Research AppraisalSystematic Review

FGF2 in Burn Wound Healing: From Molecular Function to Clinical Application-A Systematic Review

Journal of burn care & research : official publication of the American Burn AssociationNiederegger, Tobias, Schaschinger, Thomas, Brandt, Jule et al.5 May 2026DOI

Clinical Snapshot

75CEBM
Evidence: ModerateSystematic Review

PICO Framework

P — PopulationPatients with burn injuries (thermal injuries), including animal models and in vitro studies
I — InterventionFibroblast growth factor 2 (FGF2) therapy in various formulations (topical, hydrogels, liposomes, gene-activated matrices)
C — ComparatorStandard burn care, placebo, or control treatments
O — OutcomesWound healing time, scar quality, re-epithelialization, angiogenesis, fibroblast proliferation, keratinocyte migration, safety outcomes

Bottom Line

This systematic review of 33 studies suggests FGF2 shows promise in burn wound healing through multiple mechanisms including enhanced angiogenesis, fibroblast proliferation, and re-epithelialization. Topical FGF2 formulations appear to reduce healing time and improve scar quality in partial-thickness burns, with favorable safety profiles reported. However, the evidence base lacks formal meta-analysis and pooled effect estimates. The authors appropriately conclude that broader clinical adoption requires harmonized regulatory evaluation, optimized delivery systems, and multicenter validation studies. While mechanistically compelling, the current evidence is insufficient to recommend routine clinical use without further high-quality randomized controlled trials. Australian clinicians should await TGA-approved formulations and definitive efficacy data before considering implementation in burn care protocols.

Evidence: Moderate

Key Findings

  • P Value: Not reported

  • Effect Size: Not quantified in pooled analysis

  • Primary Outcome: Accelerated burn wound healing with shortened healing time and improved scar quality

  • Nnt Or Sensitivity: Efficacy dependent on dosage and wound characteristics

  • Confidence Interval: Not reported

Clinical Application

Requires optimized delivery systems and standardized protocols Would require TGA approval for therapeutic use; potential PBS listing considerations for specialized burn units; alignment with ANZBA guidelines needed Patients with partial-thickness burns, diabetic patients with complex burns

Abstract

Burn injuries trigger complex inflammatory and metabolic cascades that impair wound healing and increase morbidity. Fibroblast growth factor 2 (FGF2), a potent mediator of cellular proliferation, angiogenesis, and extracellular matrix remodeling, has emerged as a promising therapeutic agent in burn care. This systematic review evaluated the biological mechanisms, delivery strategies, and clinical outcomes associated with FGF2 in burn wound healing to clarify its therapeutic value and translational potential. Following PRISMA 2020 standards, a structured literature search was conducted across PubMed, EMBASE, Web of Science, Cochrane, and Google Scholar to identify studies investigating FGF2 in thermal injuries. Eligible records included clinical trials, in vivo models, and in vitro experiments. Methodological quality and risk of bias were assessed using the Newcastle-Ottawa Scale, the SYRCLE tool, and the Oxford Levels of Evidence. Thirty-three studies (1992-2025) met inclusion criteria, encompassing randomized controlled trials, animal models, and mechanistic analyses. Fibroblast growth factor 2 accelerated repair by stimulating fibroblast proliferation, keratinocyte migration, angiogenesis, and matrix organization. Topical FGF2 formulations shortened healing time and improved scar quality in partial-thickness burns. Innovative carriers, including hydrogels, liposomes, and gene-activated matrices, enhanced bioavailability and sustained local effects. In diabetic and complex burn models, FGF2 mitigated inflammation, preserved barrier integrity, and promoted re-epithelialization. Efficacy depended on dosage and wound characteristics. Studies reported favorable safety profiles with minimal and mild adverse events. Fibroblast growth factor 2 demonstrates regenerative and immunomodulatory potential in burn management. Broader adoption requires harmonized regulatory evaluation, optimized delivery systems, and multicenter validation to define its role in precision-guided burn care.

References

  1. 1.Niederegger, T., Schaschinger, T., Brandt, J., Munzinger, R., Karakas, E., Knoedler, L., Knoedler, S., Palackic, A., Panayi, A., & Hundeshagen, G. (2026). FGF2 in burn wound healing: From molecular function to clinical application-A systematic review. Journal of Burn Care & Research. https://doi.org/10.1093/jbcr/irag020
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