Introduction

Bedsores

Stages of pressure sores, eps8

Bedsores are also known as pressure sores or decubitus ulcers, are localized injuries to the skin and/or underlying tissue that usually occur over a bony prominence as a result of pressure, or pressure in combination with shear and/or friction. The most common sites are the sacrum, coccyx, heels or the hips, but other sites such as the elbows, knees, ankles or the back of the cranium can be affected.

Pressure ulcers occur due to pressure applied to soft tissue resulting in completely or partially obstructed blood flow to the soft tissue. Shear is also a cause, as it can pull on blood vessels that feed the skin. Pressure ulcers most commonly develop in persons who are not moving about or are confined to wheelchairs. It is widely believed that other factors can influence the tolerance of skin for pressure and shear, thereby increasing the risk of pressure ulcer development. These factors are protein-calorie malnutrition, microclimate (skin wetness caused by sweating or incontinence), diseases that reduce blood flow to the skin, such as arteriosclerosis, or diseases that reduce the sensation in the skin, such as paralysis or neuropathy. The healing of pressure ulcers may be slowed by the age of the person, medical conditions (such as arteriosclerosis, diabetes or infection), smoking or medications such as antiinflammatory drugs.

Although often prevented and treatable if detected early, pressure ulcers can be very difficult to prevent in critically ill patients, frail elders, wheelchair users (especially where spinal injury is involved) and terminally ill patients.

Pressure ulcers are especially difficult to treat in patients with spinal cord injury (SCI) and recurrence rates are high.

Complications

Pressure ulcers can trigger other ailments, cause patients considerable suffering, and be expensive to treat. Some complications include autonomic dysreflexia, bladder distension, osteomyelitis, pyarthroses, sepsis, amyloidosis, anemia, urethral fistula, gangrene and very rarely malignant transformation (Marjolin’s ulcer).

Globally, as of 2010, pressure ulcers resulted in about 43,000 deaths.

The A1 Medical Center Bedsores Treatment

The bedsores treatment is unique because it focuses on repairing tissue damage and restoring function to improve each patient’s quality of life.

Patients are treated by minimally invasive surgery and/or by injecting the stem cells by intradermal or intramuscular implantation or by injecting them directly into the dammaged area, avoiding major surgical intervention in most cases.

Almost 90% of the spinal cord injury patients treated with stem cells show not only improvement but even complete bed sores healing.

Diagnostics and Physical Assessment

Before stem cell implantation, each patient undergoes blood tests at the clinic and a comprehensive physical and cognitive assessment. Spinal cord injury patients may also undergo magnetic resonance imaging (MRI).

Step 1 – Bone Marrow Collection

Bone marrow is collected from the patient’s iliac crest (hip bone) using thin-needle mini-puncture under local anesthesia. Though some pain may be felt when the needle is inserted, most patients do not find the bone marrow collection procedure particularly painful. The entire procedure normally takes about 30 minutes.

Once the bone marrow collection is complete, patients may return to their hotel and go about normal activities.

More detailed information on the bone marrow collection procedure is available in the Bone Marrow Informed Consent document (PDF file).

Step 2 – Laboratory Processing

The stem cells are processed from the bone marrow in a state-of-the-art, government approved (cGMP) laboratory. In the lab, both the quantity and quality of the stem cells are measured. These cells have the potential to transform into multiple types of cells and are capable of regenerating or repairing damaged tissue.

Step 3 – Stem Cell Implantation

The stem cells are implanted back into the patient.

Following Treatment

Patients treated by intradermal  and/or intramuscular transplantation may return home the day after treatment.

Results

In 100 patients (86.36%), the pressure ulcers treated with adult autologous stem cells had fully healed after a mean time of 21 days. The number of MNCs isolated was patient dependent, although similar clinical outcomes were observed in each case. Compared to conventional surgical treatment, mean intra-hospital stay was reduced from 85.16 to 43.06 days. Following treatment, 5 minutes of daily wound care was required per patient compared to 20 minutes for conventional surgery. During a mean follow-up of 19 months, none of the resolved ulcers recurred.

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Pressure ulcers before and after autologous MNC therapy. (A) Patient 2, images taken before (left) and after treatment (right). (B) Patient 4, images taken before (left) and after (right) treatment.

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RNM images obtained before and after autologous MNC therapy. Patient 2, images taken before (A) and 6 months after (B) treatment. Arrows point to the pressure ulcer

Patient Stories

Lavinia Conopan – 31 years old
“…I can now feel when I need to go to the toilet and my bladder capacity has increased…”

Ransom Doyle – 52 years old
“…I have been able to increase my distance walking to over 400+ meters with a cane and riding a two-wheel bicycle over a mile at a time…”

Rich Welsh – 27 years old
“…If you happen to have the chance of autologous stem cell treatment do not let it pass you by…”

Treatment Evaluation Process

In order to be evaluated for stem cell treatment, patients must complete an online medical history form. Once you’ve completed the online medical history and submitted it, a patient relations consultant will contact you. He or she will assist you with the rest of the evaluation process. Upon treatment approval, your consultant will also assist you with treatment scheduling and trip preparation.

 

 

Picture source: J Spinal Cord Med. 2011;34(3):301-7.

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