WILL THE FUTURE PROMISE STEM CELLS IN PLASTIC SURGERY

Dr. Robert J. Brueck MD FACS reports periodically on subjects related to health, healing and plastic surgery. In this message, he hints at the possibilities for stem cell therapy in plastic surgery, based on his recent experience with it concerning his arthritic ankle.

As many of you already know, I recently went to the east coast of Florida to receive “stem cell” therapy to my severely arthritic left ankle.

Recently, I have been doing some reading and investigating into stem cells. Basically, there are two types of stem cells, embryonic and adult-derived. Embryonic stem cells are ones that come from fetuses and have been at the center of debate between conservatives and liberals for decades. Adult-derived stem cells come from your own body fat so being a little plump around the mid section may not be so bad after all - you can tell your friends and family you are stem cell planting for the future.

I traveled to Boca Raton on a Thursday evening because my appointment was at 9am on Friday and I didn’t want to be caught in traffic on Alligator Alley, or have the Alley be closed due to an accident. I really felt good and didn’t have much trouble sleeping. As usual, I got up at the crack of dawn. Linda and I put on the trusty GPS and off we went. You know me, if my appointment is at 9am, I will be there at 8am. Once we arrived at our destination we had to park and decide which building we were going to, floor, suite, etc. etc. Since we were early there really wasn’t any problem.

We went up to the waiting room and it was filled with people walking on crutches, people with canes, people wearing casts, just what one would expect. After giving them my insurance card, driver’s license and other required documentation, I returned to the lobby and was waiting for my name to be called. After about 20 minutes I was called back to an exam room and an X-ray was then taken of my left ankle.

Soon thereafter Mr. Jim Vandenbosch came into the room. He is a “clinical ortho biological specialist” working with Dr. Joe Purita, he went over the procedure with me and told me what to expect. I was not NPO so I assumed it was going to be under local. Indeed, it was, so I was able to eat breakfast.

Dr. Purita came in. He is an orthopedic specialist and is actually going to be doing the procedure. He has been doing protein rich plasma and stem cell transplants for several years and now has performed in excess of 2000. He looked at the X-ray and told me I had severe arthritis. I told him the pain in my ankle speaks to the arthritic nature of my ankle.

Basically, a stem cell is what we call a plur-poten cell, in other words it has the ability to differentiate down different cell lines depending upon the “neighborhood” it is in.

The stem cell is placed in an arthritic joint and the hope is that the stem cell will eventually form a new cartilage or bone cell and help restore and heal the involved arthritic joint.

Jim came in and prepped me and the donor site for obtaining the stem cells. It was my right posterior flank. The area was prepped and local was applied to the area, after several minutes Dr. Purita came in and made a small incision and obtained about 10cc’s of fat from the area.

The fat was allowed to separate and the fat was then transferred along with protein rich plasma and a small amount of growth hormone into a sterile syringe which was eventually going to be injected into my joint.

Protein rich plasma is derived from your own blood. They obtain about 20cc’s of blood and then spin it down separating the cells from the serum. Once this is completed, they obtain the buffy code which is in the middle and contains all of the platelets and growth factors.

This is all mixed together.

Then I went downstairs to the fluoro room. I was placed on the table and the fluoro unit was turned down to delineate my left ankle joint.

Over the course of 10 minutes, Dr. Purita injected the mixture into my ankle. At that point, I was done and he gave me instructions, and Linda and I were off to the races. We decided to stop and get a bit of lunch before we began the trek home to Ft. Myers.

That weekend I stayed home, put my leg up, packed it in ice and I was back to work on Monday. I will give you an update since it will take 4 to 6 weeks for this to start showing an effect.

In about 3 weeks, I will be going to Dr. Ron Gardner in Ft. Myers for more protein rich plasma injections to the joint in order to stimulate their growth. So far so good and we are hoping for a successful outcome that will help me avoid an ankle operation.

Is there a role for stem cell therapy in plastic surgery? At the rate, research and technology are proceeding, there well could be.