏峰,张雷,李明,等.不同敷料组合对烧伤患者供皮区创面微环境的影响[J].中国医刊,2014,49(12):49-51.
[6] 许腊梅,刘宸.两种敷料用于中厚皮片供皮区创面处理的效果观察[J].现代医学,2015,43(2):207-210.
[7] 马杰,李艳.碱性成纤维细胞生长因子凝胶治疗烧伤患者供皮区创面的疗效观察[J].中华烧伤杂志,2013,29(4):205-207.
[8] 何炳根,冯裕董,苏淑云.重组人表皮生长因子在烧伤供皮区创面的应用[J].现代医院,2009,9(1):58-59.
[9] 郭杏,谭美云,郭力,等.重组人表皮细胞生长因子对供皮区创面的修复[J].中国组织工程研究与临床康复,2010,14(5):862-864.
[10] Malik IA,Zahid M,Haq S,et al.Effect of subcutaneous injection of granulocyte macorphage colony stimulating factor(GM-CSF) on healing of chronic refractory wounds.Eur J Surg.1998;164(10):737-744.
[11] Kawada A,Hiruma M,Noguchi H,et al.Granulocyte and macrophage colony stimulating factors stimulate proliferation of human keratinocytes.Arch Dermatol Res.1997;289: 600-602.
[12] 杨柳,张友群,刘娟娟,等.重组人粒细胞巨噬细胞集落刺激因子在压疮护理中的应用[J]. 中国美容医学,2014,23(4):332-335.
[13] 刘继松,方勇,姚敏,等.重组人粒细胞巨噬细胞集落刺激因子凝胶剂对深Ⅱ度烧伤创面溶痂及愈合影响的临床研究[J].中国修复重建外科杂志,2011,25(9):1059-1062.
[14] 郭万里,段鹏,雷晋.重组人粒细胞巨噬细胞集落刺激因子凝胶剂用于深Ⅱ°烧伤创面治疗的临床疗效[A].中华医学会烧伤外科学分会2012年学术年会论文汇编[C].2012.
[15] 李辉武,沈贤友,谢俊,等.外用重组人粒细胞巨噬细胞刺激因子凝胶剂联合优拓治疗深Ⅱ度烧伤30例疗效分析[J].中国冶金工业医学杂志,2014,31(4):379-380.
[16] 邱学文,王甲汉,杨磊,等.重组人粒细胞巨噬细胞集落刺激因子治疗烧伤后残余创面[J].实用医学杂志,2011,27(7):1195-1197.
[17] 陈明华.外用rhGM-CSF凝胶治疗大面积烧伤残余创面的研究[D].广西医科大学,2014.
[18] Raghavan R,Sharma PS,Kumar P.Abacus VAS in burn pain assessment.Clin J Pain.1999;15(3):238.
[19] Singer AJ,Clark RA.Cutaneous wound healing.N Engl J Med. 1999;341:738-746.
[20] 史济湘,陆树良,廖镇江,等.烧伤创面愈合机制与新技术[M].北京:人民军医出版社,2003:7-9.
[21] Moosbauer C,Morgenstern E,Cuvelier SL,et al.Eosinophils are a major intravascular location for tissue factor storage and exposure.Blood.2007;109(3):995-1002.
[22] Mann A,Breuhahn K,Schirmacher R,et al. Keratinocyte- derived granulocyte-macorphage colony stimulating factor accelerates wound healing:Stimulation of keratinocyte proliferation,granulation tissue formation,and vascularization. J Invest Dermatol.2001;117(6):1382-1390.
[23] Mann A,Niekisch K,Schirmacher P,et al. Granulocyte- macorphage colony stimulating factor is essential for normai wound healing.J Investing Dermatol Symp Proc.2006;11(1): 87-92.
[24] Fang Y,Gong SJ,Xu YH,et al.Impaired cutaneous wound healing in granulocyte/macorphage colony stimulating factor knockout mice.Br J Dermatol.2007;157(3):458-465.
[25] Cianfarani F,Tommasi R,Failla CM,et al. Granulocyte/ macrophage colony-stimulating factor treatment of human chronic ulcers promotes angiogenesis associated with de novo vascular endothelial growth factor transcription in the ulcer bed.Br J Dermatol. 2006;154(1):34-41.