The Long-Term Outcomes Following the Application of Intralesional Epidermal Growth Factor in Patients With Diabetic Foot Ulcers

Abstract

Epidermal growth factor is used as an adjuvant to close the wound in addition to standard care in diabetic foot ulcers. This study aimed to investigate the long-term outcomes after intralesional epidermal growth factor injections in the treatment of diabetic foot ulcers. Thirty-six feet of 34 patients (n = 34) with diabetic foot ulcers were included. Patient demographics, Wagner classifications, recurrence and amputation rates, Foot Function Index, Short Form 36, and American Academy of Orthopedic Surgeons Foot and Ankle Module scores were evaluated at the final follow-up examination. The mean age was 61.000 +/- 13.743 years. The mean duration of wounds was 240.200 +/- 146.385 days. A mean of 18.125 +/- 4.494 (range 9 to 24) doses were applied. Wound closure was achieved in 33 of the 36 (91.7%) lesions. A complete response (granulation tissue >75% or wound closure) was observed in 29 (87.9%) lesions. The mean time to wound closure was 52.08 +/- 10.65 (range 25 to 72) days. At the 5-year follow-up, 4 patients were lost to follow-up because of exitus owing to diabetic complications. Of the remaining 29 patients, 27 were ulcer free. In 2 patients (2 lesions, 6.9%) toe amputation was performed due to ischemic necrosis. The mean Foot Function Index, American Academy of Orthopedic Surgeons Foot and Ankle Core Scale, and AAOS Shoe Comfort Scale scores were 55.40 +/- 12.15, 65.92 +/- 17.56, and 56.42 +/- 11.98, respectively. Complete wound healing and a low recurrence and amputation rates could be obtained with intralesional epidermal growth factor added to the standard treatment protocol. (C) 2018 by the American College of Foot and Ankle Surgeons. All rights reserved.