Regenerative Medicine in Treatment of a Patient with a Traumatic Physical Injury - Research Paper Example

The Use of Regenerative Medicine in Treatment of a Patient with a Traumatic Physical Injury As Opposed To Surgical Reconstruction (Insert (Institution) (Course) (Date) The Use of Regenerative Medicine in Treatment of a Patient with a Traumatic Physical Injury As Opposed To Surgical Reconstruction Introduction Trauma can be described as a physical injury or wound that is inflicted on the body. However, medically, physical trauma refers to a serious injury to the body. This injury can be life-threatening and can cause secondary complications such as respiratory failure and death. Physical trauma can be classified in to three categories. The first category is blunt force trauma. This kind of trauma occurs when the body is struck by an object by force. The impact of this collision causes concussions, lacerations or fractures to the victim. The second class of physical trauma is penetrating trauma. This occurs when the body is wounded as a result of an object piercing the body. The result of penetrating trauma is an open wound on the victim. Physical trauma can also be as a result of controlled injury. Controlled injury refers to the reconstructive process of the physical trauma patient through procedures like surgery which can be a cause of physical trauma (Tedeschi, Tedeschi, & Eckert, 1977, 645-650). Trauma patients are at a great risk of losing their lives because of numerous reasons. One such reason is the fact that a trauma patient loses a lot of blood and the result of this is shock. The greater the amount of blood lost, the greater the shock and the greater the risk of death for the patient. Another reason why trauma patients are at risk of death is the fact that the wounds that they suffer or the injuries which are open make them prone to infections and since bacteria can easily infiltrate the body due to its high vulnerability at the time. Multiple organ dysfunction syndromes can also be a reason or can pose the risk of death on patients because some organs may experience inflammation which can hinder the flow of blood in the body or worse still, can be punctured thus rendering it dysfunctional at the time. However, medical research has helped increase the survival chances of trauma patients especially immediately after an incident. This is because practitioners have designed care tips that help contain the damage of the wounds that trauma patients have. The body’s psychological response to trauma has been the basis on which these care tips have been developed on. The research has helped practitioners to make advances in fluid resuscitation in trauma patients. This ensures that the trauma patient is receiving ample supply of oxygen in every part of their body and also that the lost fluids are replaced. The research has also helped the practitioners to develop different ways of cleaning wounds on different parts of the body, on patients so that they can eliminate the possibility of infections on the patient. The research has also helped establish the capabilities of nutrition in helping survivors in their recuperation process. The nutrition support can be in the form of health foods or medication (Litz, 2004, p.250). Trauma survivors are admitted to hospital for a period of time in which they are monitored and acute care is taken upon them. This is the first step of recovery for trauma survivors. After the trauma patients have shown signs of recovery, they are either discharged or kept in the hospital for further monitoring. At this stage, the aim is to rehabilitate patients. Patients receive services that assist them to improve full functionality of the damaged limb or body part, increase the outcome of recovery and regain or maintain the esthetics of the patient (Litz, 2004, p. 264). There are different ways in which a patient can undergo this process. Surgical repair and the use of regenerative medicine are two such examples. However, it is arguable which of the two processes is most efficient in the recovery process of the trauma patient. This paper will develop a comparison between the regenerative medicine using the extra-cellular technique and surgical reconstruction. The objective is to use evidence to determine if extra-cellular technique of regenerative medicine has an upper hand to surgical reconstruction through increasing a patient recovery outcome, improving functionality and maintaining the aesthetics of the trauma patient. The general purpose of regenerative medicine is to restore the normal function of organs, tissues and cells in the human body by virtue of replacing them or regenerating them. Regenerative medicine stimulates the body’s own repair mechanism and helps in the healing process of tissues and organs which can be ruled out as irreparable. Regenerative medicine has aided the scientific development and growth of tissues in a laboratory. These tissues are implanted in patients whose bodies cannot heal themselves. This method is referred to as the extra-cellular matrix technique. Many approaches are being developed by scientist so that extracellular matrices and supportive tissue can be recreated (Hyndman, et. Al, 2012). The severity of injuries that physical trauma patients suffer from will differ from situation to situation. Some of the injuries can be minor meaning that the body can be allowed to use its own healing mechanism to help the patient recover. Other injuries are extremely severe to the point of no repair or the only solution is a complete replacement of the damaged organ and this is where amputation comes in to context. Practically, it cannot be medically prudent if a patient is subjected to either the surgical reconstruction or regenerative medicine. The best kind of practice would be to lay down the options to the patients with an explanation of the advantages and disadvantages of both processes and leave it to the patient to decide. Advice should be given to the patient as to which medical procedure suits best their recovery in relation to the severity of their injuries. It can be argued that either of the processes has an advantage over the other in increasing the outcome of patient recovery, improving functionality and maintaining esthetics. I would agree with this kind of ideology. The use of regenerative medicine is promising to a patient and on the basis of the evidence that has been provided in the medical field, I