Abstract
Background & Aim An ulcer is any open lesion on the skin or mucosa with loss of substance. Stem cells derived from bone marrow, with recognized plasticity and proliferative capacity, are determined to repair the function of injured tissues. Diseases of the arteries, arterioles and capillaries experienced a cause of death at all ages. Precisely, the development obtained in regenerative cell therapy has allowed treating conditions as well as diseases associated with the skin. Methods, Results & Conclusion This is an original case report from our Institute for Regenerative Medicine in Argentina where a point of care procedure started with the extraction of 110 ml of bone marrow was performed by puncture in the left posterior iliac crest under live fluoroscopy by using 5 ml of local anesthesia in a sterile procedure room.The bone marrow obtained was preserved in a sterile blood collection bag next to 2,500 IU of sodium heparin diluted in 0.1 ml every 10 ml of marrow. It was transported under sterile conditions in the laboratory of advanced therapies, where reception was received by a certified doctor in Regenerative Medicine and where cell separation was performed by density gradient of Ficoll Paque Premium and direct centrifugation through the GE Healthcare protocol under system ThermoFisher Scientific laminar flow in positive pressure sealed room. A cell count dose of 900,000,000 Bone Marrow Mononuclear Cells (BMMNCs) diluted with human autologous bone marrow plasma concentrate (H-BMPC) in a concentration of 15 ml was obtained, with a 99% viability. On the same day, asepsis of the ulcer site to be treated (4 × 6 cm) was performed, placement of sterile fields, resection of fibrotic edges through the use of a scalpel and the application of the cells in 15 injections of 1 ml with needle 30G, without local anesthesia, covering the entire surface of the ulcerative zone of the left external malleolus. After the application, the compressive bandage was performed for 5 days in a row, and it was then indicated that the ulcer was washed every 24 hours with the replacement of the compressive bandage until its closure. No type of antibiotic therapy was indicated. Complete closure of the left lower limb ulcer was observed after 110 days of the stem cell implantation. The use of bone marrow Mononuclear Cells in an autologous way is a safe application therapy, with scientific evidence both pre and clinical worldwide, and could be effective for the treatment of closure of diabetic ulcers of lower limbs.
Published Version
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