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Use of topical recombinant human platelet–derived growth factor BB in abdominal wound separation

      Abstract

      Objective: The purpose of this study was to determine whether the topical application of recombinant human platelet-derived growth factor gel influences healing after abdominal wound separation. Study design: A double-blinded randomized placebo-controlled trial was conducted in patients with surgical wound separation. Results: Ten patients were randomized to treatment, and 11 patients were randomized to placebo. There was no difference between groups with regard to age, initial wound volume, type of surgical procedure, incision, or body mass index. Patients in the placebo group received 47 ± 24 days of therapy. Patients in the treatment group received 29 ± 14 days of therapy (P = .057). The wounds of the placebo group closed 54 ± 26 days after operation. Wounds in the treatment group closed in 35 ± 15 days (P = .05). Wound closure rates were significantly different, as determined by Kaplan-Meier analysis. Conclusion: Our preliminary study suggests that the topical application of 0.01% recombinant human platelet-derived growth factor gel accelerates healing of separated surgical wounds. Additional studies will be required to determine comparative efficacy and effectiveness relative to the current clinical practice of wound granulation and secondary closure. (Am J Obstet Gynecol 2002;186:701-4.)

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      References

        • Martens MG
        • Kolrud BL
        • Faro S
        • Maccato M
        • Hammill H.
        Development of wound infection or separation after cesarean delivery: prospective evaluation of 2,431 cases.
        J Reprod Med. 1995; 40: 171-175
        • Dicker RC
        Complications of abdominal and vaginal hysterectomy among women of reproductive age in the United States (the collaborative review of sterilization).
        Am J Obstet Gynecol. 1982; 144: 841-848
        • Haley RW
        • Culver DH
        • Morgan WM
        • White JW
        • Emort TG
        • Hooton TM
        Identifying patients at high risk of surgical wound infection: a simple multivariate index of patient susceptibility and wound contamination.
        Am J Epidemiol. 1985; 121: 206-215
        • Classen DC
        • Evans RS
        • Pestotnik SL
        • Horn SD
        • Menlove RL
        • Burke JP
        The timing of prophylactic administration of antibiotics and the risk of surgical wound infections.
        N Engl J Med. 1992; 326: 281-286
        • Shapiro M
        • Munoz A
        • Tager IB
        • Schoenbaum SC
        • Polk BF
        Risk factors for infection at the operative site after abdominal or vaginal hysterectomy.
        N Engl J Med. 1982; 307: 1661-1666
        • Kurz A
        • Sessler DI
        • Lenhardt R
        Perioperative normothermia to reduce the incidence of surgical wound infection and shorten hospitalization.
        N Engl J Med. 1996; 334: 1209-1215
      1. Greit R, Oxan A, Horn EP, Kurz A, Sessler DI. Supplemental peri- operative oxygen to reduce the incidence of surgical wound infection. N Engl J Med 200;342:161-7.

        • Walters MD
        • Dombroski RA
        • Davidson SA
        • Mandel PC
        • Gibbs RS
        Reclosure of disrupted abdominal incisions.
        Obstet Gynecol. 1990; 76: 597-602
        • Dodson MK
        • Magann EF
        • Meeks GR
        A randomized comparison of secondary closure and secondary intention in patients with superficial wound dehiscence.
        Obstet Gynecol. 1992; 80: 321-324
        • Mustoe TA
        • Cutler NR
        • Allman RM
        • Goode PS
        • Deuel TF
        • Prause JA
        • et al.
        A phase II study to evaluate recombinant platelet-derived growth factor-BB in the treatment of stage 3 and 4 pressure ulcers.
        Arch Surg. 1994; 129: 213-219
        • Knighton DR
        • Ciresi K
        • Fiegel VD
        • Schumerth S
        • Butler E
        • Cerra F
        Stimulation of repair in chronic, nonhealing, cutaneous ulcers using platelet-derived wound healing formula.
        Surgery. 1990; 170: 56-60
        • Subrahmanyam M
        Topical application of honey in treatment of burns.
        Br J Surg. 1991; 78: 497-498
        • Wu L
        • Brucker M
        • Gruskin E
        • Roth SI
        • Mustoe TA
        Differential effects of platelet-derived growth factor BB in accelerating wound healing in aged versus young animals: the impact of tissue hypoxia.
        Plast Reconstr Surg. 1997; 99: 815-822
        • Soler PM
        • Wright TE
        • Smith PD
        • Maggi SP
        • Hill DP
        • Ko F
        • et al.
        In vivo characterization of keratinocyte growth factor-2 as a potential wound healing agent.
        Wound Repair Regen. 1999; 7: 172-178
        • Nilsson T
        The relative rate of wound healing in longitudinal and transverse laparotomy incisions: animal experiments.
        Acta Chirurgica Scand. 1982; 148: 251-256
        • Ellis H
        • Coleridg-Smith PD
        • Joyce AD
        Abdominal incisions: vertical or transverse?.
        Postgraduate Med J. 1984; 60: 407-410
        • Johnson B
        • Sharp R
        • Thursby P
        Incisional hernias: incidence following abdominal aortic aneurysm repair.
        J Cardiovasc Surg. 1995; 36: 487-490
        • Beer HD
        • Longaker MT
        • Werner S
        Reduced expression of PDGF and PDGF receptors during impaired wound healing.
        J Invest Dermatol. 1997; 109: 123-128
        • Nwomeh BC
        • Yager DR
        • Cohen IK
        Physiology of the chronic wound.
        Clin Plast Surg. 1998; 25: 341-356