| Background Split-thickness skin grafting is an important treatment method in plastic surgery and skin surgery.Medium thick skin graft is easy to survive,but not obvious in shrinkage,wear resistance,color change and other aspects after survival,so it is widely used in plastic surgery to repair skin defects in various parts of the body.The skin donor site left after transplantation have the pain,itching and other discomfort during the healing process,as well as complications such as infection,greatly increase the pain of patients.Epidermal growth factor（EGF）is a growth factor that can regulate the process of epithelialization by stimulating mitosis and chemotaxis of epithelial cells.Granulocyte macrophage colony stimulating factor（GM-CSF）is a multifunctional cytokine,which can promote epithelialization and accelerate wound healing through various ways.Purpose Recombinant human granulocyte macrophage colony Stimulating factor（rh GM-CSF）and recombinant human Epidermal growth factor（rh EGF）were rarely compared in donor area at home and abroad,In order to provide an alternative method for the treatment of skin graft donor site in clinical practice,this study compared the effects of rh GM-CSF and rh EGF on the wound healing of skin graft donor site through the local application of rh GM-CSF and rh EGF in skin graft donor site.Methods According to the exclusion and inclusion criteria,60 patients who were admitted to the Plastic Surgery Department of the Second Affiliated Hospital of Anhui Medical University from May 2020 to May 2021 were selected and randomly divided into control group,EGF group and GC group,with 20 cases in each group.Rh GM-CSF gel（GC group）,rh EGF gel（EGF group）and blank control group（control group）were applied on the donor area surface,respectively.After surgery,the wound was covered with vaseline gauze,and sterile gauze was used for compression dressing.The wound healing rate and complete healing time of the three groups were calculated on the 10 th and 14 th day.Visual Analog Scale（VAS）was used to evaluate the pain in the donor site of the patients on the 3rd,7th and 10 th day of dressing change.The secretion of wound surface was cultured during dressing change,and the positive rate of bacterial culture was recorded.At the third month of follow-up,scar status at the surgical site was assessed according to the Vancouver Scar Scale（VSS）.Results（1）Wound healing: The wound healing rate of GC group and EGF group was higher than that of control group（P< 0.05）,the wound healing rate in GC group was higher than that in EGF group（P<0.05）.The wound healing time of GC group and EGF group was shorter than that of control group（P< 0.05）,the wound healing time in GC group was shorter than that in EGF group（P<0.05）.（2）Pain assessment: there was no statistically significant difference in pain scores among the three groups at day 3 of dressing change（P> 0.05）;The pain score of GC group and EGF group was lower than that of control group（P<0.05）,and GC group was lower than EGF group（P< 0.05）.（3）Scar scores of GC group and EGF group were lower than those of control group 3months after operation（P<0.05）,there was no significant difference in scar score between GC group and EGF group.（4）Wound secretion culture: except for the control group and EGF group,there was only one infection,the detection rate was 4%,the difference was not statistically significant（P> 0.05）.Conclusion Compared with rhEGF gel,rhGM-CSF gel can promote wound healing of medium thickness skin donor site,reduce postoperative pain,improve healing quality,and ensure safe application. |
