Effect Of RhGM-CSF Combined With Alginate Dressing On Healing Of Chronic Cutaneous Wounds Among Middle-aged And Elderly Patients

ObjectiveTo observe and evaluate the clinical efficacy and safety of topical application of rhGM-CSF combined with alginate dressing on chronic cutaneous wounds among middle-aged and elderly patients.MethodsRandomized controlled open clinical trial design was adopted, a total of60middle-aged and elderly patients who had chronic cutaneous wounds were selected in Jinan Central Hospital of Shandong University from May2011to May2013. All cases were assigned by stratified random grouping method to four groups with15cases in each. The four groups had been followed up and observed for8weeks. Group A, B and C were considered as the experiment group, while group D was considered as the control group. In group A, the wounds were treated with topical application of rhGM-CSF combined with Alginate dressing and vaseline gauze. While in group B, the wounds were treated with topical application of rhGM-CSF on the vaseline gauze. In group C, the wounds were treated with alginate dressing combined with vaseline gauze. In group D, the wounds were treated with vaseline gauze only. The wound area and adverse reactions was recorded, and the amount of exudates, pain score, color, granulation tissue growth and epithelization in wound were observed at different time points. The wound healing rate at each time point, and the wound completely healing rate as well as efficacy rate after eight weeks of treatment were evaluated.Results 1. Wound exudates:There was no statistically significant difference in wound exudates in the four groups before the start of treatment (P>0.05) While the wound exudates amount displayed a decreasing tendency during the treatment, the difference of wound exudates amount was statistically significant at each point in the treatment (P<0.05). Wound exudates amount in group A and C were significantly less than that of group B and D from one to four weeks after the treatment (P<0.05). And group A, B and C were significantly less than group D about the wound exudates amount from five to eight weeks after the treatment (P<0.05)2. General observation:There was no statistically significant difference in wound color, granulation tissue growth and epithelialization in the four groups before the start of treatment (P>0.05). While those displayed a improving tendency during the treatment, and were statistically significantly different among the four groups from three to eight weeks after the treatment (P<0.05). Wound color, granulation tissue growth and epithelialization in group A and B, were significantly better than that of group C and D from three to four weeks after the treatment (P<0.05). And group A, B and C were significantly better than group D about the wound color, granulation tissue growth and epithelialization from five to eight weeks after the treatment (P<0.05)3. Wound pain:There was no statistically significant difference in wound pain sore in the four groups before the start of treatment (P>0.05).While it displayed a decreasing tendency during the treatment, and was statistically significantly different at each point in the treatment (P<0.05). Compared with the group B and D, there was statistically significant pain relief in the group A and C from one to four weeks after the treatment (P<0.05). And group A, B and C were significantly better than group D about the pain relief from five to eight weeks after the treatment (P<0.05)4. Wound healing rate:There was no statistically significant difference in the wound healing rate among the four groups one week after the start of the treatment (P>0.05). While it was statistically significantly different from two to eight after the treatment (P<0.05). Compared with the group D, there was statistically significant higher wound healing rate in the group A, B and C. And the group A was highest, followed by the group B and group C (P<0.05).5. Completely healing rate and efficacy rate:There was statistically significant difference in the wound completely healing rate and efficacy rate among the four groups after eight weeks of treatment (P<0.05). Compared with the group D, there was statistically significant higher wound completely healing rate and efficacy rate in the group A, B and C. And the group A was highest, followed by the group B and group C (P<0.05)6. Adverse reactions:No adverse reaction occurred during the treatment course of all groups.ConclusionTopical application of rhGM-CSF combined with alginate dressing are not in conflict but complementary. The treatment can expedite the formation of granulation tissue and reepithelialization of chronic cutaneous wounds among middle-aged and elderly patients, thus promoting the wounds to repair. It can also reduce wounds exudation and pain, which would be helpful to improve the compliance of patients, and raise their quality of life and care. And no adverse reaction occurred during the treatment course. Topical treatment of rhGM-CSF combined with alginate dressing is highly effective, safe and reliable for the non-surgical treatment of chronic cutaneous wounds among middle-aged and elderly patients.