title: Novel collagen/gelatin scaffold with sustained release of basic fibroblast growth factor: clinical trial for chronic skin ulcers.
abstract: Chronic skin ulcers such as diabetic ulcers and venous leg ulcers are increasing and are a costly problem in healthcare. We have developed a novel artificial dermis, collagen/gelatin sponge (CGS), which is capable of sustained release of basic fibroblast growth factor (bFGF) for more than 10 days. The objective of this study was to investigate the safety and efficacy of CGS impregnated with bFGF in the treatment of chronic skin ulcers. Patients with chronic skin ulcers that had not healed in at least 4 weeks were treated with CGS impregnated with bFGF at 7 or 14 μg/cm(2) after debridement, and the wound bed improvement was assessed 14 days after application. Wound bed improvement was defined as a granulated and epithelialized area on day 14 with a proportion to the baseline wound area after debridement of 50% or higher. The wound area, the wound area on day 14, and the granulation area on day 14 were independently measured by blinded reviewers in a central review using digital images of wounds taken with a calibrator. Patients were followed up until 28 days after application to observe the adverse reactions related to the application of CGS. From May 2010 to June 2011, 17 patients were enrolled and, in 16 patients, the wound bed improved. Among the randomized patients in step 2, no significant difference was seen between the low-dose group and the high-dose group. No serious adverse reactions were observed. Adverse reactions with a clear causal relationship to the study treatment were mild and patients quickly recovered from them. This study is the first-in-man clinical trial of CGS and showed the safety and efficacy of CGS impregnated with bFGF in the treatment of chronic skin ulcers. This combination therapy could be a promising therapy for chronic skin ulcers.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto City, Japan. mnaoki22@kuhp.kyoto-u.ac.jp
authors.forename: Naoki
authors.initials: N
authors.lastname: Morimoto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Miyuki
authors.initials: M
authors.lastname: Niimi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ito
authors.forename: Rino
authors.initials: R
authors.lastname: Aya
authors.forename: Junpei
authors.initials: J
authors.lastname: Fujitaka
authors.forename: Harue
authors.initials: H
authors.lastname: Tada
authors.forename: Satoshi
authors.initials: S
authors.lastname: Teramukai
authors.forename: Toshinori
authors.initials: T
authors.lastname: Murayama
authors.forename: Chikako
authors.initials: C
authors.lastname: Toyooka
authors.forename: Kazumi
authors.initials: K
authors.lastname: Miura
authors.forename: Satoru
authors.initials: S
authors.lastname: Takemoto
authors.forename: Norikazu
authors.initials: N
authors.lastname: Kanda
authors.forename: Katsuya
authors.initials: K
authors.lastname: Kawai
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yokode
authors.forename: Akira
authors.initials: A
authors.lastname: Shimizu
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000368:Aged; D003094:Collagen / Q000737:chemistry*; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000008:administration & dosage* / Q000737:chemistry / Q000627:therapeutic use*; D005780:Gelatin / Q000737:chemistry*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012883:Skin Ulcer / Q000188:drug therapy* / Q000628:therapy*; D054457:Tissue Scaffolds / Q000009:adverse effects / Q000737:chemistry*
chemical_list: D016222:Fibroblast Growth Factor 2; D005780:Gelatin; D003094:Collagen