CELL THERAPY AND STEM CELLS

N. Bhattacharya
Surgery And Ob/gyn, AMRI Hospitals, Calcutta/INDIA

Body: Introduction: The aim of the present study was to examine the effectiveness of composite and judicious use of different stem cell rich pregnancy specific biological substances (PSBS) like freshly collected amniotic membrane, amniotic fluid, and the placenta in case of extensive burn wound . Methods: Patients with more than 20 percent wound were admitted and options were given for conservative management with PSBS dressing at a non teaching hospital or provided with referral facility at the Burns Unit of another tertiary level Government Hospital. Those who opted for treatment with PSBS (procured from hepatitis-, syphilis- and HIV-seronegative mothers having undergone cesarean deliveries), were treated initially at Bejoygarh State Hospital (1999-2006) and the same regimen was followed later at Vidyasagore Hospital (2006-2009). The area affected included both partial to complete thickness thermal burns. Patients suffering from chemical burns, or burned areas in sensitive parts of the body such as the genitals or face, were also included in this study from 1999-2009. Result : 64 burn patients (male 24 , age 2years to 96 years, mean 36 years + 5.4 years and female 40, age 7 years – 68 years, mean 32 years + 5.7 years ) with 26-76 percent of total body surface area calculated on the basis of the famous rule of nine, were enrolled in the present study for PSBS treatment (1999-2009). Patients were treated with placenta After washing the burn site initially with normal saline followed by rubbing gently the burned area with a freshly collected placenta’s maternal attachment site as a dressing material (Step 1) This move may have a positive cytokine impact on the process of healing. Then to wash the burn site with freshly collected amniotic fluid as a cell therapy source (because of its rich content of epithelial and mesenchymal stem cell component, leaving aside its antibacterial propensity as a helpful adjuvant) (Step 2). At last amniotic membrane is applied at the affected area (Step 3) , as a temporary biological wound cover to expedite the healing and also to reduce the exudation, pain and infection of the burn wound site with judicious application mode, i.e., chorionic side to augment vasculogenesis in early wound and the amniotic side to promote epithelialization lately. This is an effective step to augment the cell therapy component of the amniotic fluid. Conclusion: The available currently globally used skin substitutes are costly and many are not universally available. The easily available and simple utilization of the biological waste generated from Obstetric ward for the burn victms is very effective and rewarding . Use of stem cell rich PSBS regimen has a profound regenerative impact in case of burn irrespective of the degree of burn. Its wider application is recommended on the basis of our experience of the present study, which has been carried out for ten years (1999-2009).

Disclosure: All authors have declared no conflicts of interest.