Topical application of basic fibroblast growth factor for pressure ulcers: a systematic review and meta-analysis

Abstract

Objective: To evaluate the effectiveness of topical application of basic fibroblast growth factor (bFGF) on pressure ulcers (PUs). Method: Relevant randomised controlled trials (RCTs) published from database creation to July 2018 were systematically searched. Pooled risk ratios (RR) with 95% confidence intervals (95% CI) were calculated to assess mean healing time in days as a measure of treatment efficacy. Standardised mean differences (SMD) with 95%CI were calculated to assess the proportion of complete healing. Funnel plots and Egger's regression tests were used to assess publication bias. Results: In total, 12 RCTs encompassing 664 PUs were included. The pooled effect size demonstrated a significant difference in complete healing proportions between the control groups and subjects treated with bFGF (RR=1.61 (1.40–1.85); p<0.001) and mean healing time (SMD=–1.97 (–2.54– –1.40); p<0.001). There was no indication of significant publication bias in the primary analysis. Sensitivity analysis demonstrated that the results of the meta−analysis were reliable. Conclusion: In this review, topical application of recombinant bFGF was found to be effective in the treatment of PUs. Given the limitations of the reports included, additional RCTs of higher power are warranted to confirm our findings.