Der Einfluß systemischer Wachstumshormongabe auf die Spalthautdefektheilung beim Schwein
Ultima-ratio therapies in adult burn patients using recombinant human growth hormone, revealed a faster healing of split thickness skin graft donor sites. Furthermore, no standardized studies about the influence of different wound dressings on the healing time of split thickness skin graft donor sites are available. Goal of this animal experiment was, to study the influence of systemic growth hormone administration and different wound dressings on the healing time of split thickness skin graft donor sites under standardized conditions in an adult pig model. In 15 (8 verum, 7 control) adult, male pigs a total of 30, 0.6 mm deep split thickness wounds, size 8 x 4 cm were created on the back of the pigs. Six split thickness wounds were assigned in one group and treated with different wound dressings, namingly a dry wound dressing (Braunovidon), a calcium-alginate dressing (Kaltostat), silk, a polyurethane dressing (OpSite) and a hydrocolloid dressing (Varihesive E). Pigs were followed up for 14 days and daily treated subcutaneously with recombinant human growth hormone (0,5 I.E./kg KG) or 4 ml 0.9% sodium chloride. Every 2-3 days dressing exchange was performed. One punch biopsy per group was taken out of the wound ground and the healing progress was photo documented. Furthermore, a blood sample was taken from the pigs to determine the expression of IGF-1, the peripheral mediator of growth hormone. Biopsies were histologically stained with H & E and basal membrane components were examined using immunhistochemical techniques and antibodies directed against laminin 5, collagen IV and VII. The criterion for a healed wound was a starting stratification of the newly formed epidermis. Serum IGF-1 was statistically significant increased in the verum group, when compared to the control group. Clinically and histologically the split skin graft donor sites treated with Varihesive E, OpSite and Braunovidon showed a significant faster healing rate of 1.36-2.87 days in the verum groups compared to the control group. Wounds treated with Kaltostat or silk healed faster, the difference however, was not statistically significant. Immunhistochemical analysis revealed a rebuild basal membrane zone at day 7-8 in all groups. In this standardized adult animal experiments we could demonstrate a statistically significant increase in serum IGF-1, as well as an improved healing of split thickness wounds in animals treated with recombinant human growth hormone. The increase of IGF-1 in the serum after treatment with growth hormone correlates positively with an improvement in wound healing in this group. Assuming that these results are transferable into humans, the application of systemic growth hormone in severely burned patients might indeed be useful to improve the healing time and of split skin graft donor sites.
info:eu-repo/classification/ddc/610, Medizin, Wundheilung, Wachstumshormon, Spalthautdefektheilung
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