Experience with the use of perilesional and intralesional recombinant human epidermal growth factor (nepidermin) in the treatment of patients with chronic venous ulcers
Cacua Sánchez, María Teresa
Giraldo, Luis Fernando
Vascular Disease Management, 1553-8036, Vol. 16, Num. 1, 2019, p.E3-E8
H M P Communications
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Background. Venous ulcers are a serious and highly recurring health problem that cause significant impact on the population. Currently, there are several treatment options available; however, they still entail a great therapeutic challenge, generating implications to the patient's health and quality of life. Objective. To describe the result in the healing of venous ulcers with the perilesional and intralesional use of recombinant human epidermal growth factor (nepidermin) in patients with a clinical, etiology, anatomic, pathophysiology (CEAP) VI venous insufficiency diagnosis. Methods. Retrospective review of a multicenter case series study of 28 patients with a chronic leg venous ulcer diagnosis treated at the Centro de Cirugía Ambulatoria and at Centro Médico Nuestra IPS in the city of Bogotá between November 2016 and December 2017 who received nepidermin through perilesional and intralesional injection. Patient age, sex, ulcer size, and wound-healing response assessment were evaluated. Results. In the studied series, the patients were on average 60 years of age and mostly women (61%), and many of them (47%) had an ulcer located in the medial malleolus; based on the severity of the wound, it was found that upon treatment initiation, a total of 9 patients (26%) were classified as severe, 25 patients (71%) as moderate, and 1 patient (3%) as minor. According to the posttreatment severity score, 28 lesions (80%) dropped to a minor level, 5 lesions (14%) were moderate, and 2 lesions (6%) remained severe. A 100% lesion epithelialization rate was achieved in 69% of patients, and global improvement of the patients observed was 86%. The average duration of the treatment was 5.6 weeks (range, 4-8 weeks). The average number of 75 µg nepidermin vials used was 15.7 per patient. Conclusions. The results indicate that nepidermin achieved a high level of improvement in the lesion severity index, allowing epithelialization and wound healing in most cases over a short period of time.
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