Abstract
The human placenta and its membranes have been used intermittently as wound dressings for more than 70 years. Term placenta is known to contain a number of growth factors essential to the healing process. The intense physiological activity of early placenta suggested that it should have similar attributes and we tested this hypothesis on one of the most refractory of all wounds – ulcers caused by chronic venous insufficiency.
The cytosol fraction of 6–8 week placenta was incorporated under sterile conditions into an inactive cream vehicle and applied daily to the ulcer. The preparation and quality control of this extract are described.
Eighteen patients were treated in this pilot study. The chronicity of the ulcers varied from 12 weeks to 30 years, and all had previously received conventional therapy. Ten patients with bilateral ulcers had treatment with the test preparation on one side only thereby serving as their own controls. Granulation tissue appeared between the 7th and 17th day after starting treatment, and epithelialization began within 2 weeks thereafter. The preparation produced complete healing in all cases and took 12 to 24 weeks, depending on ulcer size. None of the untreated ulcers were closed at the end of the trial. No breakdown has been seen so far on follow-up.
The healing effect suggests that trophoblast might supply the missing factor(s) normally operative in surgical wounds and uninfected traumatic wounds.
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