Becaplermin (Recombinant PDGF — Chronic Wounds)

How it works

Becaplermin is biologically equivalent to endogenous PDGF and stimulates chemotaxis and proliferation of cells involved in wound repair, promoting granulation tissue formation.

Prescribing in practice

• An increased rate of secondary-malignancy mortality has been reported with repeated tubes, so it is contraindicated in known neoplasia and should be used cautiously with careful patient selection.
• It is an adjunct only and does not replace debridement, infection control and pressure offloading.
• Apply to clean, adequately debrided, well-perfused wounds and discontinue if there is no healing response within a reasonable period.

Monitoring

Monitor wound size and granulation at regular dressing changes and reassess the appropriateness of continued therapy.

Counselling the patient

• Apply a thin layer over the ulcer as directed and cover with a moist dressing.
• Continue good foot care, offloading and glucose control.
• Tell your clinician about any history of cancer before using this gel.

Evidence & guidelines

Becaplermin is licensed as an adjunct for diabetic neuropathic ulcers, with a safety warning regarding malignancy with repeated use.