Material and Methods: Ten patients having stage IV PI were enrolled and equally divided into two groups: Group 1 patients (5) were given BM-MNCs followed by dry gauze daily dressing and Group 2 patients (5) were given only dry gauze dressing as standard wound care. Among group 1 patients, 100 ml bone marrow (BM) was harvested from the posterior iliac crest. BM-MNCs suspension was separated from BM immediately after harvesting. BM-MNCs were injected by insulin syringe after the wound was subdivided with a grid into small areas of 1 cm2. Wound assessment for healing outcome measures in both the groups was done at week 0, 3, 6 and 9. Wound biopsy was done at every 3 week to assess the matastatis.
Results: Pressure injury treated with BM-MNCs had fully healed after 6 week. When compared to group 2 patients, significant reduced surface area was observed in BM-MNCs treated PI at week 6 (p=0.001). Conversion of slough into red granulation tissue was significantly higher in BM-MNC group after week 6 (p=0.001). None of the biopsies showed signs of metaplastic roliferation/differentiation after BM-MNCs therapy.
Conclusions: This pilot study indicate that autologous BM-MNCs therapy is safe and could be an option to treat type IV pressure ulcers in patients with SCI. A larger study may help to test the efficacy of this therapy to treat pressure injury.