The exudate of pressure ulcers contains a substantial amount of vascular endothelial growth factor

Pressure ulcers (PUs) are chronic wounds that occur as areas of tissue necrosis that results from external physical compression, shear forces, and friction. Recently, the efficacy of polyvinylidene film dressing (PVFD) for PUs without any agents promoting wound healing has been reported, suggesting that PUs have their own mechanism of spontaneous healing achieved by vascularization, synthesis of extracellular matrix, and re-epithelization. Since vascular endothelial growth factor (VEGF) 165 and fibroblast growth factor 2 (FGF-2) are released at traumatic or surgical wound sites and play major roles in vascularization and wound healing, we measured the concentrations of VEGF165 and FGF-2 in the exudate and fibrinous sloughs of PUs after PVFD. We collected 10 exudate samples and 3 samples of fibrinous sloughs from 10 PUs of 9 patients immediately after PVFD for 8 h and measured VEGF165 and FGF-2 by ELISA. All 10 exudate samples contained substantial amounts of VEGF165, from 2.79 to 13.27 microg g(-1), irrespective of the severity of the PUs. In contrast, we detected FGF-2 (0.21 and 2.03 microg g(-1)) in only two exudate samples. Similarly, we detected VEGF165 (from 3.14 to 5.93 microg g(-1)) and FGF-2 (less than 0.31 microg g(-1)) in fibrinous sloughs of 3 PUs. These results demonstrate that the exudate and fibrinous sloughs of PUs contain considerable amounts of VEGF, which would contribute to the spontaneous healing of PUs by PVFD. The presence of VEGF165 in the exudate of PUs inspires us to reconsider the treatment strategy of PUs that enhances the spontaneous healing.