Topical Insulin and Timolol Combined with EGF Accelerate Healing and Minimize Pathologic Scarring in Deep Partial-Thickness Burns: A Retrospective Single Arm Cohort Study

Purpose: Deep partial-thickness burns are prone to delayed healing and hypertrophic scarring.Epidermal growth factor (EGF) expedites re-epithelialization, yet further improvements are needed.This study examines whether combining topical insulin and timolol with EGF using alginate dressing and ofloxacin ointment can promote healing and minimize scarring.Methods: Thirty-two adults with deep partial-thickness burns of the limbs were retrospectively reviewed.Topical insulin, timolol, and EGF ointment were applied every 48 hours, delivered with alginate dressing; ofloxacin ointment was used for infection prophylaxis.Clinical outcomes included days to full epithelialization, infection, surgical intervention, and scar status at 12 weeks.Representative wound photographs were obtained at initial, 5-8 days, and after epithelialization for each major burn etiology.Results: Average age was 41 years; injuries included scald (n=15), steam (n=3), contact (n=11), and flame burn (n=3).Mean epithelialization was 12.22.4days.No patient developed infection or required skin graft.Only 2 patients (slowly healing low-temperature contact burns) developed hypertrophic (not keloid) scars by 12 weeks; all others healed with minimal or imperceptible scarring. Conclusion:The protocol of topical insulin and timolol with EGF achieved rapid wound closure and, except for rare, mild hypertrophic scarring in slow-healing deep contact burns, yielded excellent scar outcomes.Alginate and ofloxacin provided supportive benefits in risk reduction and agent delivery.(