Use of Intralesional and Perilesional Human Recombinant Epidermal Growth Factor (hrEGF) in the Local Treatment of Venous Ulcer – Review Article – Expert Recommendation

Figures & data

Figure 1 Flowchart for the literature review process and expert recommendations.

Figure 2 Perspective of literature review.

Table 1 Characteristics of the Studies Included in the Analysis

N	Study Title	Year	Method	Results
1	Epidermal growth factor therapy and wound healing—past, present, and future perspectives^Citation30	2008	Review in Medline	The FCE showed positive results in the wound healing process, but due to its topical application it has been criticized due to the limited effect on the healing of chronic wounds and the association with invasive malignancies at local level
2	An approach to treating ulcers of vascular origin: review and role of epidermal growth factor^Citation26	2016	Evidence Review	The review of scientific evidence of (rhEGF) for vascular ulcers shows that it has efficacy, and tolerability, considered as an adjunctive or emerging treatment that can be considered for the management of vascular ulcers.
3	Comparative study of Four Layer Compression Bandaging and Topical Human Epidermal Growth Factor in Chronic Venous Leg Ulcer^Citation31	2018	A prospective, open-label, randomized, comparative, single-center study	Topical h-EGF along with the four-layer bandage speeds the healing time in chronic leg venous ulcer
4	Human recombinant epidermal growth factor in skin lesions: 77 cases in EPithelized project^Citation32	2018	Multicenter case series	Topical rhEGF presents results in effectiveness and tolerance. It is not compared with other technologies or drug presentations.
5	A new alternative in the management of complex vascular ulcer with recombinant epidermic growth factor, EPIPROT^® (Nepidermine)^Citation33	2019	Follow-up to three cases	rhEGF contributes to granulation and stimulates short term healing, which can reduce complications.
6	Treatment of venous ulcers with growth factors: systematic review and meta-analysis^Citation34	2019	Systematic Review	The effect of the application of growth factors for complete healing in venous ulcers is not clear, clinical trials with methodological quality are necessary for more precise recommendations.
7	Experience with the use of perilesional and intralesional recombinant human epidermal growth factor (nepidermin) in the treatment of patients with chronic venous ulcers^Citation25	2019	Retrospective multicenter case series study	rhEGF achieved an important level of improvement in the severity index of the injury, which allowed epithelialization and wound healing in most cases in a brief period of time
8	Clinical guideline on topical growth factors for skin wounds^Citation35	2020	GPC for the application of growth factors	Topical application of growth factors is promising in the treatment of several types of skin wounds
9	Efficacy of Human Recombinant Epidermal Growth Factors vs Conventional Therapy for the Treatment of Chronic Venous Ulcers: A Retrospective Case Series^Citation36	2021	Case Series Retrospective Study	rhEGF presents a higher probability of epithelization of venous ulcers compared to hydrocolloids
10	Growth factors for treating chronic venous leg ulcers: A systematic review and meta-analysis^Citation15	2022	Systematic Review	EGFs can increase the percentage of reduced ulcer area during treatment

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Daza J, Garcia R, Lozano E, Tolstano A. A new alternative in the management of complex vascular ulcer with recombinant epidermic growth factor, EPIPROT® (Nepidermine). Rev Latinoam Cir Vascular Angiol. 2019;2:1.

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Cacua Sánchez MT, Giraldo LF. Experience with the use of perilesional and intralesional recombinant human epidermal growth factor (nepidermin) in the treatment of patients with chronic venous ulcers. Vasc Dis Manag. 2019;16:1.

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Han C-M, Cheng B, Wu P. Biao Cheng, Pan Wu, Clinical guideline on topical growth factors for skin wounds. Burns Trauma. 2020;8:35. doi:10.1093/burnst/tkaa035

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Cacua M, Giraldo L, Diaz J. Efficacy of human recombinant epidermal growth factors vs conventional therapy for the treatment of chronic venous ulcers: a retrospective case series. Wound. 2021;33(2):41–49.

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Lee Y, Lee MH, Phillips SA, Stacey MC. Growth factors for treating chronic venous leg ulcers: a systematic review and meta-analysis. Wound Repair Regen. 2022;30(1):117–125. doi:10.1111/wrr.12982

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