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Stem cell therapy:
Stem cell therapy is a future of many diseases. Adipose tissue stem cells are extensively tried for wound management. Stem cell therapy is useful in degenerative bone disease, cardiac muscular degeneration, retinal degeneration, kidney disorder and some dermatological conditions in addition to wound management. Autologous stem cell therapy is likely to be accepted more easily by medical and ethical committees.
Fibroblasts, keratinocytes, adipose derived stromal vascular fraction cells, bone marrow stem cells and platelets are used as cellular therapy. When there is more skin loss, cellular therapy is a boon. Cells are derived either from a piece of skin by processing and culture or from adipose tissue in the form of stromal vascular fraction cells. The cells when applied on the wound survive on wound and start multiplying. Autologous and allogenic cells can be used for cellular therapy.
Skin and living skin equivalents:
Skin is the best dressing material. Cadaveric, allogenic, autologous and xenografts are available to cover large wounds. Acceptance of skin graft is better than bilayered skin substitutes. Skin substitutes are better to cover open bones and joints. Epidermal and Bilayered synthetic skin substitutes are very costly. Placental membrane is also available in plenty as a dressing material.
For wound management, it is gene transfer treatment and not gene therapy. There are physical, chemical and viral ways to introduce gene. Growth factor genes are transferred to wound cells. This in turn produces growth factors and helps the wound to heal faster. This therapy works better than local application of growth factors. It is a costly therapy and available in only a few centres. RNA,DNA viruses and lentiviruses are used as vectors for gene therapy.
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