Effect of local epidermal growth factor on wound healing in diabetic foot

Foot problem in diabetic patients is one of the most common and serious chronic complications and is considered to be a consequence of peripheral neuropathy, peripheral vascular disease and immunopathy. The aim of this study was to compare the efficacy of local epidermal growth factors (EGF) and placebo therapy to facilitate wound healing in diabetics with foot ulcer. This study was a single-blind placebo-controlled trial. Thirty diabetic patients (14 females and 16 males, aged 27-77 years) were treated with EGF and 10 diabetic patients (3 females and 7 males, aged 32-75 years) with placebo. Both groups received debridement, scrubbing with normal saline, systemic antibiotic therapy and bandage with EGF or placebo daily and were followed for 4 weeks. Ulcer closure (%) was calculated by use of an equation [(Final - initial-size)/Initial size] × 100. After 4 weeks, mean closure was significantly higher in EGF group compared with placebo (71.2% Vs 48.9%, p<0.03). 100% closure was observed in 7 patients (with 30 ulcers) from EGF group and in one patient (with 12 ulcers) from placebo group. EGF showed a greater efficacy in ulcer healing (RR=3.4, 95%CI: 1.84-13.61). This study showed that EGF was significantly superior to placebo in ulcer healing. As a result, use of EGF appears to be helpful to diabetics with foot ulcers.