Efficacy of combined treatment with vacuum sealing drainage and recombinant human epidermal growth factor for refractory wounds in the extremities and its effect on serum levels of IL-6, TNF-α and IL-2

Tan,Lei; Hou,Zhongyu; Gao,Yanzhi

doi:10.3892/etm.2017.5360

Efficacy of combined treatment with vacuum sealing drainage and recombinant human epidermal growth factor for refractory wounds in the extremities and its effect on serum levels of IL-6, TNF-α and IL-2

Authors:
- Lei Tan
- Zhongyu Hou
- Yanzhi Gao
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Affiliations: Traumatology Ward I, Zhangqiu Hospital of Chinese Medicine, Zhangqiu, Shandong 250200, P.R. China, Traumatology Ward II, Laiwu Iron and Steel Group Co. Ltd. Hospital, Laiwu, Shandong 271126, P.R. China, Department of Emergency, The Central Hospital of Shengli Oilfield, Dongying, Shandong 257034, P.R. China
Published online on: October 24, 2017 https://doi.org/10.3892/etm.2017.5360
Pages: 288-294
Copyright: © Tan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The objective of this study was to investigate the efficacy of combined treatment with vacuum sealing drainage (VSD) and recombinant human epidermal growth factor (rhEGF) for refractory wounds in the extremities, and its effect on serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and IL-2. Ninety-eight patients with refractory wounds in the extremities were recruited and randomly divided into the combined treatment group (underwent VSD and rhEGF treatment) and control group (underwent VSD only) with 49 cases each. Formation of granulation tissue on the wound surface was assessed and scored. The wound healing rate was calculated after 1 week of treatment, and the time of complete healing was recorded. Serum levels of IL-6, IL-2, and TNF-α were measured using enzyme-linked immunosorbent assay. After 1 week of treatment, granulation tissue formation on wound surfaces was significantly improved (p<0.05) compared with that before treatment in both groups. Moreover, granulation tissue formation on wound surfaces was superior in the combined treatment group than in the control group (p<0.05). The wound healing rate was 63.50±4.75% in the combined treatment group and 31.79±3.52% in the control group, and the difference was statistically significant (p<0.05). The time of complete healing was 15.11±2.24 days in the combined treatment group and 19.63±2.76 days in the control group, and the difference was statistically significant (p<0.05). The serum levels of IL-6, IL-2, and TNF-α, in the two groups were significantly lower than those before treatment (p<0.05). Moreover, the levels in the combined treatment group were significantly lower than those in the control group (p<0.05). In conclusion, combined treatment with VSD and rhEGF reduced inflammation and shortened the time of complete healing of refractory wounds in the extremities. Measurement of the levels of related inflammatory factors provided a reference for the prognosis of refractory wounds.

