Treatment of venous ulcers with bone marrow-impregnated collagen matrix

Abstract

Bone marrow attracted our attention as a potentially beneficial material for the treatment of wounds, because it contains multipotential progenitor cells and produces growth factors. We impregnated autologous bone marrow cells on to a collagen matrix that had been used for the treatment of chronic wounds. The bone marrow-impregnated collagen matrix was then as a biomaterial scaffold for the treatment of wounds. This study was designed with the aim of clinically evaluating the effects of bone marrow-impregnated collagen matrix on wound healing of venous ulcers. We applied the matrix in 15 patients with chronic venous ulcers, and evaluated the transcutaneous oxygen tension (TcPO2) and vascular density. The application of the matrix induced healthy granulation tissue. All patients were given a split-thickness skin graft on to the induced granulation tissue, and have remained free from complications for more than eight months since the treatment. The mean (SD) vascular density at the ulcer base increased after the treatment (before 0.011 (0.006) mm2/mm2, after 0.064 (0.036) mm2/mm2, p < 0.001). The periwound TcPO2 values tended to increase (before 17.1 (12.7) mmHg, after 30.6 (13.4) mmHg, p < 0.001). Our results have shown the efficacy of bone marrow-impregnated collagen matrix for the treatment of intractable venous ulcers.