Specialties: Hand trauma and hand surgery reconstruction, acute/chronic wound management and complex wound reconstruction, double eyelid, eye bag plastic surgery, keloid surgery, microsurgery, craniofacial fracture reconstruction, autologous tissue breast reconstruction

      When a wound has been treated but remains unhealed for more than six weeks, it is generally classified as a difficult wound. Risk factors for developing difficult wounds include diabetic foot, pressure ulcers, venous ulcers, and peripheral artery occlusion. With the aging population in our country, these risk factors have become common issues in long-term care. Often, due to unprofessional care or delayed detection, wound infections can occur, potentially leading to sepsis and requiring more medical resources for subsequent treatment.

     With advances in medical technology, various advanced dressings, medications, artificial dermis, negative pressure wound therapy, blue light and cold plasma devices are now available to assist in wound healing, in addition to conventional medical treatments. However, tissue regeneration can sometimes still be a challenge. Since the passage of the Special Medical Act in 2018 and the Regenerative Medicine Act in June 2024 in Taiwan, cell regeneration medicine has been applied clinically in our country, marking a new opportunity for the treatment of difficult wounds.

      In the application of cell therapy for chronic difficult wounds, the mainstream approach is to use "adipose stem cells." Adipose stem cells are a type of mesenchymal stem cell that can be extracted from adipose tissue. Unlike bone marrow stem cells, adipose stem cells are collected through subcutaneous liposuction or small-area fat excision, resulting in less pain for patients and a relatively quick process. Using autologous stem cells eliminates the risk of rejection, meaning there is no need for immunosuppressive drugs, thus avoiding issues with decreased immunity.

     As mesenchymal stem cells, adipose stem cells have the ability to differentiate into various cell types, including adipocytes, chondrocytes, myocytes, osteoblasts, neurons, and epithelial cells, repairing and replacing damaged or aging cells. Adipose stem cells can also secrete cytokines that stimulate the function and activity of surrounding cells.

     In the treatment of chronic difficult healing wounds, the application of adipose stem cells can not only differentiate into skin tissue cells to repair the wound bed but also secrete growth factors to activate tissue, promote angiogenesis, regulate immune function, and reduce inflammation, thereby accelerating wound healing. According to statistics from the Ministry of Health and Welfare, as of December 31, 2022, ten patients have received cell therapy for chronic wounds. The average wound area before treatment was approximately 16.96 cm2, and with conventional treatment methods combined, the average wound area was reduced by about 12.6 cm2, showing good results.

     Our hospital's Department of Plastic Surgery has collaborated with Synlogic Biotechnology Company and has officially received approval from the Ministry of Health and Welfare to perform autologous adipose stem cell therapy for chronic wounds that have not healed for six weeks or more in the second half of 2024. After appropriate preoperative assessments, patients will undergo a surgical procedure to collect about the size of a peanut's worth of adipose tissue, which will be sent to Synlogic's laboratory for approximately two months of cultivation. Following this, patients will return weekly for about half an hour of outpatient treatment. Currently, our hospital has successfully completed the first case of cell collection, and the treatment process is ongoing.

      The difficult wound care team at Far Eastern Memorial Hospital works closely with the Cell Therapy Center to provide comprehensive wound care, building on existing multidisciplinary team resources. With the addition of the most advanced cell therapy, we are better positioned to benefit our patients in the future. Patients with related needs are welcome to inquire at the Plastic Surgery clinic or the Cell Therapy Center.

 Cell Therapy process