Chronic wounds (or skin ulcers) account for approximately 6 million skin wounds in the United States and 37 million skin wounds globally. ¡°World Wound Care Markets 2008¡± Kalorama Information May 2008, New York. Pressure ulcer wounds account for the largest portion of these figures with an estimated 2.5 million each year in the United States and 9 million around the world. This is primarily due to an aging population and the increasing number of elderly that have debilitating disorders that restrict movement or provide an impetus for skin breakdown. Diabetic ulcers are an area of increasing concern with the rising incidence and prevalence of diabetes around the world. More than 2.3 million Americans are treated for a diabetes related skin ulcer each year and approximately 20 million diabetics experience these ulcers annually.
Compared to acute wounds, chronic wounds represent a greater medical challenge due to various complicating factors. A chronic wound is defined as a break in the skin of long duration (>6 weeks) or frequent reoccurrence. A myriad of factors can delay wound healing, such as chronic diseases, vascular insufficiency, diabetes, neurologic defects, nutritional deficiency, advanced age, and local factors such as pressure, infection and edema. A thorough and systematic evaluation of a patient with a non-healing wound is generally required to determine the etiology and likelihood of responding to therapeutic interventions. Etiologically common chronic wounds include venous ulcers, arterial ulcers, diabetic foot ulcers, pressure ulcers, vasculitis, and pyoderma gangrenosum.
Depending on the etiology and the condition of the wound bed, the wound care profession can choose from a wide variety of treatment modalities utilizing various products and/or devices to enable the healing. The wound care products include various wound dressings (gauzes, films, hydrogels, hydrocolloids, alginates and hydrofibers, and foams), ointment (e.g., calmoseptine ointment), paste (zinc oxide paste), Vaseline petroleum jelly; compression dressings to relieve edema and stasis. Recently topical negative pressure devices (or vacuum-assisted closure (VAC) devices) have been developed to hasten wound healing. Moreover, a few types of biological wound care products are developed to aid wound healing, including recombinant human platelet-derived growth factor isoform BB (becaplermin; Regranex®), allogenic and synthetic skin substitutes. Fonder et al. (2008) ¡°Treating the chronic wound: A practical approach to the care of nonhealing wounds and wound care dressings¡± J. Am. Acad. Dermatol. 58:185-206.
Despite of the availability of a myriad of such wound care products and devices, it still remains a major challenge to heal late stage chronic wounds which, if not healed, could lead to serious complications and threaten the patient¡¯s life (Figure 5.0.1), including A) Marjolin¡¯s ulcer in nonhealing pressure ulcer; B) Infection with malodorous green or blue exudates; C) Infection as shown by dark red granulation tissue that bleeds easily on contact; D) Maceration; E) Eschar; F) Dry wound; and G) Skin tears as a result of certain strongly adherent dressings. Fonder et al. (2008), 189, supra. In addition, long-term and high-dose usage of biologic local agents such as purified recombinant human growth factors may increase the risk of developing cancer in patients. On the other hand, application of antibacterial local agents to the wound may passively inhibit microorganism but significantly impede regeneration of the wound. To many physicians or practioners, closure of the wounds is an outcome satisfactory enough; regeneration and restoration of the physiologic structure and function of the affected body part remain unattainable.
MEBO¡¯s regeneration therapy and products have been used to successfully treat various chronic skin ulcers, including diabetic ulcers, pressure ulcers, venous stasis ulcers and artery ulcers. Interestingly, MEBO wound ointment has found to be able to locally stimulate regeneration regardless of the etiology of different types of ulcers, and to steadily sustain fresh, healthy granulation tissue growth over a long period of time, eventually leading to healing of the wound and significant restoration of structure and function of the body.
1. Regeneration of New Tissue and Skin on Diabetic Foot Ulcers
2. Regeneration of New Tissue and Skin on Pressure Ulcers
3. Regeneration of New Tissue and Skin on Venous Ulcers