title: Pressure ulcer accelerated healing with local injections of granulocyte macrophage-colony stimulating factor.
abstract: This is the first report of granulocyte macrophage-colony stimulating factor (GM-CSF) inducing accelerated healing of a sacral pressure ulcer in a bedridden patient with bilateral hemiplegia. GM-CSF was diluted and injected locally around and into the ulcer bed every 2-3 days for 2 weeks, then weekly for 4 weeks until complete healing occurred. A new firm granulation tissue was noted within a few days. The ulcer showed 85% healing within 2 weeks and 100% by 2 months. Healing started from the periphery and from within the ulcer bed at sites of GM-CSF injections. It was slower at areas where there was complete necrosis and detachment of skin from underlying tissue. The ulcer remained closed until the patient's sudden death 9 months later. A biopsy of granulation tissue showed inflammatory cells and reactive fibroblasts. The potential role of GM-CSF and growth factors in pressure ulcer therapy and wound healing are discussed.
authors.affiliation: Department of Medicine, American University of Beirut Medical Center, Lebanon.
authors.forename: N S
authors.initials: NS
authors.lastname: El Saghir
authors.forename: A R
authors.initials: AR
authors.lastname: Bizri
authors.forename: N S
authors.initials: NS
authors.lastname: Shabb
authors.forename: T W
authors.initials: TW
authors.lastname: Husami
authors.forename: Z
authors.initials: Z
authors.lastname: Salem
authors.forename: A I
authors.initials: AI
authors.lastname: Shamseddine
mesh_terms: D000368:Aged; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006429:Hemiplegia / Q000150:complications; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D003668:Pressure Ulcer / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D012445:Sacrococcygeal Region; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D016178:Granulocyte-Macrophage Colony-Stimulating Factor