In many patients, epithelialization becomes the rate limiting step in the healing process.
From our perspective, there is little clinicians can do to speed epithelialization apart from surgery. Topically applied growth factors would be best. From our review there is no business case for growth factors due to excessively high development cost (including clinical trials), risk and safety concerns. So, our approach was to focus on boosting growth factors that are endogenously produced. We investigated hydrated polyurethanes. From complex fluids, they absorb preferentially water and low molecular weight substances. Proteins enter the polymers much slower so that their concentration increases relatively in the outside fluid compartment. We looked at HGF found a 3-fold increase in relative concentration which favored faster epithelialization in scratch assays. In a pig study, split thickness donor sites had faster epithelial tongue migration with these hydrated polyurethanes compared with silicone interface dressings.