Efficacy of growth factors in the accelerated closure of interstices in explanted meshed human skin grafts.

Meshed split-thickness skin grafts, especially when required to be widely spread, do not obtain immediate biologic wound closure. In cases of patients with burns that cover a large percentage of the body surface area, this leaves the patient at risk for metabolic problems and life-threatening infection. Several cytokines and growth factors could theoretically affect the rate of epithelialization and, therefore, the rate of meshed graft interstitial closure. With the use of human meshed skin grafts explanted onto athymic "nude" rats, the epithelialization kinetics of interleukin-4 (IL-4), macrophage colony-stimulating factor (MCSF), keratinocyte growth factor-1 (KGF-1), keratinocyte growth factor-2 (KGF-2), basic fibroblast growth factor (bFGF), and transforming growth factor beta-2 (TGF(B2)) were investigated; the results were compared with the rates of epithelialization of grafts treated with a vehicle control. On postoperative day 3, wounds treated with IL-4, KGF-2, bFGF, and TGF(B2) showed a significantly increased rate of interstitial closure (P < .05). On postoperative days 5 and 7, wounds treated with KGF-2, bFGF, and TGF(B2) all exhibited a significantly higher rate of interstitial closure than the grafts in the control group (P < .05). These data suggest that epithelialization kinetics can be accelerated with the use of several topical growth factors, and they provide support for a future clinical trial.