Diabetic Foot Ulcer




Pressure ulcers are known as the deep tissue injury of the skin, formed due to constant rubbing or irritation of the skin. Increased pressure reduces the flow of blood to the area, causing the skin to die, which may ultimately form an ulcers. You are more likely to get a pressure ulcers if you

  • Use a wheelchair or stay in bed for a longer time
  • Unable to move some of the body parts due to spinal cord injury or brain injury
  • Diabetes or vascular diseases associated with the constricting blood flow
  • Due to urinary or bowel incontinence
  • Malnourishment, fragile skin

Skin is the largest organ of the body, acting as a barrier against the atmosphere. It is solely responsible for protecting it from infections by preventing the entry of pathogens. The skin mainly is made up of three layers known as The Epidermis- outermost layer, The Dermis- Middle layer and The Hypodermis- innermost layer of the skin. The outermost layer is made up of various cells such as epithelial cells, keratinocytes, fibroblasts etc., which are responsible for structural integrity of the skin and if due to any of the above mentioned reasons the pressure sore develops, these cells are highly affected delaying the process of healing. The decreased blood flow around the wound will worsen the condition so mush so that the infection has spread to even muscles, bones, tendons etc.

Since there are available medicines and ointment as the treatment regimen for these ulcers, but their healing proved to be very time consuming and the recurrent rate is also high. Although stem cell treatment trails conducted worldwide have shown some good results.


Symptoms of Pressure Ulcers

    The symptoms fall into one of four stages based on their severity, they may be

  • Stage I: It is the beginning stage of the sore with the characteristics such as red patch on the skin, the area of the affected skin may be tender, painful, firm, soft, warm compared with the surrounding tissue.
  • Stage II: The outer layer of the skin( Epidermis) or part of the underlying layer such as dermis is damaged or lost due to which the wound may look like a fluid filled blister
  • Stage III: The ulcer is with a deep wound, usually exposing some fat. The bottom of the wound may have some yellowish dead tissue
  • Stage IV: The ulcer shows large scale loss of tissue involving muscles, bones, tendons. The dead tissue that’s yellowish, dark or crusty

With the advancing technology, the treatment implementing Platelet Rich Plasma, is gaining popularity as a biological booster to accelerate body's delayed healing mechanism and maximise cell proliferation. The use of PRP is a very efficient technique being employed since 1990's to promote healing of the soft tissues as well as wounds and is categorically attracting many doctors, due to it's incredible outcomes; that have been observed through various clinical trials The PRP is a platelet concentrate with liquid plasma portion containing various essential growth factors, important to promote cell recruitment, multiplication as well as specialization, for faster healing. The PRP injections are prepared from the patient's own peripheral blood under strict asceptic conditions, following good laboratory practices. It is one of the best point of care technologies, exploiting patient's own activated platelets; that when infused back into the patient, can release various growth factors at the site of injury. This can in turn stimulate the microenvironment, cytokines and resident stem cells to boost initial healing processes such as inflammation, repair and remodelling. Various studies have indicated that the PRP shots have augmented healing, improved function by promoting the proliferation of reparative cells and reduce the pain associated with various maladies including but not limited to orthopaedic, wound healing, diabetic foot and sports injuries. So far so good, no adverse effects have been reported nor have we came across any after the PRP treatment, as we are exploiting patient's own blood, for which they should have no reaction to!

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PRP Treatment For Pressure Ulcers: Advancells Protocol

The treatment at Advancells is focused mainly on improving the patient’s quality of life along with repairing the damaged tissues and restoring its lost function. For the diabetic foot, wounds and other open sore; we have designed a specialized treatment that employes patient's own PRP. Which is actually a plasma rich in the platelets. These pletelets can secrete growth factors and cytokines enabling faster healing and regeneration of damaged cells.Various studies have confirmed that the platelets play a pivotal role in the process of wound healing by initiating the inflammation. Our top priority is thus to provide very comprehensive, individualized treatment pattern which is best suited for the patients undergoing treatment, aiming their maximum recovery; according to the pathophysiology of the injury.

