Umbilical cord mesenchymal stem cells combined with autologous platelet-rich plasma for lower extremity venous ulcers: A case report and literature review

Abstract

Rationale: Nonhealing ulcers are difficult to manage because they deviate from the normal wound healing process. Conventional therapy cannot achieve satisfactory therapeutic effects. To verify the effectiveness of combined treatment with human umbilical cord mesenchymal stem cells (hUMSCs) and platelet-rich plasma (PRP) for nonhealing ulcers, we studied a patient with left lower limb venous ulcer (LEVU) treated with combined injection therapy.

Patient concerns: We present the case of a LEVU patient who has not healed for a long period of time (up to 1 year).

Diagnoses: LEVU was diagnosed with clinical symptoms.

Interventions: The hUMSCs plus PRP were injected into the wound edge and base (1 µL of cells/cm2 of wound surface), 0.5 mL at each point, with a distance of approximately 1 to 3 cm between points. The injection point was determined according to the extent of wound involvement.

Outcomes: Seven days after hUMSC + PRP application, the wound area decreased by nearly 50%. The ulcers had almost completely healed by day 62, and no serious treatment-related toxic side effects were observed.

Lessons: hUMSCs can improve wound healing through re-epithelialization, increased angiogenesis, and granulation tissue formation. PRP has also been suggested to promote wound healing through the secretion of various nutritional factors. The combination of hUMSCs and PRP has a mutually reinforcing effect, which may achieve a 1 + 1 > 2 effect. Therefore, the combination of hUMSCs and PRP may be a safe and effective treatment option for LEVU.

Figure 1.

Representative photos showing the healing progress of lower extremity venous ulcer on days 0, 7 and 62 after cell treatment.

Figure 2.

The mechanism of combined action of hUMSCs and PRP treatment for ulcer healing. hUMSCs = human umbilical cord mesenchymal stem cells, PRP = platelet-rich plasma.