113 Basic Fibroblast Growth Factor Successfully Improves Wound Healing with Artificial Skin Substitute

Abstract

Acute wounds caused by the severe and extensive infection such as alpha-hemolytic streptococci or MRSA may be life-threatening in immunocompromised hosts such as steroid users or those with venostasis in the lower legs. The principle of the treatment is the removal of the primary pathogens, however, difficulties of the lower leg reconstruction remain due to the tissue loss and the deficiency of the circulation system after extensive soft tissue debridement. For 10 immediately-developing extensive lower extremity cases, artificial skin substitutes composed of dried bilayer membranes of outer silicone membrane and inner porcine-tendon derived collagen layer (Pelnac®, Gunze Co., Ltd., Kyoto, Japan) were immediately after extensive and meticulous debridement. While the skin substitute integrated into the wound bed for maximally 3 weeks, total 20 micrograms of the basic fibroblast growth factors (bFGF)(Trafermin®, Kaken Pharmaceutical Co. Ltd, Tokyo, Japan) were applied by the 27-Gage syringe daily. The outer membranes were removed and thin partial thickness skin grafting (9–10/1,000 inches) was performed and wound healed uneventfully. The bFGF-treated skin texture was significantly softer compared to control by a durometer (Teclock®, GS-701N, Tokyo, Japan)(p < 0.01), which was a measuring device elastic hard products such as rubbers and polymers. Reconstruction using the porcine-derived artificial skin substitute in the lower extremities after extensive debridement was safe, easy, and reproducible. The quality of the wounds with bFGF significantly improves the healed skin texture.