Using Recombinant Human Epidermal Growth Factor with Standard of Good Care for Diabetic Foot Ulcers in Inoperable Patients

J Korean Wound Management Soc > Volume 4(1); 2008 > Article

Original

Journal of the Korean Wound Management Society 2008;4(1): 16-19.

수술적 치료가 불가능한 당뇨발 환자에서 표피성장인자의 효능 및 올바른 치료 접근 방법

이효보¹ㆍ홍준표²

¹서울아산병원 성형외과, ²울산대학교 의과대학 성형외과학교실

Using Recombinant Human Epidermal Growth Factor with Standard of Good Care for Diabetic Foot Ulcers in Inoperable Patients

Hyo Bo Lee¹, Joon Pio Hong²

¹Department of Plastic Surgery, Asan Medical Center, Seoul, Korea, ²School of Plastic Surgery, College of Medicine, Ulsan University, Ulsan, Korea

Published online: 31 May 2008.

ABSTRACT

To study the healing effect of epidermal growth factor on diabetic ulcers with Mitochondria Encephalopathy Lactic Acidosis Syndrome (MELAS) resistant to standard care. When the standard care alone was not sufficient for a patient suffering from diabetic foot ulcer, epidermal growth factor (Easyef^Ⱂ, DaeWoong Pharm. Seoul, Korea) was added to the protocol. The wound was monitored for 10 weeks. A 46-year-old man with 15 year history for type 2 diabetes mellitus and Mitochondria Encephalopathy Lactic Acidosis Syndrome (MELAS) presented with 2 chronic foot ulcers (3×3 cm, 3×3.4 cm). Prior to the study, the patient was treated with standard care using advanced dressings, off-loading, and hyperbaric oxygen therapy for 12 weeks but failed to achieve improvement. Along with good standard care, Easyef^Ⱂ(DaeWoong Pharm. Seoul, Korea) was added to the regimen and both ulcers achieved wound closure within 10 and 7 weeks. Good standard of care for diabetic foot ulceration includes glycemic control, off loading, good nutrition, wound management and education. Chronic wound environment frequently with depleted growth factors can prevent the wound from healing despite of good care. Recombinant human Epidermal growth factor (rh-EGF) can play a role in healing by augmenting cell proliferation, migration and differentiation on target cells. This study reports such a case with successful use of rh-EGF. (J Korean Wound Management Soc 2008;4:16-19)

Key Words: EGF, Diabetic ulceration, MELAS