A new stem cell–based therapy may help persistent foot ulcers heal and potentially prevent amputations in people with diabetes, according to an early-stage study published in the journal Stem Cells Translational Medicine.
Diabetic foot ulcers — open wounds on the feet of people with diabetes that are typically resistant to healing, due to factors that may include reduced blood flow and nerve damage — are the leading cause of foot and leg amputations worldwide, as noted in a press release on the new study from the publisher — accounting for about 85% of all such amputations. Reduced blood flow to the feet is a common feature of peripheral vascular disease in people with diabetes, which currently has limited treatment options, the study authors noted in the press release. The aim of stem cell–based therapies, in this context, is to restore damaged blood vessels in the legs and feet and encourage the formation of new blood vessels.
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For the latest study, the researchers used a collection of different cell types derived from fat tissue, known as stromal vascular fraction (SVF). They were interested in studying the effect of local (into the foot) SVF injections in people with type 2 diabetes with foot ulcers greater than 3 centimeters (1.2 inches) in diameter. The participants were 63 people ranging in age from 35 to 70, all of whom were considered candidates for amputation. Each participant received SVF injections around the ulcer and into arteries in the foot. Progress in healing was evaluated six months and 12 months after the treatment.
The researchers found that after six months, 51 of the participants had 100% closure of their foot ulcer, while another 8 participants had greater than 75% closure. Another three participants had an amputation, and one died. After 12 months, 50 of the participants still had 100% closure of their ulcer, while another four had greater than 85% healing — demonstrating lasting benefits from the treatment. The researchers observed that healing took place not just from the outside of ulcers closing inward, as expected, but also from the bottom of ulcers toward the surface of the foot. Even larger foot ulcers greater than 10 square centimeters (1.55 square inches) in diameter saw greater than 85% closure after six months in nearly all cases, and there was no correlation between ulcer size and healing.
“By using SVF injection, surgeons can prevent limb loss, an outcome with devastating socioeconomic consequences for both the patient and society,” the researchers concluded. “The SVF protocol presented is easy to execute, can be carried out quickly and safely as an ambulatory procedure and can be done under the demanding conditions that are often experienced in the developing world.” More studies will probably be needed, though, before SVF injections become an accepted and widespread therapy for nonhealing diabetic foot ulcers.
Want to learn more about keeping your feet healthy with diabetes? Read “Caring for Your Feet When You Have Diabetes,” “How to Choose Footwear” and “Improving Blood Flow to the Feet.”
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