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Case Study
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The role of autologous blood-derived growth factors in limb threatening wounds Julie Cucco, BSN, MSA, Leon Gervich, RN, MPH, Elena Shur, RN, Weiss Memorial Hospital, Chicago, IL The topical application of autologous blood-derived growth factors may play an important role in complicated, limb threatening wounds. This poster presents a case series of 4 patients who exhibited lower extremity, limb threatening wounds, in which a number of wound therapies had failed. A multi-disciplinary team management approach was utilized in the care of these complicated cases. When wound healing failed to occur, the addition of topical autologous blood-derived growth factor was implemented into the treatment plan. Total wound healing was achieved as well as limb salvage in each of these challenging cases. The weekly treatment of autologous blood-derived growth factor gel application was a key component in the treatment plan. The bedside treatment was achieved by drawing a small amount of blood which is specially treated to release the growth factors. The plasma rich gel is topically applied to the wound with a protective dressing covering. The protocol included weekly application of the topical growth factors. The wound volumes exhibited response after the first application with continued wound contraction observed weekly until total wound healing occurred The key role of growth factors in wound healing continues to emerge as more and more types of growth factors are identified. The functions of each of the growth factors is lesser understood. As new methods to identify physiological components of chronic wounds are developed, the role of growth factors as well as their mechanism of action, will be better understood. Currently the availability of topical growth factors in wound care provides options for patients with recalcitrant, often limb threatening wounds. While several studies have been published relating to the application of topical growth factors in wound healing and diabetic lower extremity ulcers, there are many questions that need further research. The frequency of application of the growth factors, at what point in the course of the wound treatment for the optimal application, and the quality and quantity of autologous growth factors are several of the areas needing additional research Greenhalgh DG. The role of growth factors in wound healing. J Trauma Inj Infect Crit Care. 1996;41(1):159Ð167 Fu X, Li X, Cheng B, Chen W, Sheng Z. Engineered growth factors and cutaneous wound healing: success and possible questions in the past 10 years. Wound Rep Regen. 2005;13:2:122Ð130 Ringwald S, Walz R, Zimmermann J, et al. Hyperconcentrated platelets stored in additive solution: aspects on productivity and in vitro quality. Vox Sanguinis. 2005;89(1):11Ð18 Zimmermann R, Loew D, Weisbach V, et al. Plateletpheresis does not cause long-standing platelet-derived growth factor release into the donor blood. Transfusion. 2005;45(3):3414Ð3419 Zimmermann R, Arnold D, Strasser E, et al. Sample preparation technique and white cell content influence the detectable levels of growth factors in platelet concentrates. Vox Sanguinis. 2003;85(4):283Ð289 Snyder EL, Calhoun BC. Topical platelet growth factor therapy: of lotions and potions. Transfusion. 2001;41(10):1186Ð1189.. |
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