The new way to heal diabetic ulcers ... a jab of muff in top fat

THE dreaded muffin n top is the bane of many y people’s l i ves – an n unsightly roll of flab b that spills over the top p of trousers or a skirt. But now doctors have discovered d an ingenious use for the excess s fat – they are using it in injections s for painful foot ulcers that are diffficult to treat.

The technique, which results in n rapid healing of the ulcer, has been n found to be particularly effective e among diabetic patients.

Researchers running a trial say y the results so far have been impress sive, with an average healing time of about one month with the ‘fat at jab’ compared with six to 12 months s with conventional treatment.

More than 15 per cent of diabetic c patients will develop ulcers due to o high blood sugar damaging nerves s in their legs and feet.

This nerve damage dulls feelings s and sensations, meaning diabetes s sufferers may be unaware that

a their the foot is injured or cut, and may continue to walk on it until a painful blister or ulcer is formed.

In healthy skin, the migration of new, healthy cells to the affected area speeds up healing.

However, diabetic patients experience 75 per cent less healthy cell migration, meaning the wound struggles to heal.

H IGH blood sugar levels can also clog the arteries and reduce blood flow to a wound, resulting in severe infections. And amputation is a very real danger; once an ulcer develops, the risk of losing a limb rises eight- fold, with 6,000 diabetic patients requiring this drastic surgery every year.

The usual treatment of diabetic ulcers involves a course of antibiotics or a steroid cream. But it is not always successful and tends to involve slow healing rates and, if the ulcer returns, repeated trips to hospital.

But the new 30-minute procedure, currently being tested at the Royal Free Hospital in North London, offers hope to those who suffer recurring ulcers up to ten square centimetres in size.

Although the trial is in its very early stages, Professor Ash Mosahebi, the surgeon leading the trial, has witnessed a dramatic improvement in his patients.

‘Diabetic wounds can be disabling for some patients as they are often sore and painful when walking,’ he says.

‘But after this procedure, the local anaesthetic wears off within a couple of hours and the wound is healed within a month, rather than up to a year.’

The procedure uses stem cells – cells that are capable of turning into all kinds of other cells the body

td needs. This helps to regenerate damaged areas and also release anti-inflammatory proteins to aid the healing process.

Stem cells can be derived from bone marrow, the blood or fat tissue – and in the treatment of ulcers and wounds, the cells from fat are key.

Fat cells are particularly useful as they are very rich in stem cells and can be extracted by a single injection.

During the procedure, patients are first given a local anaesthetic in both their abdomen and around the area of the wound.

A large syringe is then inserted into the abdomen to extract about 10ml of fat tissue. The fat is spun rapidly in a centrifuge, which separates the active stem cells from everything else.

A blood sample is also taken and then processed in the same machine in order to extract concentrated blood cells with healing properties, known as platelet-rich plasma.

The wound is cleaned and prepared before the fat and the blood are injected into the affected area using a needle. The patient then goes home.

Because the treatment involves a combination of the patients’ own fat cells and blood, there is a lower risk of the injected cells being seen as a foreign body by the immune system and attacked.

‘ We are seeing wounds heal extremely quickly,’ says Prof Mosahebi. ‘ With conventional treatments, such as creams and dressings, patients can be back and forth for years experiencing infections - and may need to be prescribed antibiotics.

‘Body fat is a rich source of stem cells, which several studies have shown have great potential in wound repair and in improving blood supply, but the regenerative power of fat and blood has not been fully realised yet.’

P ROF Mosahebi adds: ‘ Wound repair is a complex process involving inflammat i on, t he growth of new blood vessels and the forming of new tissue. This method of stem-cell transfer brings the repairing elements into the wounds, rather than waiting for them to develop naturally.’

Although further medical trials are needed to determine long-term success rates, surgeons report that many of the patients so far trialled have been delighted with the results.

Prof Mosahebi says: ‘We hope this method is speeding up the repair process. We think it has the potential to make a real impact on the treatment of these patients, for which so far no definitive treatment has been developed.’

Although the trial is currently available only for diabetic patients, Prof Mosahebi believes this method has the potential to treat a range of other wounds in the future.