Comparision of vacuum-asisted closure and intralesional epidermal growth factor in the treatment of diabetic foot wounds patients

Introduction: Diabetes mellitus (DM) is a common public health problem all over the world with serious complications. The mortality rate is 40% within 5 years in patients with major amputation due to diabetic foot wounds (DFW). Therefore, a nonsurgical but effective treatment method is needed for the treatment of DFW. In this study, we aimed to compare the results of intralesional epidermal growth factor (EGF) injection and negative pressure wound therapy (NPWT) for the treatment of DFW. Materials and methods: The medical records of patients who were treated for DFW with EGF or NPWT between February 2017 and December 2017 were retrospectively reviewed. Patients demographics, wound characteristics, allergic reactions and treatment responses were evaluated. Results: Amongst 42 patients, 20 patients were treated with the injection of EGF and 22 patients treated with NPWT. The duration of diabetes was higher in EGF group when compared to the NPWT group without a statistically significance (EGF: 20,7 years, NPWT:16,9 years). According to the Wagner-Meggitt classification, the grade of the wounds was comparable in both groups. A complete response were obtained in 17 (85%) patients and 50% wound closure was achieved in the other patients in EGF group. In the NPWT group complete response rate was 45.4%. No major amputation was performed in any patient. In NPWT group, 13 (59%) of wouds were closed with split-thickness skin graft, only 3 patients (15%) of the EGF group were required a skin graft. The main advers affect of the EGF injection was an elevated fasting blood glucose level. In both groups, A decreased HbA1c levels were found after the wound treatment. Conclusion: Both administration of intralesional EGF and NPWT are safe, effective and non-surgical methods for the treatment of DFW. NPWT is seems to be a more effective treatment modality for infected wounds.