“Extensive burns and full thickness skin wounds can be devastating to patients, even when treated. There are an estimated 500,000 burns treated in the United States each year. The overall mortality rate for burn injury was 4.9 % between 1998 and 2007 and medical costs for burn treatments approach $2 billion per year,” Owan TE, Hodge D.O., Herges R.M, et al. (2006).
These statistics could as well be over 11 million injuries per year as claimed by some medical reports. Other than burns, full-thickness chronic wounds also claims a large number of patients and despite technological development of therapeutic approaches, healing rates remain way below 50 % of success.
Patients with the non-healing chronic wounds are as well estimated at about 7 million per year in the US alone. Yearly costs on the other hand continue to rise, the figure is currently approaching $25 billion. Patient survival is reportedly inversely proportional to the amount of time required to recover from such a chronic wound and to stabilize.
Those with severe burns of between or more than 15–20 % total their body surface area are also likely to go into shock without rapid treatment. In addition, without sufficient and or rapid fluid resuscitation, patient conditions deteriorate and mortality rates increase steeply.
Inadequate therapeutic programs often result in long-term patient complications including open wounds, prominent scars, prolonged pain, high temperature sensitivity, loss of feeling to touch and or itching.
Patients who suffer from such burns and or chronic wounds benefit from prompt treatments that result in appropriate closure and or protection of the wounds. Burn patients in particular, who receive delayed treatments, are usually subject to prolonged therapeutic care that has long-term negative physiological side effects.
Recent medical advancements have been made to handle wound healing; however, the generally accepted and practiced treatment approach still remains an autologous split-thickness skin graft. This involves extracting a piece of skin with the goal of removing stem cells from a minor surgical site on the patient’s body, stretching the skin, and re-applying the graft on the burn or chronic wound.
Stem cells are unspecialized cells in the body that majorly bear two specific characteristics. They have the capacity to replicate themselves indefinitely and have the ability to replace and or repair nearly all body tissues as directed.
Stem cells extracted from the amniotic fluid, (AFS) are reportedly a very rich cell source for use in regenerative therapy due to their high proliferation capacity, immune-modulatory activity and multipotency.
AFS also have the capacity to modulate inflammatory responses and secrete therapeutic cytokines. Because of these characteristics, AFS cells have been explored for treatments in wound healing and skin regeneration among similar therapeutic care.
These attempts have over time been backed by relevant scientific studies that increasingly indicate AFS cells are effective in accelerating healing of skin in embryonic environments and more recently in treating wounds in adults. More scientific evidence also points to the fact delivered cells are often temporary, that is, do not permanently integrate into final skin tissue.
Instead, they hide a portfolio of effective growth factors very vital to the skin regeneration and angiogenesis, suggesting a trophic ability of enhancing skin and or wound healing.
These initial pieces of scientific studies suggest delivery of AFS cells have the potential to be an effective cell treatment for enabling wound healing and should be considered for clinical trials and use in treating skin wounds in patients.
While this treatment indicates the ability to yield a reasonably good therapeutic outcome, if the wound is extensive, the number and size of donor sites may be limited, making autographs difficult to use in cases that require rapid and or aggressive measures to save the wounded patient’s life.
Alternatively, allografts may be used but the option suffers a critical need of immuno-suppressive drugs so as to prevent body immune rejection of the graft. This limitation has thus caused the creation of noncellular dermal substitutes, which most often comprises a polymeric scaffold.
They include skin regeneration template and Biobrane among others. Even though such polymeric scaffolds result in improved wound healing, they are costly to produce and more often result in relatively poor temporary outcomes.
Recent developments in tissue engineering have also led to more complex biological skin parallels that may yield more suitable alternative wound care options for patients. These include: cellularized graft-like products such as dermagraft, Apligraf (Organogenesis), and TransCyte, (Advanced BioHealing) among others.
The products are commonly polymer scaffold patches that are planted with human fibroblasts and cultured in vitro prior to their application. Unfortunately, these grafts are also expensive to produce, and as allografts, can suffer from the same immunological setbacks mentioned earlier.
This topic can go on and on. It is actually very interesting but it would not be possible to include everything in one article. However more information can be found at www.awaremednetwork.com. Dr. Dalal Akoury M.D., M.P.H., who is also a family physician and has many years of experience in integrative medicine will be of great assistance.
Also, do not miss an opportunity to learn and interact with various professionals during this year’s Integrative Addiction. For more information about the upcoming conference, visit http://www.integrativeaddiction2015.com. The conference will also deliver unique approaches to telling symptoms of addiction and how to assist patients of addiction.