The Role of Recombinant Proteins and Growth Factors in the Management of Diabetic Foot Ulcers: A Systematic Review of Randomized Controlled Trials

Table 8

Outcomes of RCTs that evaluated G-CSF safety and effectiveness.

Ref	Type of growth factor	Wound closure	Mean time to heal in treatment groups	Mechanism mentioned as complete healing		Confounders				Further outcomes
				Granulation tissue	Reepithelialization	Sex	Baseline HbA1c	Wound size	Offloading	Recurrence rate	Amputation rate
[25]	G-CSF	G-CSF therapy was associated with earlier eradication of pathogens from the infected (), quicker resolution of cellulitis (), shorter hospital stays (), and a shorter duration of intravenous antibiotic (). Neutrophil superoxide production was higher in the G-CSF-treated group ()	NM	NM	NM	NM	NM	NM	NM	NM	2 cases in the placebo group
[28]	G-CSF	At the 3- and 9-week assessments, no significant differences in terms of complete closure of the ulcer without signs of underlying bone infection	NM	NM	NM	NM	NM	NM	NM	NM	15% in the G-CSF group and 45% in the control group.
[26]	G-CSF	No foot ulcer had completely healed at the end of the study. Patients who received G-CSF did not have an earlier resolution of clinically defined cellulitis (). The ulcer volume, was reduced by 59% in G-CSF and by 35% in placebo patients ()	NM	NM	NM	NM	NM	NM	NM	NM	2 cases in total from both groups
[27]	G-CSF	No significant differences for duration of hospitalization, duration of parenteral antibiotic administration, time to resolution of infection, and need for amputation	NM	NM	NM	NM	NM	NM	NM	NM	13.3% in the treatment group and 20% in the placebo group.

G-CSF: granulocyte colony-stimulating factor; Y: yes; N: no; NM: not mentioned.