Nepalese hospital tests ‘life-changing’ treatment for leprosy wounds | Global development

Doctors at a Nepalese hospital testing a new treatment for skin sores say the technique, which mimics the process of scab formation, has “tremendous potential”.

Trials at the mountaintop Anandaban Leprosy Hospital, south of Kathmandu, have shown promise and brought hope to patients around the world. It is hoped the treatment will also help millions of people with diabetes, who are at increased risk of amputation.

Led by the University of Birmingham and funded by the National Institute for Health Research, a year-long randomized trial involving 130 adults has begun to measure leprosy ulcer healing rates.

Professor Richard Lilford from the University of Birmingham, who is the project leader, said the procedure was similar to forming a scab to cover a child’s knee injury.

“You may remember when you were a kid you scraped your knee and a scab formed. When the scab came off a few days later – bingo! The skin underneath had miraculously healed,” he said.

“Perhaps the substances in the scab promoted healing. We plan to test this idea in people affected by leprosy ulcers. From the patient’s blood, my colleagues at Anandanban Hospital in Kathmandu make a a kind of artificial crust that is used to dress the ulcer.This has been widely used but never properly evaluated.

The patient’s own blood cells were used to make a gel strip membrane called L-PRF that mimics the body’s natural healing processes.

Leprosy is a chronic infectious disease caused by bacteria and Nepal has 3,200 new diagnoses every year.

Despite positive changes in attitudes in Nepal, leprosy, a curable disease, is still heavily stigmatized and mythological, with thousands of undiagnosed cases.

“The prevalence rate of leprosy [in Nepal] is increasing, although this may be due to improved reporting and active case finding,” the trial’s research protocol states.

“While leprosy can be cured with HAART, Nepalis may hide early symptoms due to stigma based on cultural perceptions that leprosy is a punishment for past life transgressions. Thus, there are often delays in the presentation of leprosy, which can lead to the development of complex ulcers requiring long hospital stays.

Leprosy patient’s foot healing after LPRF treatment at Anandaban Hospital, with the front wound seen on the phone screen for comparison. Photo: Kate Gent/Courtesy The Leprosy Mission

Indra Napit, senior surgeon at Anandaban Hospital’s Leprosy Mission, said with the new treatment he had seen faster recovery times.

“If left untreated, leprosy causes nerve damage. As a result, people affected by leprosy often have to be hospitalized to treat ulcers, which can take months or even years to heal,” he said.

“But with L-PRF, even the most severe ulcers could heal much faster. This can prevent disability and even amputation. L-PRF can be life-changing for leprosy patients, as it means they can return to their families and jobs, if they are lucky enough to have them.

“For us at Anandaban, there are so many benefits across the board. Faster healing frees up hospital beds so we can treat more people.

About Antoine L. Cassell

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