David L Steed1. 1. Department of Surgery, University of Pittsburgh, UPMC Presbyterian Hospital, Pittsburgh, Pa 15213, USA. steeddl@hotmail.com
Abstract
BACKGROUND: Diabetic foot ulcer is a major health care problem that leads to amputation. METHODS:Patients with full-thickness diabetic neurotrophic foot ulcers present for longer than 8 weeks without healing were entered into one of five randomized, prospective, blinded clinical trials comparing treatment with platelet-derived growth factor (PDGF) or placebo gel for up to 20 weeks. The purpose of these trials was to assess the safety and efficacy of PDGF used with good wound care. Each patient had an adequate arterial blood supply, was free of infection, was off-loaded, and was extensively débrided. The ulcers had been present for at least 8 weeks. RESULTS:A total of 922 patients were entered into the study. Analysis of ulcers with a baseline area of less than 10 cm (95 percent of patients) showed that patients treated with PDGF at 100 mug/g had a significant increase in complete healing compared with patients given placebo (50 percent versus 36 percent, p < 0.007). PDGF also decreased the time to complete healing by 30 percent (14 weeks versus 20 weeks, p = 0.01). Adverse events were similar in both treatment groups, as were recurrent ulcer rates. CONCLUSION:PDGF applied once daily was effective in healing chronic diabetic neurotrophic foot ulcers when used in conjunction with good wound care.
RCT Entities:
BACKGROUND:Diabetic foot ulcer is a major health care problem that leads to amputation. METHODS:Patients with full-thickness diabetic neurotrophic foot ulcers present for longer than 8 weeks without healing were entered into one of five randomized, prospective, blinded clinical trials comparing treatment with platelet-derived growth factor (PDGF) or placebo gel for up to 20 weeks. The purpose of these trials was to assess the safety and efficacy of PDGF used with good wound care. Each patient had an adequate arterial blood supply, was free of infection, was off-loaded, and was extensively débrided. The ulcers had been present for at least 8 weeks. RESULTS: A total of 922 patients were entered into the study. Analysis of ulcers with a baseline area of less than 10 cm (95 percent of patients) showed that patients treated with PDGF at 100 mug/g had a significant increase in complete healing compared with patients given placebo (50 percent versus 36 percent, p < 0.007). PDGF also decreased the time to complete healing by 30 percent (14 weeks versus 20 weeks, p = 0.01). Adverse events were similar in both treatment groups, as were recurrent ulcer rates. CONCLUSION: PDGF applied once daily was effective in healing chronic diabetic neurotrophic foot ulcers when used in conjunction with good wound care.
Authors: Eiichi A Miyasaka; Shreya Raghavan; Robert R Gilmont; Krittika Mittal; Sita Somara; Khalil N Bitar; Daniel H Teitelbaum Journal: Pediatr Surg Int Date: 2011-02 Impact factor: 1.827
Authors: Thomas A Davis; Alexander Stojadinovic; Khairul Anam; Mihret Amare; Shruti Naik; George E Peoples; Douglas Tadaki; Eric A Elster Journal: Int Wound J Date: 2009-02 Impact factor: 3.315