Successful application of conditioned culture medium for the treatment of a chronic wound of an amputation stump: a clinical case

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Abstract

Background: Amputation of the lower extremities is a necessary procedure to save a patient with critical arterial and neurotrophic disorders in the lower extremities. The amputation stump-related complications develop in many patients with diabetes mellitus (up to 40% of the total population).

Clinical case description: Patient Yu., 64 years old, was admitted on October 19, 21 for an outpatient treatment of purulent-necrotic wounds of the amputation stump of the right lower limb. А high amputation was performed on September 24, 2021 due to thrombosis of the femoral-tibial bypass, installed on September 08, 2021 (bypassing below the knee joint gap with a Vascutek 7 mm synthetic prosthesis on the right) and the development of critical ischemia of the right lower limb with necrosis of the distal phalanges of the right foot toes. The wound was assessed according to the Bates-Jensen scale (BJ) and examined according to the developed protocol. The wound treatment was carried out according to an individual plan using a conditioned culture medium from mesenchymal stem cells (CM-MSCs), which stimulates angiogenesis and improves remodeling and recovery in the wound area. CM-MSC application made it possible to reduce the healing time and achieve a scarless closure of the tissue defect.

Conclusion: The use of CM-MSC can be an effective method for healing a purulent-necrotic postoperative wound resulting from amputation of a limb in patients with critical ischemia of the lower extremities.

About the authors

Andrey I. Cherepanin

Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency

Author for correspondence.
Email: surgdoccher@yandex.ru
ORCID iD: 0000-0002-6254-8966
SPIN-code: 8652-7153

MD, PhD, Professor

Russian Federation, 28, Orekhovy blvd, Moscow, 115682

Olga V. Pavlova

Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency

Email: vasa-vasorum@mail.ru
ORCID iD: 0000-0002-9459-7391
Russian Federation, 28, Orekhovy blvd, Moscow, 115682

Vladimir A. Kalsin

Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency

Email: vkalsin@mail.ru
ORCID iD: 0000-0003-2705-3578
SPIN-code: 1046-8801

научный сотрудник лаборатории клеточных технологий

Russian Federation, 28, Orekhovy blvd, Moscow, 115682

Mikhail A. Konoplyannikov

Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency

Email: mkonopl@mail.ru
ORCID iD: 0000-0003-1180-2343
SPIN-code: 9211-6391

PhD, Cand. Sci. (Biol.)

Russian Federation, 28, Orekhovy blvd, Moscow, 115682

Olga N. Kucherova

City Clinical Hospital named after V.V. Vinogradov

Email: ola-kucherova@mail.ru
ORCID iD: 0000-0003-3773-9629

MD, Ph.D.

Russian Federation, Moscow

Victor L. Baldin

Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency

Email: baldinvl@gmail.com

MD, PhD

Russian Federation, 28, Orekhovy blvd, Moscow, 115682

Sergey V. Deryabin

Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency

Email: deryabin@mail.ru
SPIN-code: 4929-0910

врач-сердечно-сосудистый хирург отделения сосудистой хирургии

Russian Federation, 28, Orekhovy blvd, Moscow, 115682

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2. Fig. 1. Patient Yu., 64 years old, diagnosis: “Atherosclerosis of the arteries of the lower extremities, occlusion of the femoral-popliteal segment on the right”: the wound condition at the beginning of the treatment (BJ scale).

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3. Fig. 2. The same patient: a wound in the area of the right lower limb stump (amputation at the level of the middle third of the thigh), the initial wound appearance.

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4. Fig. 3. The same patient: a view of the wound in 1.5 months.

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5. Fig. 4. The same patient: a complete wound closure in 3.5 months, the final result.

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Copyright (c) 2022 Cherepanin A.I., Pavlova O.V., Kalsin V.A., Konoplyannikov M.A., Kucherova O.N., Baldin V.L., Deryabin S.V.

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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