Tissue Engineering Therapy for Unhealed Diabetic Wound Using Mononuclear Stem Cells, Plasma Rich Platelets and Collagen
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 10, Issue 3
Abstract
Diabetic wound is the most dreadful complication of Diabetes Mellitus (DM) in musculoskeletal system of human being. Diabetic wound healing is considerably challenging due to the poor ability of tissue regeneration in diabetic patients. Here we reported a case study of tissue engineering therapy on unhealed wound in the back of young female DM patient. We decided to not do any surgery treatment. We did standard wound therapy with combination tissue engineering therapy. The tissue engineering treatment will be using Peripheral Blood Mononuclear Stem Cells (PBMNCs), Cord Blood Mononuclear Stem Cells (CBMNCs), Collagen, and Plasma Rich Platelets (PRP). To develop a PRP preparation, blood must first be drawn from patient and put it in PRP tube. The platelets are separated from other blood cells and enriched by centrifugation. CBMNCs were isolated from human placenta blood (donor) which is collected during delivery process, the PBMNCs were isolated from patient's blood and they were extracted with Ficoll gradient. PRP and MNCs was applied topically and subcutaneously to the wound. We gave collagen every week, PBMNCs at week 4, CBMNCs at week 6 and PRP at week 8. We did tissue engineering therapy for 8 weeks and the result showed perfect wound healing without complication. In conclusion tissue engineering therapy using MNCs stem cell, PRP and collagen could treat successfully unhealed diabetic wound.Diabetes mellitus (DM) often inflicts complication on musculoskeletal system in the form of diabetic wound. This complication is very terrifying because diabetic wound often ends up with amputation and resulted in death. Diabetic wound is difficult to heal despite various interventions such as wound care and surgery has been done. It gives a challenge to clinicians to solve this problem. Generally, wound healing is a complex process and requires good function and integrity of the tissue. The process may be disrupted due to several factors and when it occurred, wound healing process would be disturbed, and wounds are difficult to heal, it becomes severe, chronic wound and ends up with unhealed wound. Several factors that inhibiting wound healing process includes continuous pressure to tissues, blood vessels obstruction, elderly, and chronic diseases such as DM. Diabetic wounds are difficult to heal because the patient has dysregulation in the wound healing process, both in tissue level and cellular level.In tissue level there are neurological and vascular disorder, also infection. In cellular level there are disturbance in cell proliferation, extracellular matrix production, growth factor expression, and failure of neovascularization. Until now, diabetic wound therapy consists of debridement, wound pressure release, antibiotic administration and blood flow management. The therapy has not been satisfactory yet, therefore a breakthrough is needed to overcome the problem the current therapy had only touched healing process in tissue level, not yet at cellular level. We need cellular based diabetic wound therapy; the alternative is tissue engineering [1]. Tissue engineering is a technique to repair damaged tissues by using three components, i.e. cells, signal molecules and scaffolds. These techniques are comfortable and safe for patients and they give satisfactory results. The cells used were stem cells, and signal molecules used were growth factors. Meanwhile, the scaffolds used were certain media.
Authors and Affiliations
Basuki Supartono
Keywords
Related Articles
- EP ID EP592319
- DOI 10.26717/BJSTR.2018.10.001960
- Views 169
- Downloads 0
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