Introduction
Peripheral neuropathy is a condition that most commonly occurs in diabetic patients. It is characterized by tingling, numbness, or even pain. These symptoms are especially common in the hands and feet. A dreaded complication of peripheral neuropathy is ulcers. Neuropathy ulcers are especially hard to treat. Stem cells may offer a new solution for many such patients.
The Formation of Ulcers
As stated above, neuropathy ulcers often occur in diabetic patients. Both types of Diabetes, Diabetes Mellitus Types I and II, can cause microvascular and nerve damage over time. These changes interfere with how the body heals itself in addition to how the body maintains peripheral nerves.
Common symptoms of peripheral neuropathy include paresthesia, numbness, and loss of sensation. Loss of sensation is especially dangerous. Without sensation, people can get injuries without realizing it. Common injuries include fractures, cuts, and stress ulcers. Stress ulcers occur from repeated stress on the same area. These injuries can be caused by mal-fitting shoes, stubbing one’s toe, and accidentally cutting too close with nail-clippers. Other deformities can occur, like hammertoes, bunions, and Charcot foot.
Neuropathic Ulcers’ Appearance
Neuropathic ulcers are a special type of wound that can develop from any of the injuries listed above. Ulcers can range from pink/red in color to brown/black. Generally, ulcers are round in nature with well-defined borders. Some ulcers may have visible underlying pockets of infection. If the infection reaches the bone, it can cause osteomyelitis, infection of the bone.
Normal Treatment of Ulcers
The first step in treating an ulcer is identifying the cause, the exacerbating factors, and eliminating them. For example, if a diabetic patient develops an ulcer on their foot after wearing certain shoes, the first step is to better control their diabetes and buy better-fitting shoes.
From there, treatment of the ulcer depends on the severity of the ulcer. Generally, ulcers should be debrided, meaning that old, dead tissue is cut away to reveal healthier tissue. Often, primary care physicians will send high-risk patients to wound specialists. These specialists can recommend debriding on a certain schedule with special bandages. The bandages will have special ingredients that facilitate healing.
Unfortunately, ulcers can prove very stubborn to treat. Some patients require vascularization, meaning that if there are any identifiable vessels to fix, they need to be fixed. In some cases, the infection will spread to the bone, causing osteomyelitis. Depending on the area and the severity, doctors may prescribe a long-term course of antibiotics. In some cases, surgeons may even have to amputate the affected limb.
Stem Cells in Ulcers
Fortunately, new gains have been made in stem cell treatments for ulcer healing. New studies have shown that stem cells can be an alternative to amputation for some patients, even without revascularization.
One review found 90 studies that examined the use of stem cells in diabetic foot ulcers specifically. The majority of these were in mice with only 8 studies examining stem cells in humans. Those studies used bone marrow-derived mesenchymal stem cells, adipose-derived stem cells, human umbilical cord-derived mesenchymal stem cells, and peripheral blood-derived mesenchymal stem cells. There were more rare stem cells used in certain studies, but these were the exception rather than the rule. This review found that each stem cell type had an advantage, either in terms of practicality of harvest or in actual treatment outcomes. The authors of this review concluded that stem cells are an adequate adjunct in treating diabetic foot ulcers, but that the practice needs to be standardized in order to create a protocol.
Stem Cell Therapy and Real Patients
One patient, James Drews, can attest to the benefits of stem cell therapy. James was treated at the Stem Cell Transplant Institute in San Jose, Costa Rica for a foot ulcer caused by a third-degree burn. His ulcer was on the bottom of his foot, interfering with his everyday life. “I’m very grateful and thankful for the help of Dr. Leslie, Dr. Vargas, and Ronald, and the rest of the team for allowing my third-degree burn on the bottom of my foot to heal within 5 weeks. I’m so thankful to be getting back to my normal life.”
Summary
Ulcers can be scary. They are difficult to treat, interfere with everyday life, and can be caused by something as simple as poorly fitting shoes. Conventional therapy does not work for everyone. Fortunately, stem cell therapy is a viable option. Many patients can attest to the ability of stem cells to help them heal. Contact us at the Stem Cell Transplant Institute to learn more about your options today.
