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Exciting development in treating one of leprosy's most awful problems 03rd December, 2019

Leprosy patients could soon be benefitting from a life-changing new treatment developed by TLM surgeon Dr Indra Napit at TLM’s Anandaban Hospital in Nepal

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Dr Napit, a reconstructive and orthopaedic surgeon, and his team have developed a new method for treating ulcers in leprosy patients which could lead to fewer amputations, faster healing and less time spent in hospital.

Ulcers happen when leprosy damages nerve endings in patients’ feet and hands causing a loss of sensation which means they do not feel any pain when they hurt themselves. This can lead to blisters developing into open ulcers which sometimes penetrate right down to the bone. Patients are then prone to infection and are at an increased risk of amputation.

Dr Napit has treated countless patients affected by leprosy-related ulcers and has witnessed the pain and disfigurement ulcers can cause. It is this that has led him to pioneer the regenerative treatment known as LPRF (Leukocyte Platelet-Rich Fibrin), which is showing exciting results in healing ulcers.  

LPRF is a concentration of the white blood cells, healing factors and regular stem cells that circulate in the blood. To begin with, the team at Anandaban collect a blood sample from the patient, and then spin it in a centrifuge to separate the red and white blood cells. Afterwards the healing cell mixture is pressed into strips that can be directly applied like plasters on the ulcer. Then they put a basic dressing on the wound and leave it for a week, after which, they assess the ulcer and repeat the process as necessary.

This is a completely new method for treating leprosy patients and the initial results have been very exciting. A formal clinical trial will begin soon. Dr Indra believes that the treatment will be faster than traditional saline treatments and will be able to cure even the most complicated of ulcers.

Around 50-90 per cent or more of admissions at leprosy hospitals are due to ulcers. Currently, the average ulcer takes around six weeks to heal and some of the more complicated ulcers can leave patients in hospital for 10 months or more as the doctors exhaust every last hope to try to save the limb. Additionally, when an ulcer gets very bad, it can be hugely unpleasant, giving off a nasty smell that leads people to be shunned by their families and communities.

For many years, ulcers have been treated with a daily saline dressing and lots of rest, to give the wound time to heal. But some ulcers do not respond well to this treatment. And often ulcers can reoccur; this can mean that the person is in and out of hospital for the rest of his or her life. The impact on their family and their ability to work and earn a living can be huge.

Now, people in Nepal who are affected by leprosy ulcers are hearing about how effective this new treatment has so far proven to be. And many new patients are attending the hospital, hoping to benefit from the skills of Dr Indra and his team.

Dr Indra is hopeful that this treatment will soon be used across the world. If it is, it will very likely be a complete game changer for hospital staff treating patients with leprosy, and, more importantly, for the patients themselves.  

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