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Published on: March 25, 2020
Efficacy of Concentrated Growth Factors in Regulating Macrophage Immune Responses and Promoting Wound Healing After
1Department of Plastic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Objective:
To evaluate the clinical effect of concentrated growth factor (CGF) on postoperative wound healing after plastic surgery, and to explore its association with changes in local immune-inflammatory markers and macrophage-related indicators.
Methods:
Ninety-six patients with postoperative wounds after plastic surgery were retrospectively included. According to the wound management approach, they were assigned to an observation group and a control group, with 48 patients in each group. The control group received routine wound care, whereas the observation group received CGF in addition to routine care. Wound healing time, epithelialization time, time to reduced exudation, number of dressing changes, wound area reduction rate, infection, pain score, scar score, and patient satisfaction were compared between groups. Local levels of IL-6, TNF-α, IL-10, TGF-β, and VEGF were measured before treatment and on day 7 after treatment. In a subset of patients, macrophage-related markers, including CD68, CD86, CD163, and CD206, were analyzed in wound tissue samples.
Results:
The observation group had shorter wound-healing time, epithelialization time, and time to reduced exudation than the control group. The number of dressing changes was lower, and the wound area reduction rate on day 7 was higher in the observation group, with statistically significant differences (P<0.05). The infection rate and mild wound edge dehiscence rate did not differ significantly between groups (P>0.05). The VAS score on postoperative day 7 and the VSS scar score at 3 months were lower in the observation group (P<0.05). On day 7, IL-6 and TNF-α levels were lower, and IL-10 levels were higher in the observation group (P<0.05), whereas TGF-β and VEGF levels were higher but not statistically significant (P>0.05). Exploratory analysis of macrophage-related markers showed lower CD86 expression and CD86/CD68 ratio, and higher CD163 expression and CD163/CD68 ratio, in the observation group (P<0.05).
Conclusion:
CGF, combined with routine wound care, may shorten wound-healing time, improve epithelialization, and reduce wound exudation after plastic surgery. These clinical changes were accompanied by changes in selected immune-inflammatory markers and macrophage-related indicators. The findings suggest a potential auxiliary role for CGF in postoperative wound repair, but the underlying immunoregulatory mechanism warrants further investigation.
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