Symposium i‐2. pathophysiology and treatment of pressure ulcer Moderated by Takashi Tajiri: Wound Bed Regeneration by Autologous Unfractionated Bone Marrow Transplantation

Although the pathogenesis of chronic ulcer still remains undefined, one of the characteristics is poor granulation of wound bed, in other words, disruption of wound angiogenesis. Experimental studies have shown that bone marrow (BM) derived endothelial progenitor cells take part in postnatal neovascularivation in cutaneous wound healing. BM cells also contain mesenchymal stem/progenitor cells with pluripotency differentiating into myofibroblasts and fibroblasts. We treated nonhealing leg and foot ulcers sustained over one year by topical transplantation of autologous fresh unfractionated BM-impregnated collagen sponge (BMiCS). In all patients, the treatments led to rapid generation of well-vascularized granulation tissue. All of the wounds were healed up completely with conservative treatment or skin grafting. We suggest that direct transplantation of autologous bone marrow cells on the wound may represent a novel procedure for regeneration of disrupted wound healing on recalcitrant cutaneous ulcers.