Applying a substance called nerve growth factor to pressure ulcers may help them heal, an Italian study suggests. Pressure ulcers, also called bedsores, are wounds that commonly develop in patients who are bedridden or confined to a chair. These sores can form in as little as an hour when skin is squeezed between bed linens and a bony protuberance like an anklebone, but they are hard to treat and can cause infection. Pressure ulcers are usually treated with frequent position changes, moist wound healing techniques and good skin care. Nerve growth factor (NGF), however, may represent a new chapter in bedsore treatment. Researchers have recently discovered that certain substances in the body can stimulate healing by promoting the growth of cells that were previously lost. NGF was first identified as a substance that causes nerve cells to grow in damaged areas, and it was later found to stimulate the development of skin and other cells as well.
The Italian study, undertaken by Dr. Francesco Landi, from the Catholic University in the Sacred Heart in Rome, and colleagues, involved 36 nursing home patients with severe, non-infected pressure ulcers on their feet. Patients were divided into two equal groups and their pressure ulcers were measured.
One group, the control group, received a treatment of salt water dripped on the wound every day for six weeks. The other patients were treated with NGF, dissolved in salt water and applied the same way. Neither the patients nor the doctors knew who was in what group.
The results of the study were published in the Oct. 21 issue of the Annals of Internal Medicine.
The patients treated with NGF showed significant improvement relative to the control group. The NGF-treated ulcers reduced in size by an average of 738 millimeters squared, compared with 485 millimeters squared in the control group. Of the NGF-treated patients, eight saw their ulcers heal completely, compared with only one in the other group.
There are, however, some limitations to the study, writes Dr. David R. Thomas, of St. Louis University, in a related editorial. The ulcers treated only with salt water improved more slowly than usual, which may account for some of the difference. Since only foot ulcers were treated, the results will not necessarily apply to bedsores on other parts of the body.
Finally, while NGF improved healing better than salt water, it is not yet clear whether it is more effective than other standard treatments for bedsores.
