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Macrophage Suspensions Treatment of Infected Sternal Wounds Following Cabg Surgery

Abstract

Macrophages serve as the coordinators of the wound healing process. Since 1998 following the Israeli Ministry of health authorization, macrophage suspensions have been used for the treatment of ulcers, in more than 800 elderly and paraplegic patients suffering from decubital chronic ulcers. As previously published, a significant number of genes showed increased levels of expression in hypo‐osmotic shock activated cells, using DNA microarrays technique. The majority of these genes are considered to be directly involved in the macrophage function and in the wound healing process. Macrophge suspensions are prepared from a whole blood unit of healthy, young volunteer blood donors in a closed, sterile system, as previously described. The activated cells are applied to the wounds either by local injection or by direct deposition to the wound. Between January 2000 and October 2003, 112 patients with postoperative sternal wound infection were treated with macrophage suspension. Full closure of the wounds was achieved in 104 (93%) of the patients. Original wound surface area8–175 cm2 (mean 93)Days until treatment6–180 (mean 47)Days until 50% closure6–60 (mean 21)Days until full closure10–138 (mean 49) No side effects were noted. The use of macrophage suspension is a safe and effective therapeutic strategy that reduces risk of complications and morbidity and improves the quality of life for long ‐suffering patients. Length and cost of hospital stay may be reduced, as the treatment requires no hospitalization.