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Healing powers of placenta prevent limb loss

Telegram & Gazette - June 24, 2015
By Geraldine A. Collier  

Nerve Damage and Circulation Issues

People living with diabetes often develop nerve damage in their feet that produces a numbness, preventing their feeling a cut or other minor injury, according to Dr. Samir Malkani, Director of Diabetes Services for member and affiliate hospitals at UMass Memorial Medical Center.  Sometimes that breakage in the skin opens up to an infection.

“Diabetes also causes blockages in your circulation, so you get what we call peripheral vascular disease,” explained Dr. Malkani, one of the specialists whose skills are called upon by UMass Memorial’s Limb Preservation Center. “You end up getting poor circulation to the limb along with the loss of sensation.”

Developing Ulcers

If that’s wasn’t enough, “while the nerve damage and poor circulation predisposes a person with diabetes to ulcers, once ulcers occur high glucose (blood sugar) in addition to the nerve and vascular damage prevent them from healing,” said Dr. Malkani.

The average time for an ulcer to heal is three to five months, according to Dr. Malkani, but some ulcers can take up to a year. Overall, about 80 percent of ulcers heal, but the remainder end up with a minor or major amputation because of infection of the bone and soft tissue that cannot be controlled.

Loss of Limbs

“The major fear of anyone with diabetes is limb loss,” said Dr. Louis M. Messina, chief of vascular surgery at UMass Memorial and acting director of the Limb Preservation Center where Richard Thibeault sought help when his left foot started to be trouble.

He had already lost his right leg three years earlier, because he hadn’t received effective treatment fast enough. Hearing that UMass Memorial was using a new kind of treatment, Thibeault went there, hoping he was not going to end up being a double amputee.

While it’s not the only way that the Limb Preservation Center treats ulcers, using the placenta definitely has kind of a “wow” factor to it.

What is Placenta

Simply put by medical dictionaries or online sites, the placenta is defined as “a membrane that develops during pregnancy, lining the uterine wall and partially enveloping the developing fetus to which it is attached by the umbilical cord. It provides oxygen and nutrients and transfers wastes from the developing fetus.”

That definition, however, doesn’t include one very important aspect of the placenta.

Placenta’s Ability to Heal Wounds

“There are very, very powerful factors in-utero (in the womb) that promote healing,” said Dr. Messina. For example, when surgery is done on a fetus that’s removed from the womb — a truly awesome procedure — and then put back into the womb, no scars develop.

Donating Plasma During Childbirth

It’s actually the innermost layer of the placenta, which is called the “amnion,” that’s used for healing wounds, but, of course that wouldn’t be available unless pregnant women didn’t agree in advance to donate their babies’ placentas, according to Ms. Manochi.

Babies are all delivered by Caesarian section – scheduled by obstetricians, not because of this donor program, but because of physical problems that make an alternate method of childbirth unfeasible.

After the baby is delivered, a recovery technician stationed in the delivery room, takes charge of the placenta, placing it in a sterile container and then in a cooler. It’s then rushed to a nearby Memphis laboratory belonging to Bio-D — a partner of DERMASCIENCES — where it is modified.

UMass Limb Preservation Center

Once in the hands of healthcare facilities, like the UMass Limb Preservation Center, “the membrane begins working right away to enhance the re-growth of the patient’s own tissue,” said Lorraine Loretz, a nurse practitioner/podiatrist who applies the tissue to the wound.

How It Helps People with Diabetes to Heal Ulcers

Promoting new blood vessels that are fundamental to healing leg and foot ulcers, the tissue is absorbed into the wound bed. “It’s reapplied, usually at two-week intervals, depending upon the re-growth rate of response,” she added. In Thibeault’s case, it took only about a month to heal his foot.

While there have been many ideas for healing diabetic ulcers, but most have not been rigorously tested, according to Dr. Messina. “The use of the placenta membrane is relatively new and there have been studies done that suggest that it will make a big impact, but it’s still on the early side.”