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.
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