Topical Treatment of Pressure Ulcers with Nerve Growth Factor

Background: The prevalence of pressure ulcers of the foot is a major health care problem in frail elderly patients. A pressure sore dramatically increases the cost of medical and nursing care, and effective treatment has always been an essential nursing concern. Management options for pressure ulcers include local wound care; surgical repair; and, more recently, topical application of growth factors.

Objective: To examine the effects of topical treatment with nerve growth factor in patients with severe, noninfected pressure ulcers of the foot.

Design: Randomized, double-blind, placebo-controlled trial.

Setting: Teaching nursing home of Catholic University of the Sacred Heart, Italy.

Patients: 36 persons with pressure ulcers of the foot.

Intervention: 18 patients received nerve growth factor treatment, and 18 patients received only conventional topical treatment.

Measurements: The course of the ulcers during follow-up was evaluated by tracing the perimeter of the wound onto sterile, transparent block paper and determining the stage.

Results: At baseline, the treatment and control groups did not differ across demographic variables, clinical characteristics, and functional measures. The mean area (SD) of the ulcers was 1012 633 mm² in the treatment group and 1012 655 mm² in the control group (P > 0.2). The average reduction in pressure ulcer area at 6 weeks was statistically significantly greater in the treatment group than in the control group (738 393 mm² vs. 485 384 mm²; P = 0.034).

Conclusion: Topical application of nerve growth factor may be an effective therapy for patients with severe pressure ulcers.