A short course of granulocyte-colony-stimulating factor to accelerate wound repair in patients undergoing surgery for sacrococcygeal pilonidal cyst: proof of concept.
OBJECTIVE
Stem cells, namely easily accessible bone marrow-derived cells (BMC), are reportedly capable of tissue repair in different damaged organs and might favor wound healing. The present study was undertaken to evaluate the feasibility and safety of BMC mobilization induced by granulocyte-colony-stimulating factor (G-CSF) in patients undergoing surgery for sacrococcygeal pilonidal cysts (SPC). To evaluate the possible clinical benefit of G-CSF in reducing the time to complete resolution, a comparison with a control group receiving surgery without G-CSF was performed.


METHODS
Eight patients with complex SPC were included in this prospective trial. Patients were treated with G-CSF (5 µg/kg b.i.d.) for 3 consecutive days; standard surgical exeresis of the pilonidal cyst was scheduled on day 2 of mobilization. Mobilization was assessed in terms of circulating CD34(+) cells and granulocyte-macrophage colony-forming unit (CFU-GM) progenitors.


RESULTS
Mobilization of CD34(+) cells and CFU-GM occurred in all patients, along with a marked increase in white blood cells (median peak value 28 435/µL, day 3). G-CSF was well tolerated and no adverse events occurred. All patients received the planned surgical treatment without any complications. Interestingly, the G-CSF group patients had a median time to resolution (117 days, range 110-130) significantly shorter than control patients (145 days, range 118-168) (P = 0.034).


CONCLUSIONS
G-CSF administration, along with BMC mobilization, is feasible and well tolerated in patients undergoing surgery for SPC; clinical results compare favorably with those observed in controls not receiving G-CSF; the results suggest the potential use of G-CSF as an additional treatment to accelerate wound healing in patients undergoing surgery.
VI Division of General Surgery, AOU San Giovanni Battista, University of Torino, Italy.
Carlo Maria Fronticelli
CM
Baldelli
Marco
M
Ruella
Stefano
S
Scuderi
Manuela
M
Monni
Roberto
R
Passera
Paola
P
Omedè
Corrado
C
Tarella
D000328:Adult; D001854:Bone Marrow Cells / Q000166:cytology / Q000187:drug effects; D064987:Cell- and Tissue-Based Therapy; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D008297:Male; D010864:Pilonidal Sinus / Q000473:pathology / Q000601:surgery / Q000628:therapy; D012445:Sacrococcygeal Region / Q000473:pathology / Q000601:surgery; D014945:Wound Healing / Q000187:drug effects*
D016179:Granulocyte Colony-Stimulating Factor