Autologous bone marrow derived stem cell therapy for pressure ulcer in Spinal cord injury cases- A pilot study

Introduction: Pressure ulcers (PUs) or pressure injury, is a major complication of spinal cord injury (SCI) and has a significant effect on general health and quality of life. Promising results have been reported in the treatment of small series of mainly chronic lower-extremity wounds with bone marrow-derived stem cells. The purpose of this study was to investigate the effect of stem cell therapy in PUs of Spinal cord injury cases.

Material & Methods: Ten SCI cases with PUs of grade IV participated in the study. Five cases were allocated in Stem cell group and five in standard care group. For stem cell therapy, autologous bone marrow (100 ml) was harvested from the posterior iliac crest. Stem cell (BM-MNCS) was separated from bone marrow and processed using Ficoll density gradient method. The selected stem cell suspension was injected into the wound bed by. PUs was covered with wet to moist gauze and followed up to 6 weeks. The outcome measures were surface area, exudate levels and rate of formation of granulation tissue in both the groups.

Results: Surface area (SA) were significantly (p<0.01) decreased in stem cell therapy group as compared to standard care group at week 6. Exudate levels were significantly lower in the stem cell therapy group as compared with the standard care from week 3 (2.96 ± 0.21 vs 2.62 ± 0.49); this difference persisted up to week 6 (1.35 ± 0.75 vs 0.14 ± 0.35). Removal of slough and formation of red granulation tissue was significantly higher in the stem cell therapy group after week 3 (P = 0.001) to week 6.

Discussion: Stem cell therapy using autologous bone marrow derived cell is safe and may be a treatment option for pressure ulcer in SCI cases. Future studies with large sample size would give more evidence.