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Wound Healing Morphology in an Acute Wound Healing Study

Background: Physiological healing in acute wounds generally occurs by granulation from the wound base and by migration of epithelium from the wound edges toward the center of the wound in a uniform, concentric fashion. The Wound Healing Cooperative Group (WHCG) compared this phenomenon in acute wounds treated with standard care versus acute wounds pharmacologically stimulated with growth factor therapy. Methods: With informed consent, 20 normal healthy volunteers underwent four 6 mm biopsies of the flexor surface of both forearms. The biopsy sites were randomly assigned to a control arm (daily bacitracin) or to one of three treatment arms: i) rhPDGF‐BB 0.01% gel Q.D., ii) rhPDGF‐BB Q.O.D., iii) daily rhPDGF‐BB (Q.D. × 7 days followed by bacitracin alone daily). Wound morphology was carefully examined and photographed daily until complete healing was achieved. Results: There were distinct differences in the morphological pattern of healing seen between control wounds and growth factor‐stimulated wounds. Acute wounds treated with bacitracin tended to heal in circumferential fashion, as predicted. Growth factor‐stimulated wounds, by contrast, exhibited accentuated angiogenesis (granulation), with non‐uniform epithelial islands streaming into the wound. Conclusion: This pilot study suggests that rhPDGF‐BB influences acute wound healing by promoting accelerated granulation and epithelialization. Accelerated healing is manifest by different healing morphologies. The biological basis for these differences requires further histological and molecular analyses. Acknowledgements: Funding from The Angiogenesis Foundation.