Doctors at a Nepal hospital trialling a new treatment for skin wounds say the technique, which mimics the scabbing process, has “enormous potential”.
Trials at the mountaintop Anandaban leprosy hospital, south of Kathmandu, have been promising, bringing hope to patients worldwide. It is hoped that the treatment will also help millions living with diabetes, who have an increased risk of amputation.
Led by Birmingham university and funded by the National Institute for Health Research, a year-long randomised trial involving 130 adults has started to measure healing rates of leprosy ulcers.
Prof Richard Lilford from Birmingham university, who is the project lead, said the intervention was similar to a scab forming to cover a wound on a child’s knee.
“You might remember as a child grazing your knee and a scab forming. When the scab came off a few days later – bingo! The skin underneath had miraculously healed,” he said.
“Maybe substances in the scab were promoting healing. We plan to test this idea in people affected by leprosy ulcers. Using the patient’s blood, my colleagues at Anandanban hospital in Kathmandu make a kind of artificial scab which is used to dress the ulcer. This has been widely used but never properly evaluated.”
The patient’s own blood cells have been used to make a membrane in gel strips known as L-PRF that mimics the body’s natural healing processes.
Leprosy is a chronic infectious disease caused by a bacterium and Nepal has 3,200 new diagnoses every year.
Despite positive changes in attitudes in Nepal, leprosy, a curable disease, still has much stigma and mythology attached, with thousands of cases remaining undiagnosed.
“The prevalence rate of leprosy [in Nepal] is rising, though this may be due to improved reporting and active case finding,” says the trial’s research protocol.
“While leprosy is curable with multi-drug therapy, Nepalese people may hide early symptoms due to stigma based on cultural perceptions that leprosy is a punishment for former life transgressions. Thus, there are often delays in presentation of leprosy, which can lead to the development of complex ulcers requiring long hospital stays.”
Indra Napit, a senior surgeon at the Leprosy Mission’s Anandaban hospital, said with the new treatment he has been seeing faster healing times.
“If left untreated, leprosy causes nerve damage. As a result, people affected by leprosy have frequent hospital stays to cure ulcers, which can take many months or even years to heal,” he said.
“But with L-PRF even the most severe ulcers could heal far quicker. This can prevent disability and even amputation. L-PRF can be life-changing for leprosy patients, as it means they can return to their families and jobs, if they are blessed to have them.
“For us at Anandaban, there are so many benefits all round. Faster healing frees up hospital beds so we can treat more people.”
