Chronic ulcers are long-lasting, non-healing wounds that persist for 12 weeks or more, defying conventional treatment methods. These wounds commonly affect patients with diabetes, venous insufficiency, poor circulation, or limited mobility, often appearing on the feet, legs, and toes.Traditional wound care approaches—such as cleaning, debridement, antibiotics, specialized dressings, and offloading (reducing pressure on the wound)—focus on symptom management. They often fail to address the underlying biological causes of poor healing, such as vascular insufficiency, nerve damage, or chronic inflammation. As a result, a growing number of clinicians are turning toward regenerative medicine, a rapidly advancing field that aims to repair or replace damaged tissues through the body’s own healing mechanisms. At the heart of this movement lies Umbilical Cord–derived Mesenchymal Stem Cell (UC-MSC) therapy, a transformative approach now gaining momentum in Thailand.
Why Chronic Ulcers Resist Healing
- Impaired Circulation (Ischemia): Reduced blood flow prevents oxygen and nutrients from reaching damaged tissue, starving cells that are critical for regeneration.
- Neuropathy (Nerve Damage): Common among diabetic patients, nerve damage diminishes sensation, allowing minor injuries to progress unnoticed and reducing the body’s healing responses.
- Chronic Infection: Constant bacterial colonization prolongs inflammation and interferes with the normal tissue repair process.
- Mechanical Pressure: Repetitive friction or pressure—often seen in bed-ridden or wheelchair-bound patients—leads to continuous tissue breakdown.
- Systemic Health Issues: Conditions such as diabetes, peripheral artery disease, and heart failure exacerbate wound formation and hinder recovery.
The Power of UC-MSC Stem Cell Therapy
Stem cell therapy represents a paradigm shift in chronic wound management because it tackles the problem at its root—by repairing and regenerating damaged tissue.
Among the different types of stem cells, Mesenchymal Stem Cells (MSCs) are particularly valuable because of their ability to self-renew, differentiate into various cell types, and secrete bioactive molecules that enhance healing. While MSCs can be obtained from bone marrow or adipose tissue, umbilical cord–derived MSCs (UC-MSCs) have distinct advantages: they are non-invasive to obtain, as the umbilical cord is a medical waste product collected after childbirth with donor consent. UC-MSCs are highly proliferative, expanding rapidly in culture without losing their regenerative potential.
In Thailand, UC-MSC therapy offers an innovative and potentially life-saving option for patients struggling with chronic ulcers.
How UC-MSCs Promote Wound Healing
- Tissue Regeneration: UC-MSCs can transform into skin, endothelial, and connective tissue cells. This capability allows them to directly replace damaged structures, rebuild the extracellular matrix, and close wounds more effectively.
- Angiogenesis: These cells secrete vascular endothelial growth factor (VEGF) and other angiogenic signals that stimulate new capillary formation. The resulting improvement in blood flow delivers oxygen and nutrients necessary for cell repair.
- Inflammation Control: Chronic ulcers are often locked in an extended inflammatory phase. UC-MSCs produce anti-inflammatory cytokines, reducing local inflammation and creating an environment conducive to tissue regeneration.
- Immune Regulation: UC-MSCs interact with immune cells such as macrophages, shifting them from an inflammatory (M1) state to a regenerative (M2) state. This promotes healing while preventing tissue destruction.
- Paracrine Effects: Beyond direct differentiation, UC-MSCs release exosomes and soluble factors that activate nearby skin cells, stimulate fibroblast and keratinocyte activity, and orchestrate the complex process of wound closure.
- Antimicrobial Action: Recent studies show that MSCs can produce antimicrobial peptides that suppress bacterial growth, helping to protect the wound from infection.
Clinical Application and Delivery Techniques
- Topical Application: UC-MSCs are integrated into hydrogels, creams, or dressings and applied directly to the wound This method works best for shallow ulcers and promotes localized regeneration.
- Perilesional Injection: Cells are injected around the wound edges, allowing them to migrate inward and initiate healing from the periphery toward the center.
- Scaffold-Based Systems: Biocompatible scaffolds—such as collagen or fibrin matrices—loaded with UC-MSCs offer structural support, improving cell retention and survival in the wound
- Combination Therapy: UC-MSCs can be used alongside platelet-rich plasma (PRP), growth factors, or negative pressure wound therapy to enhance outcomes synergistically.
Advantages Over Conventional Treatments
- Faster Healing: By addressing the biological barriers to repair, UC-MSCs promote faster tissue regeneration and wound
- Improved Tissue Quality: Regenerated skin exhibits stronger structure, better elasticity, and more natural appearance compared to scar tissue formed through conventional healing.
- Reduced Risk of Amputation: By restoring circulation and controlling infection, UC-MSC therapy can prevent ulcers from worsening into deep, non-viable tissue.
- Low Risk and Good Tolerability: Clinical studies worldwide have demonstrated that UC-MSC treatments are generally safe, with minimal adverse reactions and no significant immune rejection.
- Comprehensive Repair: The therapy rebuilds all wound layers—epidermis, dermis, and underlying vasculature—offering a more complete recovery than symptomatic care alone.
Current Research and Developments in Thailand
Thailand is emerging as a regional hub for regenerative medicine, supported by government regulation and advanced biomedical infrastructure. Several Thai hospitals and research centers are now exploring the use of UC-MSC therapy for chronic ulcers, diabetic wounds, and tissue regeneration.
Clinical observations suggest that Thai patients receiving UC-MSC treatments show faster wound closure, improved blood flow, and better pain control compared to those treated with conventional care. GMP-certified stem cell laboratories in Bangkok, Chiang Mai, and other cities ensure that UC-MSC products meet international standards for safety and efficacy.
Thailand’s favorable regulatory framework under the Ministry of Public Health and Thai FDA allows licensed clinics to conduct cell-based therapy within controlled clinical protocols, making it one of the most accessible destinations in Asia for regenerative medicine.
Conclusion
Chronic ulcers remain a major medical challenge, particularly among diabetic and elderly populations. Traditional wound care often fails to achieve lasting results because it does not correct the underlying biological deficiencies. Umbilical Cord–derived Mesenchymal Stem Cell (UC-MSC) therapy offers a scientifically grounded, regenerative solution—stimulating angiogenesis, reducing inflammation, rebuilding tissue, and accelerating healing.
With growing research support, proven safety, and expanding clinical adoption, UC-MSC therapy is ushering in a regenerative revolution in Thailand. By combining cutting-edge science with the country’s strong healthcare infrastructure, Thailand stands at the forefront of transforming chronic wound care into a pathway of true healing and recovery.