At Advancells, in choosing the treatment strategy, we give special consideration to the stage of wound and accordingly the purpose of the treatment such as protection, moisturization, removal of necrotic tissue etc. An algorithm for assessment and treatment is made accordingly. As a part of our treatment, patient's peripheral blood is withdrawn to prepare autologous plasma concentrate highly rich in platelets possessing various growth factors. In general for the treatment of DFU, PRP is infused locally around the wound to speed up the process of effective healing.

Step 1- Qualification For The Treatment

A safety and efficacy assessments will be prescribed by our experts in order to investigate the stage of severity and qualify the patient for the treatment. Following pretreatment assessments can be suggested depending upon the patient's medical and family background:

Pre-Treatment Assessments Wounds

  • Infectious Disease Testing
  • Routine Blood tests
  • Physical Examination
  • Urine analysis
  • X ray
  • MRI
  • CT-Scan
  • Non Invasive Vascular Studies
  • X ray
  • Medical Reports & History

As per these results, the patient will be counseled further for final decision of protocol.

Step 2- Source Extraction

PRP is rich platelet concentrate, with the seven essential protein growth factors which can rapidly initiate cascade of reactions for wound healing; additionally it includes three very fundamental proteins that can act as a "Cell Adhesion Molecules" to activate signal transmission. This activation can express the gene, directing the cellular proliferation, matrix formation, osteoid formation and collagen synthesis; which promote tissue repair and regeneration. Reasearch has as well confirmed that after injection in the body, PRP can actively secrete the growth factors within 10 mins while more than 95% of them are secreted within 1 hr after activation.

If you are curious to know more about the procedure, kindly refer our detailed snapshot below:

stem cell treatment for ALS

Step 3- Laboratory Processing

PRP is generally obtained from the peripheral blood of the patient drawn at the time of treatment. Approximately 30CC will be drawn from the patient depending upon the baseline platelet count of the individual.In order to prevent unnecessary activation of platelet, the venous blood of the patient will be collected using suitable anticoagulent. A specialized process will be employed to separate the platelet rich plasma from the whole blood of the patient; which is then infused around the wound or other targeted area under the guidance of specialist to promote faster wound healing.

The sample will undergo minimum manipulation to be enriched with the pure population of platelet; which would the best possible treatment for faster wound healing.

The client will be given a third party certificate from Internationally Accredited Lab for the quality purpose.

Step 4 - Implantation

Once the PRP ready to be injected back into the body, we generally put them back through local intradermal administration through syringes around the wound.

  • Intra-Dermal Administration:- The technique is used in case of open sores, wherein PRP will be infused locally in and around the wound area.

Follow up Treatment

Post treatment, the patient will be asked to visit the doctors for reclamation therapies such as Physiotherapy, patients counselling etc. for accelerated recovery.


Pressure Ulcers Treatment Results

Patients, who have undergone a PRP treatment with Advancells for their wounds such as diabetic foot have acquired a very fast recovery. All of them were suffering from non healing diabetic foot during their late 50's as a major complication of Diabetes. Since the management of the wound in diabetic patients is very poor and painful, a kind of advanced technology was suggested for them as a treatment to manage the problem; which can easily take over to traditional options such as surgeries, debridement, antibacterial actions etc. A PRP was isolated from the peripheral blood of all the patients and injected around the wound through microneedles. The results showed that 100% ulcers completely closed after about 7-8 weeks. Although, patients response to the wounds was not typical; no adverse effect has been observed till now. The method is completely authentic, approved by the regulatory authority as a novel and minimally invasive method.

Patient's Stories

Mr. Ramesh Sharma (name changed), 60 years, Diabatic foot

" In 2006, when Mr. Ramesh Sharma had been diagnosed with the diabetes, his family were shocked with the news! He was a fit, healthy man with happy family and work life. Mr. Ramesh began with the treatment that was progressing effectively. However the treatment left him with the severe diabetic foot wound on his right leg. The wound was causing him severe pain disturbing his routine life. He had previously sought treatment at different centers before finally being referred to Advancells........"




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