A New Medical Device, in the Management of Complex Wounds
Innovative Wound Healing: The Gcells Solution
Because of the complex nature of the wound healing process, an injury on the skin can pose several challenges and likely complications, especially when acute. They can deteriorate from acute to chronic conditions, requiring external intervention best understood by a specialist physician to restore normalcy to the affected area.
The Complexity of Wound Healing
The complexity of wound healing and research remains an ocean of knowledge that is continuously researched intensely to uncover depths of wound healing techniques and interventions. Hence, this report contains an introduction and details on the use of a new medical innovation called Gcells, used primarily for the management of wounds of different etiologies.
Gcells: A Breakthrough in Wound Management
In cases where the process of wound healing seemed difficult, Gcells proved great effects, attributed to their design and working protocol. Gcells are conditioned to work with an enriched suspension of progenitor cells that can efficiently aid the tissue repair process. In this case report, two subjects were used as donors and acceptors of these micro-grafts.
Understanding the Skin’s Repair Mechanism
The skin is the outer layer of the body, offering protection to the underlying layers. A wound breaks this layer, inhibiting its various functions and potentially exposing or breaking the underlying tissue layers. Repair processes are inherent and part of homeostatic processes of the body to try to restore the skin to its normal structure and function.
Basic Wound Healing Process
The basic process for skin repair involves clot formation and inflammation, where vessels dilate and monocytes activate, leading to the breakdown of necrotic tissues. This basic process can be inhibited or delayed by various factors, leading to the transformation of acute wounds to chronic forms. If there is no alteration in the repair process, mesenchymal cells kickstart the proliferative process, beginning to repair and restructure the affected tissues from the base. At the same time, epithelial tissues begin to grow around the wound, leading to the final step of the healing process: skin remodeling and scar maturation.
Factors Affecting Wound Healing
These processes work best under certain conditions. Factors such as cardiovascular ailments, diabetes, bacterial infections, or other types of infections can inhibit these processes.
Importance of Mesenchymal Cells
During the proliferative phase of wound healing, mesenchymal cells are key players. Their structure includes mesenchymal stem cells (MSCs), which are multipotent and offer supportive, therapeutic, and trophic functions. They can release viable trophic, anti-inflammatory cytokines, and anti-apoptotic molecules that offer protection during the repair of wounded skin. MSCs also possess subpopulations with stem-like nature, commonly referred to as “side population” (SP) cells. These cells are enriched in progenitor and multipotent stem cells and exist in various tissues and tumors.
Research on Stem Cells
Research has shown that these stem cells can differentiate into osteoblasts and build a woven bone by forming an extracellular matrix (ECM) secreted by the osteoblasts. This discovery demonstrated the potential of dental pulp as a rich source of progenitor/autologous cells that can aid in healing processes, including the regeneration of craniofacial bones.
Gcells Innovation: Working Principle
Gcells successfully separate this side population with a size of 50 microns. At this cell population, they can form autologous micro-grafts that can be used alone or alongside biomaterials prepared in a biocomplex ready for use when necessary.
Case Report Overview
In this case report, two subjects were used as donors and acceptors of these micro-grafts for enhanced healing of complex wounds through autologous micro-grafts using Gcells.
Clinical Case 1: Abdominoplasty Bariatric Complications
The first case involves a 50-year-old woman with no diseases or disorders. She underwent a laparoscopic gastric bypass surgery and was doing well with weight loss parameters. Two years later, she moved in for abdominoplasty bariatric surgery. Post-surgery complications showed necrosis, discovered after the first medical examination, with tissue loss of about 150 to 200cm² at the end of the flaps.
Initial Treatment
An initial necrosectomy showed an intense loss of tissue, and the wound was placed on VAC therapy. The patient actively participated in this therapy for one week, then continued at home as an outpatient. The VAC therapy showed progressive wound cleansing and granulation tissue formation around the base area.
Gcells Intervention
The Gcells protocol started after consent from the outpatient. A 3cm² skin sample was collected from the patient to obtain the cell suspension needed to be injected into the granulation tissue. Conventional wound treatment followed, including cleaning and replacement with sterile gauze dabbed with Vaseline.
Outcome
The wound area began to improve in healing progress and general appearance. In two months, the undermined area disappeared and leveled with the skin surface. Two months later, the wound reduced to a very mild and smooth scar compared to the initial condition.
Clinical Case 2: Complications from Liver Cirrhosis and Surgery
The second case involves a 78-year-old man who suffered from liver cirrhosis, hiatal hernia, and diabetes. He underwent complex surgery, including distal esophagectomy and ileostomy protection. Post-surgery complications included necrotic tissues around the biological prosthesis.
Initial Treatment
Necrosectomy was conducted, leaving the biological prosthesis half exposed. Further treatment helped cover the biological prosthesis with granulation tissue. Plastic surgeons evaluated the patient, and VAC therapy was used on the wound for about 15 days.
Gcells Intervention
The Gcells protocol was applied when the wound dimension progressed to about 250cm². The tissue granulation near the ileostomy improved, though it appeared undermined.
Outcome
Gcells protocol proved highly effective in healing and restoring damaged tissues. This progress opens the way for its use in clinical practice for treating and managing acute and chronic wounds and other medical fields needing tissue repair.
Discussion and Conclusion
Gcells protocol has demonstrated efficiency in aiding wound healing, especially for wounds likely to develop from acute to chronic conditions. The working principle of Gcells, using one individual as both the donor and acceptor, reduces complications related to non-autologous implants or micro-grafts. Gcells are flexible and can be used in operating rooms and ambulatories. This innovation is spreading and is currently used in oral-maxillofacial fields, plastic surgery, dermatology, and orthopedics.
Final Thoughts
Gcells offer a promising, efficient, and low-risk innovation in medicine for wound management and healing. The device still needs further testing on subjects with different conditions, but its potential to improve healing of complex wounds is significant. Gcells can reduce the use of expensive devices and offer employment in clinical procedures aiding in wound management.
- Published in Corporate News / Blog