Effects Of Recombinant Human Granulocyte-Macrophage Colony-Stimulating Factor Hydrogel On Healing Of Deep Partial-Thickness Burn Wounds And Its Mechanism Analysis

Objective: This study is aimed to evaluate the efficacy of topical rh GM-CSF hydrogel treatment in the healing of deep partial-thickness burn wounds and discuss on its possible mechanism of promoting the healing,provide clinical experience for treating deep partialthickness burn wounds,and provide theoretical basis for clinical application of rh GM-CSF hydrogel in the treatment of deep partial-thickness burn wounds.Methods: From March 2015 to September 2016,96 cases of deep partial thickness burn wound wounds in our hospital were randomly divided into experimental group(n=48)and control group(n=48).The experimental group was with treatment of rh GM-CSF hydrogel [state drug approval document NO: S20080003],the control group was with traditional treatment of Vaseline gauze bandage.The time observation was 28 days.Wound healing time and wound healing rate,total effective rate at the 7th,14 th and 21 th day after treatment were observed and recorded.The wound tissue samples(n=6)from burn wound at different time point were obtained for detecting the expression of TGF-?1 and T?RII through immunohistochemical methods.The experimental data were analyzed and summarized,and the efficacy of the two methods were summarized and compared.A two-side P<0.05 was considered significant.Results: One hundred patients with deep partial-thickness burn wounds were enrolled in this study.Four patients dropped out the trial.The data of ninety-six patients were analyzed.The median wound healing time in the experimental groups(19d,95%CI:218-20d)was significant-ly shorter than that in the control group[(24d,95%CI:23-25d),p<0.05).The wound healing rate in the experimental groups was(30±15)%,(70±22)% and(91±8)% respectively at 7th,14 th and 21 th after remedy,which was significantly higher than that in the control group [(19±11)%,(46±18)% and(76±18)%,p<0.001].The efficacy of the experimental group was significantly better than the control group(p<0.05).The total effective rates in the experimental groups was 4.2%,60.5% and 98.0% respectively at 7th,14 th and 21 th after remedy,which was also significantly higher than that in the control group(0.0%,18.8% and 81.2%,p <0.05).Through immunohistochemical methods,there was not differences in the expression of TGF-?1 and T?RII between two groups(p>0.05).However,the expression of TGF-?1 and T?R? in the experiment group at 7th and 14 th was significantly much more than that in the control group,respectively(p<0.05).Conclusion: The topical application of a rh GM-CSF hydrogel can significantly accelerate and enhance deep partial-thickness burn wound healing.Its mechanism may be association with increasing the expression of TGF-?1 and T?R? in wound tissue.