Combined treatment using artificial dermis and basic fibroblast growth factor (bFGF) for intractable fingertip ulcers caused by atypical burn injuries

Abstract

Artificial dermis effectively induces regeneration of socalled dermis-like granulation tissue when applied to skin defects caused by trauma, burn or other injuries. However, when the blood circulation is poor in the surrounding tissues, it seems better to avoid the use of artificial dermis. Gospodarowicz et al. [1] isolated a protein from bovine pituitary gland that markedly promoted growth of fibroblasts. This protein was named fibroblast growth factor (FGF). Bohlen et al. [2] elucidated the presence of two types of FGF protein with different isoelectric points, basic and acidic sides, which were designated as basic (basic FGF) and acidic (acidic FGF). Later, Esch et al. [3] determined the entire amino acid sequence of bovine bFGF, and Abraham et al. [4] determined the entire DNA sequence of human bFGF. The structural elucidation of bFGF coupled with progression of gene recombination technique allowed largescale production of human bFGF. As studies of basic and clinical application rapidly progressed with the history described above, bFGF has recently become commercially available in Japan as Fiblast. bFGF is used for the treatment of intractable skin ulcers to accelerate proliferation of fibroblasts, regeneration of the blood network and finally granulation. In this paper, we describe our clinical experience with the combined use of artificial dermis and bFGF for the treatment of intractable fingertip ulcers caused by atypical burn injuries.