Topical treatment of pressure ulcers with nerve growth factor: a randomized clinical trial

Ann Intern Med. 2003 Oct 21;139(8):635-41. doi: 10.7326/0003-4819-139-8-200310210-00006.


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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Aged
  • Aged, 80 and over
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Foot Dermatoses / drug therapy*
  • Foot Dermatoses / physiopathology
  • Humans
  • Male
  • Nerve Growth Factor / administration & dosage*
  • Placebos
  • Pressure Ulcer / drug therapy*
  • Pressure Ulcer / physiopathology
  • Wound Healing / physiology


  • Placebos
  • Nerve Growth Factor