Intralesional epidermal growth factor for diabetic foot wounds: the first cases in Turkey.
BACKGROUND
Intralesional recombinant epidermal growth factor (EGF) was produced in the Centre for Genetic Engineering and Biotechnology (CIGB), Cuba, in 1988 and licensed in 2006. Because it may accelerate wound healing, it is a potential new treatment option in patients with a diabetic foot wound (whether infected or not) as an adjunct to standard treatment (i.e. debridement, antibiotics). We conducted the initial evaluation of EGF for diabetic foot wounds in Turkey.


METHODS
We enrolled 17 patients who were hospitalized in various medical centers for a foot ulcer and/or infection and for whom below the knee amputation was suggested to all except one. All patients received 75 μg intralesional EGF three times per week on alternate days.


RESULTS
The appearance of new granulation tissue on the wound site (≥75%) was observed in 13 patients (76%), and complete wound closure was observed in 3 patients (18%), yielding a 'complete recovery' rate of 94%. The most common side effects were tremor (n=10, 59%) and nausea (n=6, 35%). In only one case,a serious side effect requiring cessation of EGF treatment was noted. That patient experienced severe hypotension at the 16th application session, and treatment was discontinued. At baseline, a total of 21 causative bacteria were isolated from 15 patients, whereascultures were sterile in two patients. The most frequently isolated species was Pseudomonas aeruginosa.


CONCLUSIONS
Thus, this preliminary study suggests that EGF seems to be a potential adjunctive treatment option in patients with limb-threatening diabetic foot wounds.
Department of Infectious Diseases and Clinical Microbiology, University of Adnan Menderes School of Medicine, Aydin, Turkey; bertugrul@adu.edu.tr.
Bulent M
BM
Ertugrul
Department of Infectious Diseases and Clinical Microbiology, University of Ege School of Medicine, Izmir, Turkey.
Cagri
C
Buke
Department of Infectious Diseases and Clinical Microbiology, University of Adnan Menderes School of Medicine, Aydin, Turkey.
Ozlem Saylak
OS
Ersoy
Department Infectious Diseases and Clinical Microbiology, Istanbul Pendik Government Hospital, Istanbul, Turkey.
Bengisu
B
Ay
Department of Plastic and Reconstructive Surgery, Antalya Training and Education Hospital, Antalya, Turkey.
Dilek Senen
DS
Demirez
Department of Orthopaedics and Traumatology, University of Adnan Menderes School of Medicine, Aydin, Turkey.
Oner
O
Savk
diabetic foot; intralesional epidermal growth factor; treatment