The ability of surgeons to accelerate wound healing through pharmacologic intervention is limited. The effects of locally applied, biosynthetic human epidermal growth factor (EGF) and transforming growth factor-beta (TGF-beta) on tensile strength of experimental incisions were investigated. A single dose of EGF in saline failed to increase tensile strength over controls. Thus, EGF was incorporated into multilamellar liposomes, which prolonged the exposure of incisions to EGF (p less than 0.001). A single dose of EGF in multilamellar liposomes produced a 200% increase in wound tensile strength over controls between 7 and 14 days (p less than 0.05). Light and electron microscopy of the wounds revealed increased collagen formation and fibroblast proliferation. A single dose of TGB-beta in a collagen vehicle stimulated a 51% increase in wound tensile strength at 9 days (p less than 0.01). We conclude that addition of EGF and TGF-beta in appropriate vehicles stimulates early transient increases in wound tensile strength in normal rats.
Journal Article Failure of Opsonization as a Sign of Lethal Sepsis Get access I. Randell Cohen, I. Randell Cohen Department of Surgery and Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, Kentucky Search for other works by this author on: Oxford Academic PubMed Google Scholar Mary S. Sciutlo, Mary S. Sciutlo Department of Surgery and Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, Kentucky Search for other works by this author on: Oxford Academic PubMed Google Scholar Gregory L. Brown, Gregory L. Brown Department of Surgery and Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, Kentucky Search for other works by this author on: Oxford Academic PubMed Google Scholar Hiram C. Polk, Jr. Hiram C. Polk, Jr. Department of Surgery and Price Institute of Surgical Research, University of Louisville School of Medicine, Louisville, Kentucky Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 149, Issue 4, April 1984, Page 651, https://doi.org/10.1093/infdis/149.4.651 Published: 01 April 1984
"Fast 4D‐Lite" at Arnold provides fault sealing evidence and risk reduction for a one well, near $100 million project. We define 4D‐Lite as not using co‐processing to build difference volumes. Key seismic analyses took only four months, avoiding lengthy and expensive co‐processing. Marathon built conditioned near and far angle seismic inversions from two speculative data surveys shot ten years apart. Visualization, petrophysical ties, and seismic forward models clearly support an undrained, yet fairly complex fault block target. Dynamic reservoir modeling confirms predicted seismic reservoir volumes and fault sealing. Depleted Pliocene Cris S channelized sand reservoirs at two existing wells show strong impedance increases. Superb inversions measure high confidence net pay distribution and depositional pattern details. "Fast 4D‐Lite" succeeded in reducing project risk for these key reasons: 1) simple velocity field and stable migrations in low structural dips 2) thick, blocky, high quality sands with strong impedance separation of pay sands, wet sands and shales 3) broadband speculative legacy and monitor seismic with similar acquisition 4) no diagenetic sand overprint 5) known fluid types and 6) very efficient inversion output and interpretation. Seismic guided a high confidence reservoir model. Internal faults, baffles and aquifer effects were incorporated into reservoir simulation and analysis for a risked decision table. Final economics avoided a second high cost proposed well. Arnold is an excellent economic project due to reduced risk guided by quick and robust 4D seismic results and reservoir simulation.
Experimental studies in animals have demonstrated that the topical application of epidermal growth factor accelerates the rate of epidermal regeneration of partial-thickness wounds and second-degree burns. We conducted a prospective, randomized, double-blind clinical trial using skin-graft-donor sites to determine whether epidermal growth factor would accelerate the rate of epidermal regeneration in humans. Paired donor sites were created in 12 patients who required skin grafting for either burns or reconstructive surgery. One donor site from each patient was treated topically with silver sulfadiazine cream, and one was treated with silver sulfadiazine cream containing epidermal growth factor (10 μg per milliliter). The donor sites were photographed daily, and healing was measured with the use of planimetric analysis. The donor sites treated with silver sulfadiazine containing epidermal growth factor had an accelerated rate of epidermal regeneration in all 12 patients as compared with that in the paired donor sites treated with silver sulfadiazine alone. Treatment with epidermal growth factor significantly decreased the average length of time to 25 percent and 50 percent healing by approximately one day and that to 75 percent and 100 percent healing by approximately 1.5 days (P<0.02). Histologic evaluation of punch-biopsy specimens taken from the centers of donor sites three days after the onset of healing supported these results. We conclude that epidermal growth factor accelerates the rate of healing of partial-thickness skin wounds. Further studies are required to determine the clinical importance of this finding. (N Engl J Med 1989; 321:76–9.)
Abstract : Soft tissue injuries and burn wounds constitute the greatest types of battlefield injuries. The goal of our research was to develop agents that would enhance healing of soft tissue injuries. The first objective was to establish the profile of growth factors and proteases during acute healing of skin wounds and to compare this with the profile of these agents in chronic wounds to establish what biochemical abnormalities need to be corrected to accelerate healing of slowly healing wounds. Our second objective was to evaluate the effect of topical treatment of exogenous growth factors on healing of autograph skin grafts in a pig model of full-thickness burns treated with partial thickness skin grafts. Our results demonstrate that cytokines, growth factors, their receptors and proteases play key roles in regulating healing of acute wounds. Furthermore, an imbalance of these agents which results in elevated levels of MMPs contributes to the impaired healing of chronic wounds. This implies that optimum treatment of battlefield injuries that are extensive including large burns or injuries with large tissue losses may require combination therapies that include growth factors and inhibitors of MMPs to achieve rapid healing.
