AAWM Internet update
The American Academy of Wound Management has two new Web sites. The first, at www.aawm.org, provides information on AAWM’s wound care board certification and includes a list of certified wound specialists and an application for board certification.
Wound care information and resources at www.wound.net include The Wound Care Forum, an open discussion on wound care issues; wound care resources; wound care companies and facilities; and a wound care meetings calendar.
Growth factor for wound healing starts clinicals
K eratinocyte growth factor-2 (KGF-2), a member of the fibroblast growth factor family, is begin- ning phase two clinical trials in the process of applying for FDA approval. William Haseltine, PhD, chairman and chief executive officer of Human Genome Sciences in Rockville, MD, manufacturer of the growth factor, says KGF-2 has finished both its animal and safety trials and is now being tested for use on patients with large, persistent venous ulcers in double-blind, placebo-controlled tests. Haseltine, a former professor of pathology and cancer biology at Harvard Medical School and Harvard School of Public Health, expects KGF-2 to be used in a topical formulation applied directly to the wound.
"KGF-2 has a distinct advantage over other growth factors that have been tested because it regenerates — at least in preclinical animal studies — epidermal and dermal tissues that are well-vascularized with strong connective tissue," Haseltine says. "We know of no other growth factor that has the favorable properties of KGF-2. It’s the growth factor your body uses to repair wounds to the skin and to mucosal epithelial tissues, as well as the lining of the lung and bladder." HGS also hopes to use KGF-2 systemically for healing wounds to internal mucosa, primarily those wounds induced by high-dose chemotherapy, with which it would be delivered simultaneously.
Growth factors are natural substances, usually proteins, that the body makes to promote the proliferation of cells. One gene specifies one protein, and that protein is a specific growth factor. There are several growth factors currently used as medications. One is human growth hormone, a protein made from a gene expressed in the pituitary gland that is a general growth factor for many types of human tissues. Another is platelet-derived growth factor, which helps promote granulation of wounds. (See related story in Wound Care, March 1999, p. 25.)
Thomas A. Mustoe, MD, professor and chief of plastic surgery at Northwestern University Medical School in Evanston, IL, did some of the work with KGF-2 during its animal trials. "The animal experience with several wound healing models showed that KGF-2 is highly effective," Mustoe says. "I personally think that growth factors have a lot of promise for wounds. We just have to figure out how to put them on." One of the problems with using growth factors has been that the protease enzymes present at wound sites that defend the wound from bacteria also destroy growth factor proteins. Mustoe observes that KGF-2 is resistant to proteases, but says its application may need to be combined with protease inhibitors.
HGS has assembled an automated, computer-driven gene isolation and characterization system that Haseltine describes as "the equivalent of using an assembly line to create new knowledge about human genes. We were able to isolate and characterize what we believe are 98% of all human genes between January 1993 and December of 1995." Genes are isolated by extracting messenger RNA from human tissue and converting it to complementary DNA. Reading the text of the genes’ nucleotide sequence allows scientists to predict which of them may be growth factors. Haseltine says the 40 novel growth factors reviewed by HGS prior to selecting KGF-2 for further study have not been previously described in scientific literature.
For further information, contact Human Genome Sciences, 9410 Key West Ave., Rockville, MD 20850. Telephone: (301) 309-8504. Web site: www.hgsi.com.
New manual can steer you through Y2K
With the year 2000 deadline fast approaching, hospitals, other health care providers, and the medical device industry are scrambling to complete a process that in many cases was started too late. What may have once been a logistical issue is burgeoning into an overwhelming problem, compounded by scarcity of time, rising costs, and a lack of programming resources and expertise.
The health care industry has found itself under increased pressure as the realization dawns that it is behind the curve in preparing for Y2K. According to a recent Modern Healthcare/ PricewaterhouseCoopers survey, the biggest Y2K-related worry among 69% of health care providers is that patients will be "affected due to faulty monitoring gear," followed by concern over "inaccurate lab tests and pharmacy orders" (36%), problems with patient records (34%), and worries about billing and paychecks.
As the Y2K problem moves far beyond a solely technological issue, American Health Consultants, publisher of Wound Care, has published the Hospital Manager’s Y2K Crisis Manual, a compilation of resources for nontechnical hospital managers. This 150-page reference manual includes information in nontechnical language on the problems your facility could face, the potential fixes, and the possible consequences, including:
• Will your computers and software work in 2000?
• What does Y2K mean for patient care?
• What will happen to your medical devices?
• How can you make sure your vendors are Y2K-compliant?
• Are you at legal risk due to Y2K?
• Are you prepared if Y2K delays HCFA payments?
Jan. 1, 2000, is not a moving target. Either your computer systems, medical devices, and suppliers can handle the date change and maintain business as usual, or they can’t — in which case your entire organization may face serious problems. The Hospital Manager’s Y2K Crisis Manual is available now for $149. For more information on the Hospital Manager’s Y2K Crisis Manual, contact American Health Consultants’ customer service department at (800) 688-2421 or www.ahcpub.com.