Treatment of pressure ulcers in patients with spinal cord injury: Conventional surgery vs. cellular therapy

Advancements in cell-based therapies for the treatment of pressure injuries: A systematic review of interventional studies

“…Similarly, another non-randomized controlled trial study reported a shorter hospitalization duration (length not specified in the study) when comparing BM-MNCs therapy (injection of 10 mL of cell suspension under the suture) to only direct surgical closure of PI (grade III/IV) in patients with SCI. 25 Although the incidence of complications during the initial trimester after surgery demonstrated a comparably high percentage (>30%), the intrasurgical administration of the cell suspension negatively influenced the healing rate and led to an increased rate of recurrence. In the long-term – between 6 months and 1 year post-treatment – the recurrence rate was significantly higher (39% against 3%) in the group treated with BM-MNCs compared to the conventional surgery (fasciocutaneous flap).…”

“…Quality of each study was examined using the NHLBI Quality Assessment Tool and Cochrane risk of bias tools (Tables S2-S4, Supplemental Material, File 2). Out of six studies, one was a randomized controlled trial, 28 two of them were non-randomized controlled trials, 25,29 , three were uncontrolled pre-post studies (Table 2). 24,26,27 Five studies demonstrated a moderate risk of bias, because the outcomes measured could be minimally influenced by knowledge of the intervention received by study participants.…”

“…One study, the RCT, was classified at high risk of bias due to the unclear method of randomization of the patients included in study. Three studies (50%) were classified as Level 3, 25,28,29 , three studies were classified as Level 4 study. 24,26,27…”

“…PI recurrence was not reported in almost all patients after intervention with cells, however there was an increased relapse in BM-MNC-based therapy after 1 year. 25 Whether this relapse highlights a potential downside in the use of BM-MNC is unclear because the initial healing rate within the initial 3 months following surgical closure remained indistinguishable, regardless of the cell therapy. The claimed shorter hospitalization due to accelerated wound healing was not confirmed by the presented data.…”