Studying Of External Using Ecombinant Human Ranulocyte-macrophage Colony-stimulating Factor Hydrogelto Treat Residual Extensive Burn Wounds

Objective: To observe the clinical effects of recombinant humangranulocyte-macrophage colony stimulating factor (rhGM-CSF) hydrogel on thetreatment of residual extensive burn wounds.Methods：forty two wounds of21extensive burn patients who sufferedfrom burn without heal over curing two months and hospitalized in thedepartment of the burn and plastic surgery of the first affiliated of guangximedical university, were admitted in this study. The wounds of each patient wererandomly divided into experimental group or control group by match-pairsdesigning principle. Experimental group (external use rhGM-CSF hydrogel,n=21) and control group (external use Mupirocinointment, n=21).The two groupwounds’ dressings were changed once two days. At the7th,10th,14th,21th,28thday,observation items of the experiment were as following:(1)Wound healingtime and percentage, wound discharge (quantity, color, smell, etc.), granulationtissue (color, oedema, aging, etc.), wound inflammation, and the infection of burn wounds, local and systemic side effect of drugs were observed andcompared between two groups;(2) Lab test with the pathologic staining method,pathology identified the difference of granulation tissue, inflammatory cells,fibroblast between the two groups, Immunohistochemistry detected the numberof new vessels and fibroblast.Results：(1)The Healing time [(17.28±6.70)days] with the application ofrhGM-CSF hydrogel, comparing with control wounds[(22.14±7.38)days)],significantly shortened5days. Comparing cure rates during each period: the curerates of the7th,，the experiment wounds were(29±20)%,but the control(32±21)%，there was not statistically significant(P﹥0.05); the cure rates of the10th, the experiment wounds were(54±27)%,which was remarkably higher thanthe control (43±27)%(P﹤0.01);the cure rates of the14th, the experimentwounds were(60±36)%,which was remarkably higher than the control(48±30)%(P﹤0.01);the cure rates of the21th, the experiment woundswere(92±17)%,which was remarkably higher than the control (80±27)%(P﹤0.05);the cure rates of the28th, the experiment wounds were(95±14)%,whichwas remarkably higher than the control (92±20)%(P﹥0.05), there was notstatistically significant. At the7th,10th,14th,21th,28thday, Comparing with thecontrol group,the other group showed slighter wound inflammation, less woundpurulence and discharge, but more granulation tissue. And at the7th,10th,14th,21th,28thday, the bacteria clearance rate of experiment group(42.85%、52.38%、90.47%、95.24、95.24%)is more higher than control group(4.76%、4.76%、38.10%、76.19%、80.95%). At the14thday.(2)the average numericalvalue of optical density of VEGF on experiment group(0.21±0.01)is more thanon the control group(0.18±0.02）（P﹤0.05） and the average numerical value ofoptical density of FGF on experiment group(0.25±0.01)is more than on the control group(0.18±0.02)(P﹤0.05).Conclusion：rhGM-CSF hydrogel not only promotes the healing process ofresidual extensive burn wounds effectively, and enormously cuts down theperiod of hospitalization, but also cleans majority bacteria or inhibits theirgrowth, eventually,it has certain effect on reducing the generation and growthof the wound bacteria.