believe that this processes has more to offer in terms of delivery of the outcomes of the patients recovery process. Evidence Between2001 and 2005, a study was conducted to evaluate the results of surgical reconstruction on patients who had suffered a traumatic open knee dislocation. The study used seven patients to evaluate and compare the outcomes of the surgery. Standard trauma protocol was followed when treating the patients and the patients were all treated at a level 1 trauma center. The traumatic injuries were as a result of different scenarios. Two of the patients were car accident victims, one was a pedestrian who was struck by a vehicle and the remaining four were motorcycle accident victims. During the surgical procedure, spanning external fixators were placed on all patients and were later on removed after the patients were able to undergo orthopedic procedures. The injuries were classified using the KD classification. There were three anterior dislocations, three posterior and one lateral dislocation. After the follow up of the recovery process of the patients, most of them reported residual symptoms. These symptoms included pain, complications of nerve palsies, and knee instability. However, none of the patients expressed complaints about more than one residual symptom. Four of the patients were reported to have engaged in an activity that required the use of their legs and one of them even went back to being a driver. However, the aesthetics of the disfigured limb were not regained through the reconstructive surgery and some of the patients reported inflammations on their reconstructed limb (King III, Cerynik, Blair, Harding, & Tom, 2009, p.1030). The above study shows that surgical reconstruction is a credible procedure for helping in the recovery of patients from traumatic injuries. It is however notable that the results as not entirely satisfactory in terms of the whole recovery process. Another study was conducted by scientists to evaluate how efficient regenerative medicine is in the reconstruction of damaged tissue. The study was conducted by implanting samples of menisci which were harvested from young pigs and then diced in to radial slices. The radial slices were then cut and regularized using a scalpel. A solution of cellular fibrinogen was then placed on top of the meniscal slice and afterwards, thrombin was added to the solution. Another meniscal slice was then placed on top of the initial sample in order to form a sandwich-like specimen. The specimen was then implanted in the subcutaneous tissue of nude mice for four weeks. After the four weeks of study, the samples were retrieved but initially no differences were evident in the samples. The samples were then cut and at the interface in the experimental samples, a tissue was present. Upon farther tests, it was noted that there was a firm adhesion within the experimental samples. This was as a result of the tissue which was formed between the meniscuses. This shows that regenerative medicine can help in the generation of tissue and damaged ligaments and aid the whole process of recovery in traumatic patients (Scotti, et al 2009, and pp.645-8). Regenerative medicine uses stem cells to repair damage in cell and organ tissues by promoting the natural healing ability of the human body (Omori, 2005, p.431). Mesenchymal cells can be extracted from the patient’s own tissue and used in the stem cell therapy. Chien (2008, p.303) discusses how Mesenchymal cells can be used not only to help in the recovery process but also in the study of the human models of human disease. In his case study, he evaluates the extent to which regenerative medication can be used as a therapy for reversing an advanced heart failure. The spine and joint center in Bergen County is a center dedicated patients who have experienced trauma in their spine or in any other joint of the body. The facility offers both regenerative medicine procedures and surgical procedures. Practitioners at the facility extract mesenchymal cells from a patient’s body fat tissue. The cells are then injected in to the injured area to repair the damaged spinal tissue and joint tissue. This extracellular procedure has been effective in the whole recovery process of the trauma patients because their spinal functionality is regained to a high percentage. The procedure is also non-invasive. This is because the cells are injected in to the patient without having to perform a surgical procedure. The extra-cellular matrix of injecting the mesenchymal cells is also safe. The risks, if any, of infection on the patient are very minimal and furthermore, the procedure does not alter the aesthetics of the patient. The cells regenerate and regroup to regain the initial form of the injured part. In totality, the procedure is safe and efficient. Counter Arguments It can be argued that the extra-cellular technique of regenerative medicine can cause complications in patients because the cells can mismatch. Also, a patient’s body can reject be match the donor cells but reject the treatment. However true and possible this may be, experts have designed a way in which cells will not react with the body of the patient and won’t be rejected. As is the case in the spine and joint center, the mesenchynal cells are extracted from the patient themselves. The body fat tissue cells are extracted from a different part of the body of a patient and injected in to the injured area. This therefore nullifies the possibility of the body rejecting the treatment. Surgical reconstruction on patients is said to take less time; the patients recovery process and period is shortened. It can therefore be argued that regenerative medicine is a slow remedy to helping patients recover from traumatic injuries. This is because the regeneration process of cells is not rapid. The rate of cell regeneration and multiplication is determined by the body strength of the patient and how readily it will accept treatment. However, the regeneration process can be catalyzed medically to hasten the recovery process of the patient. The aim of catalyzing is to enhance the growth factors and protein levels in the cells. One such way of catalyzing the extra-cellular matrix technique is by using platelet rich plasma, PRP, injections (Rahi, 2012). The PRP injection is used together with the stem cells so that the growth factors and protein levels in the cells can be enhanced. This injection can be used in treatment of severe or