In the case of lesions that have not healed for over a month or which, due to the particular conditions of the patient, are unable to close on their own, the Plastic, Reconstructive and Aesthetic Surgery Area directed by Prof. Persichetti provides a clinic dedicated for diagnosis and new minimally invasive techniques for treatment. All in agreement with the National Health Service
 
 
A wound that after more than a month fails to heal, a 'chronic' ulcer that forces those who suffer from it to live with continuous pain, movement limitation and, often, even infectious complications. I am injuries that usually affect the elderly, people with walking difficulties, but also diabetics and people with circulatory problems. The particular type of patient, the site of the injury and the local conditions of the affected area are the main factors preventing wound healing. Infections, poor blood flow to the wound area, together with the constant need to use walking aids, such as treadmills or wheelchairs, are further elements at the origin of the ulcerations affecting these patients.
 
For them, thePlastic, Reconstructive and Aesthetic Surgery Unit of the Campus Bio-Medico University Hospital, directed by Prof. Paolo Persichetti, activated a specific outpatient clinic, dedicated to 'difficult wounds' and a service agreed with the SSN which was born in the bed of the so-called 'regenerative' medicine, a new area of ​​medical research which aims to enhance the body's ability to achieve healing, through the contribution and stimulation of local and systemic factors useful for regeneration and not just for repair. Among the pathologies for which this new frontier of medicine is most suitable we find chronic leg ulcers, pressure ulcers, skin burns and their sequelae, scars, e.g. from acne, alopecia.
 
"With the increase in average life – underlines Prof. Persichetti – the number of people who find themselves having to deal with this kind of problem is growing. The so-called difficult wounds also produce a social cost for the family members and an economic cost for the National Health Service, both of which are not indifferent. For this reason, we have decided to create an outpatient clinic specialized in the treatment of these lesions, within which the individual case is assessed in a personalized way and the most suitable path is prepared to favor the resolution of the pathology".
 
Together withteam of hematologists of the prof Maria Cristina Tirindelli, in particular, the opportunity to proceed with theapplication of autologous platelet gel (the so-called PRP, i.e Platelet rich plasma), a blood component made up of 95 percent platelets, rich in growth factors that help tissue regeneration. PRP is extracted directly from the subject's blood to be, therefore, placed in contact with the wound. "This method – explains Persichetti – it has shown a great ability to regenerate injured tissues and a strong antibacterial power".
 
The alternative, which however can also be applied in combination with the first method, is the adipose tissue transplant taken from the abdominal area. “If it's true – clarifies the specialist of the Campus Bio-Medico University – that bone marrow is a major source of adult stem cells and is increasingly used for therapeutic interventions, yet the process of extracting cells from it remains complex and painful. In this sense, adipose tissue can represent a new, promising, source of regenerative cells. Inside, in fact, there is a quota of special cells, called 'vascular stromal fraction': that is undefined stem cells, along with immune, blood vessel lining (endothelial) and connective tissue cells. All with properties similar to those of bone marrow, obtainable through the conventional liposuction technique, in a safe and relatively painless way”. The tissue previously taken from the patient is then applied minimally to the lesion area. In this way, even the most stubborn ulcers can be healed, without the risk of allergies, contamination or toxicity.
 
There are currently no structured data on the incidence of ulcerative lesions in Italy. However, the first report of the Italian Association of Cutaneous Ulcers ONLUS, part of a screening that will end at the end of 2016, brings out some interesting data: among all, the one according to which 20 percent of these patients require hospitalization, which in turn is the 'source' of ulcerative lesions in 60-80 percent of patients. Nearly a quarter of them have had the problem for more than two years, while 57 per cent have had it for between six and 18 months. More than 60 out of patients are women. The greatest number of 'difficult' wounds (more than 60 percent) are localized on the leg. Finally, again according to AIUC data, about half of the total is made up of pressure ulcers (23 percent) and venous ulcers (22 percent).