Papers of The 3rd Japan Scar Workshop
17. Use of Nepidermin(rh-EGF) to prevent scar formation
Joon Pio Hong, MD,PhD, MBA
Associate Professor Asan Medical Center University of Ulsan
Department of Plastic and Reconstructive Surgery Seoul, Korea
In this pig wound model study of Nepidermin (recombinant human-
epidermal growth factor (Easyef®), Daewoong Pharmaceutical Company,
Seoul, Korea), the effect against scarring is investigated.
A total of 7 domestic pigs weighing 15 – 20 Kg were used to evaluate the
effect of Nepidermin on acute full thickness wounds with 5 x 5 cm
dimensions. The wound was categorized into two groups; Group EGF dressed
with nepidermin twice daily and covered with compound dressing (Versiba®,
Convatec, USA) and Group non-EGF dressed twice daily only with the
compound dressing. Wounds were evaluated daily until epithelialization
was achieved. Digital photos were used and evaluated using Bersoft image
measurement (v 4.01, USA) to measure granulation, epithelialization and
contracture (scar formation).
Findings showed total granulation was achieved in 5 days in the EGF
group and 9 days in the non-EGF group. The EGF group showed a faster
rate of epithelialization compared to the non-EGF group. Total
epithelialization of the wounds was achieved in an average of 45 days
while the non-EGF group was epithelialized in an average of 53 days.
Comparison of the rates of contracture showed similar contraction rate
in the early phase but the rate of contracture seemed to slow down in
the EGF group at about 2 weeks and ending in fairly less contracture at
53 days. Biopsies showed better defined spidermo-dermal junction with
thicker epithelium in the EGF group.
The overall effect of EGF can be seen not only in epithelialization but
also in the rate of granulation formation. Interestingly, contracture
was less observed in the EGF group compared to the non-EGF group. This
data coincides with the reports of EGF having favorable condition
against wound contracture. Although the number of specimens are few to
draw a conclusion based on statistics, , the observed effects of EGF
were to stimulate epithelialization, granulation and perhaps to suppress
contracture of the wound.