mild spine and joint injuries. The effectiveness of the PRP injections on the recovery process of traumatic injuries make them to be given preference over surgery for patients who have orthopedic injuries or conditions (Archer, et. Al., 2009, p.1342). Extra-cellular matrix technique of regenerative medicine can be viewed as an expensive venture due to the amount invested in research and development of the technique. The process of studying cells and examining their compatibility with that of a patient’s cells can be mistaken for an expensive mode of treatment. However, if compared to surgical reconstruction, regenerative medicine treatment is cheaper by far. This is because the treatment is administered and the body is left to heal by its own self. Furthermore, the procedure is very quick because it is a simple injection of cells in to the injured part of the body and additionally, it does not require many medics to operate on a patient at a time. Surgical reconstruction on the other hand is extremely expensive as compared to regenerative medicine. This is because of the requirements which need to be availed so that the health of the patient undergoing surgery is not put at risk. Unlike cell injection, a surgical procedure will require several attendants to be with a patient in the operating room. Generally, the requirements of a surgical procedure make the price of treatment to be extorted. Another issue that can be pointed out as an argument against the use of regenerative medicine is the applicability of the procedure under different circumstances. The reason for this is the fact that certain injuries such as fractures are a different form of trauma. Now the applicability and efficiency of the extracellular matrix technique of regenerative medicine in such a situation can be questioned. The reason for this can be the fact that cell injection in to the bone can be ruled out as impossible. However, this technique can still be employed in such a scenario. Extracted cells in such a case can be injected to the flesh around the fracture. The flesh will then regenerate and produce a ligament that will hold the bone together at the point of fracture and help it regain its form. It is important to point out that the best way to approach such a situation is to use both surgery and regenerative medication. The reason for this would be to quicken the recovery process of the patient. The regenerated cells can then aid in regaining the aesthetics of the fractured area in the way that they re-arrange themselves (King III, Cerynik, Blair, Harding, & Tom, 2009, p. 1031). Recommendations The extra-cellular matrix technique of regenerative medicine has helped tremendously in the field of medicine. It has helped patients to undergo treatment without having their inner parts of the body exposed. However, in some cases, surgical reconstruction has the upper hand over regenerative medicine. Taking a hypothetical situation of a patient who has suffered fire injuries to the tune of 90% as an example, in such a case, the technique helps the patient’s tissue cells to regenerate and recover but it however does not restore the aesthetic state of the victim. The skin and parts of the body, though healed, still remain dis-figured. Experts should therefore carry out research and try to develop skin reconstruction cells. These cells should help the fire victim to regain their prior looks without having to undergo plastic surgery to do so (Smith, 2008, p.230). Researchers can also extend their scope of cell sources used as regenerative medicine. They should examine the probability of using cells from other species or animals. It is possible that if a certain animal or species cell is conjoined with that of a human cell having a traumatic injury, then the patient would recover fully from their injury. Scientists should therefore study the behavior of cells of different when they are put together and evaluate the possibility of generating a cell that can result in a total recovery from a traumatic injury in all aspects especially esthetics. It is also possible that putting together two cells from different species can help produce a cell that will hasten the recovery process by a large margin. In conclusion, the extra-cellular technique generally increases patient recovery, improves functionality of the injured part of the body, and maintains and helps the patient regain their esthetics in comparison to surgical reconstruction. The procedure is also better because it is non-invasive; no incisions or surgical openings have to be made on the patient (Meyer, et.al p.565). Furthermore, the technique helps utilize the resources within the body to aid in the recovery process. The extracted cells generate and multiply in the infected area and restore the health of the patient. Regenerative medicine has helped curb the issue of transplants. Donors have slowly reduced and it has therefore become difficult for patients with traumatic injuries to rely on donated organs for their survival. In addition, the technique has helped avoid the complications that arise from transplants because the cells generated are similar to others in any other part of the body. This increases the patient recovery because they do not have to undergo a rehabilitation process to help their bodies get used to the newly attached organs. References Archer, K. R., MacKenzie, E. J., Castillo, R. C., &Bosse, M. J. (2009). Orthopedic Surgeons and Physical Therapists Differ in Assessment of Need for Physical Therapy After Traumatic Lower-Extremity Injury. Physical Therapy, 89(12), 1337-1349 Chien, K. R. (2008). Regenerative medicine and human models of human disease. Nature, 453(7193), 302-305. Hyndman, M. , E., Kaye, D., Field, N., C., Lawson, K., A., Smith, N., D., Steinberg, G., D., Schoenberg, M., P. &Bivalacqua, T., J. (2012). The Use of Regenerative Medicine in the Management of Invasive Bladder Cancer. King III, J. J., Cerynik, D. L., Blair, J. A., Harding, S. P., & Tom, J. A. (2009). Surgical outcomes after traumatic open knee dislocation. Knee Surgery, Sports Traumatology, Arthroscopy, 17(9), 1027-1032. Litz, B. T. (2004). Early intervention for trauma and traumatic loss. New York: Guilford Press. Pp. 250-264. Meyer, U. (2009). Fundamentals of tissue engineering and regenerative medicine. Berlin: Springer. P. 565 Omori, K. (2005). Regenerative Medicine of the Trachea: The First Human Case. 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