Spray on Skin Cells Heal Wounds Fast

Non healing ulcers and wounds in the elderly are a common and severe problem. These skin breakdowns are painful, often get infected and often require wound care teams to treat the problem.  Robert Kirsner, MD, PhD of the University of Miami Miller School of Medicine Division of Dermatology reported in the online edition of the prestigious Lancet magazine that he is using a spray bottle containing a mix of skin cells called keratinocytes and fibroblasts to enhance the rate of healing.

Dr. Kirsner is looking at healing venous stasis ulcers of the legs. It is common to find venous insufficiency of the legs in senior citizens (poor return of blood from the legs through the veins and back towards the heart).  Venous ulceration and skin breakdown occur in 1 – 2.5% of these adults 65 years and older.  Treatment routinely consists of clearing and controlling infection with antibiotics, primary dressings and compression bandages and stockings. This is successful in 30% – 75% of the situations.  The remaining cases require skin grafting and surgical procedures to heal.

To treat this common and persistent problem, Dr Kirsner and associates have been working with a product known as HP802-247 which is a cryopreserved sampling of fibroblasts and keratinocytes derived from neonatal foreskin tissue that is discarded after circumcision of newborn infants. Thawed cells are suspended in a spray for application to a wound.   The researchers created three strengths of the spray and tested all against standard treatment.  All patients in the study, whether receiving the experimental spray or a placebo, received standard and traditional wound care.  Kirsner’s results show that by using the lowest dose of the spray he was able to achieve complete healing in almost a third more patients as compared with the placebo group.  Differences in the healing rate became apparent within the first week of the treatment.

The product, HP802-247, has shown enough improvement in healing rate and total healing to warrant advancing it to Phase III studies which have begun in the United States and Europe.  While the initial studies have looked only at wounds caused by venous insufficiency, it will be interesting to see if similar studies are initiated on additional slow healing wounds common in seniors as well as in burn unit situations.

Flu Shot Campaign Begins

As school bells ring out announcing a new school year and pigskins fly through the air announcing the arrival of a new football season, the Center for Disease Control and Prevention (“CDC”) begins its annual influenza vaccine campaign.  “Flu” or influenza is a viral illness associated with fever, severe muscle aches, general malaise and respiratory symptoms.  Most healthy children and adults can run a fever for 5 – 7 days and fight off the infection over a 10 day to three week period.  There is clearly a long period of malaise and debilitation in many that lasts for weeks after the acute febrile illness resolves.

The illness is especially severe and often lethal in the elderly, in infants, in patients with asthma and chronic lung disease and in those patients who have a weakened immune system due to disease or cancer treatments. Diabetics and heart patients are particularly vulnerable to the lethal effects of unchecked influenza.

The CDC recommends vaccinating all Americans over six years old against influenza.  Adults can receive an injection, or a nasal application.  The 2012 – 2013 vaccine has been updated from the 2011 – 2012 version based on samplings of current influenza viruses spreading around the world.   It takes about two weeks to develop antibodies and immunity to influenza after you receive the vaccination.  If you received the vaccine last season or had the flu last season you are still advised to receive the 2012 – 2013 vaccine this year because immunity fades with time.  Flu vaccine should have arrived in most physician offices and community health centers and pharmacies by mid- August.  The CDC advises taking the shot as soon as it is available.

The vaccines used are not live viruses so one cannot catch the flu from the vaccine. Side effects usually include warmth and tenderness at the injection site and rarely general malaise and low grade fever a day or so later.  The benefits of receiving the vaccine far outweigh these minor and rare ill effects which can be treated with an ice pack to the injection site and some acetaminophen.  Please call your doctor to set up an appointment for a flu vaccine.

For those individuals who catch the flu we still have several antiviral agents available to treat the illness. These agents should decrease the intensity or severity and duration of the flu. We try to use these medicines as infrequently as possible because the flu can develop resistance to them over time.

Prevention of disease is an ever increasing component of our everyday language. Vaccination against an infectious disease such as flu or influenza is clearly one of the more effective preventive strategies physicians have available to offer patients.  While you are making arrangements to receive your flu shot inquire about several other effective adult vaccines including Pneumovax to prevent bacterial pneumonia, Zostavax to prevent shingles and post herpetic neuralgia and Tdap to prevent whooping cough or pertussis and tetanus.