Basic fibroblast growth factor is beneficial for postoperative color uniformity in split-thickness skin grafting

Abstract

Color changes of visible and exposed body surfaces, such as the face and extremities, after burn injury or surgery, such as skin grafting, flap, or sclerotherapy for vascular malformations, are sometimes a concern. The consequences reduce the satisfaction of both patients and physicians. An easy and reproducible method has not yet been established for an objective analysis of color changes; therefore, we tested a hand-held color analyzer (NF-333; Nippon Denshoku Co. Ltd) with data transport to a computer database and analysis software for posttreatment skin color change. The parameters included L, a, and b, which measure clarity, red, and yellow, respectively. Two groups were prospectively divided with 20 (11 females and nine males) patients per group. One group received skin grafting plus basic fibroblast growth factor (bFGF) spray daily and the other group received only skin grafting. The patients were randomized by the date of their first visit to our hospital. Patients were treated with bFGF on odd days, while patients who came on even days were included in the non-bFGF-treated group. The donor site for skin grafting was the lateral thighs and the thickness was similar in both groups. The results were compared at 1-year posttreatment follow-up. Clinical and objective assessments of the scars were performed 1 to years after complete healing. Color change differentials in comparison with the surrounding skin were lower with bFGF treatment in all parameters (p<0.01), along with clinical assessment with the Vancouver Scar Scale; therefore, the treatment contribute to a better color match with skin grafting postoperatively.

Objective Quantification of Subjective Parameters in Scars by Use of a Portable Stereophotographic System

“…1,5 The characteristics added by 3-dimensional to standard 2-dimensional photography were volume and SI. Technical advances could allow future integration of other scar features like pigmentation and level of redness 16,17 in an automated analysis of 3-dimensional photographs, ultimately providing an integrated objective tool for scar analysis.…”

Basic Fibroblast Growth Factor in Scarless Wound Healing

“…The augmented phosphorylated 125 FAK on melanocytes may explain for bFGF action, but further in vivo and clinical efficacy should be obtained. 2 On the contrary, in a rat study using oral polyenzyme therapy after laparotomy and abrasion of the visceral and parietal peritoneum reduces the extent of postoperative intestinal adhesions, and this favorable effect can be explained by the lower levels of angiogenic factors such as vascular endothelial growth factor and bFGF or laminin after the administration of hydrolytic enzymes. 8 Another study in a basal lamina gel incorporated in a neuroinflammation cell culture model and in a glial scarring around electrodes, serum and inflammatory factors to induce the neural progenitor cell activation and migration to the site of injury, where growth factors such as bFGF and PDGF induce proliferation of cells that eventually form the glial scar formation.…”

“…1 Thus, bFGF, a glycoprotein of approximately 17 Kd in human recombinant form and activated through a distinct seven-spanning membranous receptor, is beneficial in both clinical and objective scar assessment, thus shortening healing time and promoting postoperative color uniformity in split-thickness skin grafting. 2 bFGF is a potent mitogen, and was first named for its ability to induce fibroblast proliferation. It promotes angiogenesis, and has been shown to downregulate collagen I and tropoelastin mRNA transcription in periodontal ligament fibroblasts and to upregulate hyaluronic acid (HA) synthesis in skin fibroblasts in vitro.…”

Review of Burn Research for the Year 2010

“…The patients and nurses on average reported improved pain and anxiety with music therapy. 53 These two articles show the benefit of distraction and relaxation techniques on reducing pain associated with burn injuries and dressing changes.…”

“…The investigators found that patients who were treated with bFGF had less color differences from their skin grafts than the control group implicating bFGF as a potential treatment for hyperpigmentation. 53 Pentoxifylline, used traditionally in altering red blood cell morphology and decreasing blood viscosity, has been shown to decrease cell proliferating in hypertrophic scars. In this next study, pentoxifylline was administered to patients with burn hypertrophic peribuccal scaring.…”