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1	Game FL, Attinger C, Hartemann A, Hinchliffe RJ, Löndahl M, Price PE and Jeffcoate WJ: International Working Group on the Diabetic Foot: IWGDF guidance on use of interventions to enhance the healing of chronic ulcers of the foot in diabetes. Diabetes Metab Res Rev. 32 Suppl 1:75–83. 2016. View Article : Google Scholar : PubMed/NCBI
2	Kim H, Kong WH, Seong KY, Sung DK, Jeong H, Kim JK, Yang SY and Hahn SK: Hyaluronate-epidermal growth factor conjugate for skin wound healing and regeneration. Biomacromolecules. 17:3694–3705. 2016. View Article : Google Scholar : PubMed/NCBI
3	Suh H, Lee AY, Park EJ and Hong JP: Negative pressure wound therapy on closed surgical wounds with dead space: Animal study using a swine model. Ann Plast Surg. 76:717–722. 2016. View Article : Google Scholar : PubMed/NCBI
4	Poon H, Le Cocq H, Mountain AJ and Sargeant ID: Dermal fenestration with negative pressure wound therapy: A technique for managing soft tissue injuries associated with high-energy complex foot fractures. J Foot Ankle Surg. 55:161–165. 2016. View Article : Google Scholar : PubMed/NCBI
5	Memon AA, Sundquist K, Ahmad A, Wang X, Hedelius A and Sundquist J: Role of IL-8, CRP and epidermal growth factor in depression and anxiety patients treated with mindfulness-based therapy or cognitive behavioral therapy in primary health care. Psychiatry Res. 254:311–316. 2017. View Article : Google Scholar : PubMed/NCBI
6	Guo XF, Zhu XF, Cao HY, Zhong GS, Li L, Deng BG, Chen P, Wang PZ, Miao QF and Zhen YS: A bispecific enediyne-energized fusion protein targeting both epidermal growth factor receptor and insulin-like growth factor 1 receptor showing enhanced antitumor efficacy against non-small cell lung cancer. Oncotarget. 8:27286–27299. 2017.PubMed/NCBI
7	Gomez-Villa R, Aguilar-Rebolledo F, Lozano-Platonoff A, Teran-Soto JM, Fabian-Victoriano MR, Kresch-Tronik NS, Garrido-Espíndola X, Garcia-Solis A, Bondani-Guasti A, Bierzwinsky-Sneider G, et al: Efficacy of intralesional recombinant human epidermal growth factor in diabetic foot ulcers in Mexican patients: A randomized double-blinded controlled trial. Wound Repair Regen. 22:497–503. 2014. View Article : Google Scholar : PubMed/NCBI
8	Singla S, Garg R, Kumar A and Gill C: Efficacy of topical application of beta urogastrone (recombinant human epidermal growth factor) in Wagner's Grade 1 and 2 diabetic foot ulcers: Comparative analysis of 50 patients. J Nat Sci Biol Med. 5:273–277. 2014. View Article : Google Scholar : PubMed/NCBI
9	Wu W, Zeng LN, Peng YY, Lu XH, Li CY and Wang ZC: The effects of recombinant human epithelialgrowth factor and protein-free calf blood extract for recovery of corneal mechanical epithelial defects healing and neovascularization. Eur Rev Med Pharmacol Sci. 18:3406–3411. 2014.PubMed/NCBI
10	Shin JU, Kang SW, Jeong JJ, Nam KH, Chung WY and Lee JH: Effect of recombinant human epidermal growth factor on cutaneous scar quality in thyroidectomy patients. J Dermatolog Treat. 26:159–164. 2015. View Article : Google Scholar : PubMed/NCBI
11	Ojalvo AG, Acosta JB, Marí YM, Mayola MF, Pérez CV, Gutiérrez WS, Marichal II, Seijas EÁ, Kautzman AM, Pacheco AE, et al: Healing enhancement of diabetic wounds by locally infiltrated epidermal growth factor is associated with systemic oxidative stress reduction. Int Wound J. 14:214–225. 2017. View Article : Google Scholar : PubMed/NCBI
12	Yang F, Shi B and Cao L: Effect of vacuum sealing drainage on the expression of VEGF and miRNA-17-5p in seawater-immersed blast-injury wounds. Exp Ther Med. 13:1081–1086. 2017. View Article : Google Scholar : PubMed/NCBI
13	Braun LR, Fisk WA, Lev-Tov H, Kirsner RS and Isseroff RR: Diabetic foot ulcer: An evidence-based treatment update. Am J Clin Dermatol. 15:267–281. 2014. View Article : Google Scholar : PubMed/NCBI
14	Ertugrul BM, Lipsky BA and Guvenc U; Turkish Intralesional Epidermal Growth Factor Study Group for Diabetic Foot Wounds, : An assessment of intralesional epidermal growth factor for treating diabetic foot wounds the first experiences in Turkey. J Am Podiatr Med Assoc. 107:17–29. 2017. View Article : Google Scholar : PubMed/NCBI
15	Cheng HT, Hsu YC and Wu CI: Efficacy and safety of negative pressure wound therapy for Szilagyi grade III peripheral vascular graft infection. Interact Cardiovasc Thorac Surg. 19:1048–1052. 2014. View Article : Google Scholar : PubMed/NCBI
16	Novak A, Khan WS and Palmer J: The evidence-based principles of negative pressure wound therapy in trauma and orthopedics. Open Orthop J. 8:168–177. 2014. View Article : Google Scholar : PubMed/NCBI
17	Xing B, Wu F, Li T, Qi S, Xie J and Ye Z: Experimental study of comparing rhEGF with rhβFGF on improving the quality of wound healing. Int J Clin Exp Med. 6:655–661. 2013.PubMed/NCBI
18	Dumantepe M, Fazliogullari O, Seren M, Uyar I and Basar F: Efficacy of intralesional recombinant human epidermal growth factor in chronic diabetic foot ulcers. Growth Factors. 33:128–132. 2015. View Article : Google Scholar : PubMed/NCBI
19	Gainza G, Aguirre JJ, Pedraz JL, Hernández RM and Igartua M: rhEGF-loaded PLGA-Alginate microspheres enhance the healing of full-thickness excisional wounds in diabetised Wistar rats. Eur J Pharm Sci. 50:243–252. 2013. View Article : Google Scholar : PubMed/NCBI
20	Nasole E, Nicoletti C, Yang ZJ, Girelli A, Rubini A, Giuffreda F, Di Tano A, Camporesi E and Bosco G: Effects of alpha lipoic acid and its R+ enantiomer supplemented to hyperbaric oxygen therapy on interleukin-6, TNF-α and EGF production in chronic leg wound healing. J Enzyme Inhib Med Chem. 29:297–302. 2014. View Article : Google Scholar : PubMed/NCBI
21	Rozenblum N, Zeira E, Bulvik B, Gourevitch S, Yotvat H, Galun E and Goldberg SN: Radiofrequency ablation: inflammatory changes in the periablative zone can induce global organ effects, including liver regeneration. Radiology. 276:416–425. 2015. View Article : Google Scholar : PubMed/NCBI
22	Okada Y, Shirai K, Reinach PS, Kitano-Izutani A, Miyajima M, Flanders KC, Jester JV, Tominaga M and Saika S: TRPA1 is required for TGF-β signaling and its loss blocks inflammatory fibrosis in mouse corneal stroma. Lab Invest. 94:1030–1041. 2014. View Article : Google Scholar : PubMed/NCBI