Gel made with your own blood can heal leg ulcers
Agel made from a cocktail of the patient’s own blood and vitamin C offers a new way to treat chronic wounds. The mixture is thought to kick-start a patient’s own repair mechanisms and close wounds that have failed to heal for months or even years.
Initial results suggest nine out of ten wounds that hadn’t healed for nearly a year responded to the new gel.
Sixty- six patients with diabetic foot ulcers are now taking part in an NHS trial to test the treatment’s effectiveness.
A large proportion of chronic wounds treated by the NHS each year are diabetic foot ulcers — open wounds or sores that develop on the skin of the foot as a common complication of diabetes.
They are caused by factors including peripheral neuropathy, where chronic exposure to high blood sugar damages nerves and leads to reduced sensation in the feet. This means patients feel little pain, so any injuries go unnoticed and may worsen and become infected.
Diabetes also damages blood vessels, so oxygen-rich blood and immune cells needed for healing are not delivered.
Previous research has shown that up to 40 per cent of diabetic ulcers take at least three months to heal, and in 14 per cent of cases, they are still present after a year. every year in the UK, around 5,000 people need to have a leg amputation as a result of diabetic foot complications.
The new gel builds on a technique called plateletrich plasma (PRP).
It involves doctors taking a sample of a patient’s blood and spinning it in a centrifuge to separate out the plasma — a clear serum that is rich in platelets, cells important for clotting — and proteins called growth factors that help with healing.
The new gel is made using an advanced form of spinning that also separates out a protein called thrombin, which helps activate the platelets and boosts tissue regeneration. Doctors then add vitamin C to create a gel.
This is all done at the patient’s bedsides in devices supplied by UK company Biotherapy Services. Vitamin C is thought to have a key role in the gel, as it is involved in the production of collagen, a tough protein that helps rebuild lost tissue and close a wound.
The gel is placed directly onto the wound, which is then wrapped with a standard dressing.
A preliminary study at Barts Health NHS Trust, in london, showed that nine out of ten wounds that had not healed for nearly a year responded to the treatment, according to results published in the British Journal of Surgery.
‘Massively amplifying the healing response for patients trapped in a non-healing phase was associated with rapid wound closure,’ says Sandip Sarkar, a consultant vascular surgeon who conducted the pilot study. In the new trial at the same trust, 66 patients with diabetic foot ulcers that are not improving will receive either the new treatment or standard care.
Researchers will compare results after three months.
Commenting on the new gel, Stella Vig, a consultant vascular surgeon at Croydon University Hospital, says: ‘Chronic wounds are a burden to the patient, family and the NHS. Patients can also become allergic to dressings if they are applied over a long time, which further aggravates the problem.
‘A wound dressing made of a person’s own blood reduces the risk of allergic reactions. And a gel that provides healing for 90 per cent of patients who have given up on the wound ever healing is a real bonus.’
MeANWHIle, a hand-held device that measures oxygen levels in the skin could help doctors work out which patients are at risk of wound complications, say researchers at loyola University Chicago.
In a preliminary study of patients who had undergone cancer surgery, it was found that low oxygen levels near the wound increased the chances of a patient having complications after surgery, while higher oxygen levels meant the skin healed without difficulty.
The findings could change the way operations are scheduled.