Chronic ulcerative wounds remain one of the most difficult medical conditions to manage, particularly for individuals with underlying health problems such as diabetes, vascular disease, or limited mobility. Common types of chronic wounds include diabetic foot ulcers, venous leg ulcers, pressure injuries, and ulcers caused by poor blood circulation. When a wound fails to heal within approximately three months, it is considered chronic. These persistent wounds can lead to ongoing pain, recurrent infections, reduced mobility, and, in severe cases, tissue loss or limb amputation.
Traditional wound care focuses on cleaning the wound, removing dead tissue, preventing infection, improving circulation, and reducing pressure on the affected area. While these methods are essential, they may not be sufficient when the body’s natural healing ability is impaired. In many chronic ulcer cases, the underlying problem is not simply surface damage but a breakdown in the biological processes required for tissue repair. As a result, regenerative medicine—particularly therapy using umbilical cord–derived mesenchymal stem cells (UC-MSCs)—is gaining attention as a new approach that aims to restore the wound’s healing capacity rather than only managing symptoms.
Why Chronic Ulcers Fail to Heal
Normal wound healing occurs in several coordinated stages: inflammation, tissue formation, and remodeling. Chronic ulcers become trapped in a prolonged inflammatory phase, preventing the formation of healthy new tissue. Several factors contribute to this disruption, including poor blood supply, nerve damage, infection, repeated pressure or trauma, and systemic diseases such as diabetes or peripheral artery disease.
Reduced oxygen and nutrient delivery to the wound slows cell activity, while impaired immune responses make it difficult to control infection. At the same time, excessive inflammation damages surrounding tissue and interferes with regeneration. These combined problems create a hostile environment where healing cannot progress effectively.
Because conventional treatments do not directly restore the damaged biological environment, researchers and clinicians have turned to stem cell therapy to reactivate the body’s natural repair mechanisms.
How Stem Cell Therapy Promotes Ulcer Healing
UC-MSC stem cell therapy works through several complementary biological actions that address the root causes of chronic wound failure.
- Tissue Reconstruction: Stem cells support the formation of essential structural cells, including fibroblasts that produce connective tissue, keratinocytes that rebuild the skin surface, and endothelial cells that form blood vessels. This helps restore damaged tissue from deeper layers outward.
- Improved Blood Supply: Poor circulation is a major barrier to healing in chronic ulcers. UC-MSC stem cells release factors such as vascular endothelial growth factor (VEGF), which encourages the development of new capillaries. Enhanced blood flow improves oxygen delivery, nutrient supply, and waste removal, all of which are critical for tissue recovery.
- Control of Inflammation: Persistent inflammation prevents wounds from progressing to the repair phase. Stem cells release anti-inflammatory molecules that help shift the wound environment from a destructive state to one that supports regeneration.
- Immune Regulation: UC-MSC stem cells interact with immune cells to improve their ability to fight infection while preventing excessive inflammatory responses. This balanced immune activity helps protect new tissue as it forms.
- Paracrine Signaling Effects: Through the release of bioactive substances, stem cells stimulate local repair cells to migrate, multiply, and produce new tissue. Even when stem cells do not permanently integrate into the wound, their signaling activity can significantly enhance healing.
- Antimicrobial Support: Some research suggests that mesenchymal stem cells produce antimicrobial peptides that help limit bacterial growth, further supporting wound
Methods of Stem Cell Delivery
The method used to deliver stem cells depends on the type, size, and depth of the ulcer.
- Topical Application: Stem cells may be incorporated into gels, sprays, or specialized dressings and applied directly to the wound
- Local Injection: For deeper or more complex wounds, cells are injected into and around the wound bed to stimulate repair within underlying tissues.
- Biomaterial Scaffolds: Stem cells can be combined with supportive materials such as collagen or fibrin to create protective patches that help maintain cell viability and guide tissue formation.
- Intravenous Administration: In certain cases, stem cells are delivered through the bloodstream, allowing them to travel to areas of injury and support healing systemically.
Benefits of Regenerative Therapy for Chronic Ulcers
Stem cell–based treatment offers several advantages compared with conventional wound care alone.
- Comprehensive Tissue Repair: Supports regeneration of full-thickness skin and underlying structures rather than surface healing only.
- Reduced Scarring: Encourages organized tissue formation, improving both function and appearance.
- Lower Infection Risk: Faster closure and improved immune function help prevent complications.
- Stronger, More Durable Tissue: Regenerated skin tends to be more resilient and less likely to break down.
- Prevention of Amputation: In severe cases, early regenerative intervention may help preserve limbs by promoting healing in wounds that would otherwise worsen.
Conclusion
UC-MSC stem cell therapy represents a major advancement in the treatment of chronic ulcers by addressing the biological causes of impaired healing. Through improved blood flow, inflammation control, immune regulation, and tissue regeneration, this approach aims to restore normal repair processes rather than simply managing symptoms.
As clinical evidence grows and new technologies continue to emerge, regenerative therapy is becoming an important option for patients with difficult-to-heal wounds. In Thailand, where advanced medical facilities and regenerative medicine programs are expanding, stem cell therapy offers new hope for improved healing, reduced complications, and better long-term outcomes for individuals living with chronic ulcers.