Effects of basic fibroblast growth factor on the healing of partial-thickness donor sites. A prospective, randomized, double-blind trial.
A phase I/II clinical study was performed to evaluate the safety and potential efficacy of topical recombinant human basic fibroblast growth factor on the healing of partial-thickness skin graft donor sites in burned children. Each child served as his or her own control. In a blinded and random fashion, one donor site was sprayed with basic fibroblast growth factor (5 microg/cm(2)) on days 0 to 4 after harvest, whereas the other site was treated with vehicle. Twelve patients were entered in the study but one patient died of sepsis that was unrelated to growth factor treatment. Of the remaining 11 patients, no adverse events related to basic fibroblast growth factor occurred. Serum basic fibroblast growth factor levels were never detected and antibody levels remained unchanged. No differences in the rate of epithelialization or days until complete closure were noted (basic fibroblast growth factor = 12.9 +/- 3.9 days, placebo = 12.2 +/- 5.5 days; mean +/- standard error of the mean). No differences in pain, itching, wound fragility, erythema, scarring, or pigmentation were noted. All of the scars matured within 1 year with good to excellent results. Investigators, patients, or families could not distinguish between the two wounds. Although basic fibroblast growth factor proved safe, no enhancement of donor site healing was seen in this small study. Because the time for donor site healing limits subsequent autograft use in patients with sizeable burns, studies should focus on accelerating healing in patients with larger burns where donor site healing is delayed and reharvest is required.
Greenhalgh
D G
DG
Shriners Burns Institute, Cincinnati, Ohio, USA.
Rieman
M
M