The doctors in our hospital use a number of injection methodologies to deliver stem cells. Reliant on every patient’s specificdisorder, one or severalmethodologies of delivery will be used during a standard treatment sittingin an attempt to maximize safety and efficiency. It is vital to remember that our protocols always prioritize security first and the immunizations procedures provided are little invasive but still a very concentrated on delivering the stem cells as close as possible from the injury location. For more info regarding the diverse injection approaches, please take a look below.
The intravenous injection (IV) can be defined as the infusion of liquid elements straight into a vein. IVs allow healthcare specialists to administer fluids, blood products and medicines straight into a patient’s bloodstream via a small tube. This permits speedy absorption and precise control over the dosage of the element administered, which is imperative for a multiplicity of medical processes. As stem cells can be taken by the circulatory system to every region of the body, they will stroll to the location of injury or disease.
- The IV tubing is being set up suitably and two IV bags (saline solution and stem cells) are being suspended on a raised stand.
- The inoculation site (where the IV will be inserted) is being sanitized.
- The IV catheter (IV catheters are fixed over the needle used to puncture the vein) is removed from its sterile wrapping and the needle is then inserted into the vein.
- The shielding cover is being removed from the end of the IV tubing and is cautiously inserted into the catheter hub. A piece of tape is placed over the catheter hub to protect the IV.
- The nurse checks on the movement of fluid into the vein during the whole process which lasts 30 to 60 minutes. If the patient feels any uneasiness during or after the process, the medical staff on-site should be alertedimmediately.
- Once the infusion is done, the nurse closes the roller clamp to stop the torrent of fluid. She places a clean piece of gauze over the IV site and applies elusive pressure as the catheter is drawn out.
- Patients are requested to press sterile cotton wool onto immunization site for at least 5 minutes.
Retrobulbar injections (RB) are usually used worldwide to offer local anesthesia in the retrobulbar zone (behind the eye). During our stem cell treatment process, this set of injection is used to deliver stem cells as close as possible from the optic nerve and/or retina in an attempt to better target the site of injury.
The whole procedure is quick and safe (as described below) and normally allows our patients to get more benefits from the treatment. Please note that retrobulbar inoculations will only be provided to patients older than 11 years old. The final decision will be made by the attending doctor upon admission at the hospital.
- The patient is requested to lie down. Aantiseptic is then cautiously applied on the skin from the lower eyelid margin to the lower orbital rim, respectively.
- The patient is asked to look in the direction of the opposite side of the eye being treated and look slightly up. If the inoculation is done for the right eye, the patient should look at the top left side and vice versa.
- A thin needle is then inserted upright about 2 millimeters deep in the quadrant between the outside 1/3 and inside 2/3 of the lower orbital rim.
- The needle passes the equator of the eye sphere and is then focused towards the upper nasal site until it is about 3 centimeters in depth. Stem cells are then be inoculated into the retrobulbar space.
- Once the vaccination is done, the needle is slickly removed and the ocular globe is repeatedly compressed with sterile bandages for numerous minutes. Generally, the entire procedure is completed in about 15 minutes and the inoculation itself is done in a few seconds.
The Intrathecal Administration encompasses an injection made into the spinal canal so as to access the cerebrospinal fluid (CSF) and by extension, the central nervous system. This type of administration permits delivering the stem cells to the brain and spinal cord in an easier and more effective way. Before the injection, a lumbar puncture (LP) is implemented in the first place so as to extract a little quantity of CSF and exchange it with the stem cells.
- The patient is asked to not eat after 10 PM the day before the process.
- Patients will be relocated into a surgical operating suite where the doctor supported by two nurses, will give the injection.
- Patients will be placed on their side with their backs near the verge of the table or bed. A nurse will then help patients in bending their knees towards their belly and stretching their head to the chest in a fetal position. This position aids to separate the vertebrae so that the needle can be put in more straightforwardly.
- The doctor will first scrutinize the patient’s lower back and mark the appropriate insertion site (between two lumbar vertebrae from L2 to L5).
- The region is then cleaned with an antiseptic and a local anesthetic is introduced beneath the skin to numb the zone where the needle will be inserted into the spinal canal.
- Once the needle is in the accurate position, the stylet from spinal needle is then withdrawn and about 2 ml of cerebral spinal fluid is gathered.
- The stem cells (around 1ml) and saline solution (around 1 ml) will then be administered respectively via the needle into the cerebral spinal fluid.
- The process is completed by withdrawing the needle with the reinserted stylet while giving pressure on the perforation site. Placement of the needle, accompanied by the infusion, is normally concluded in 20 minutes to hour.
- All patients are asked to lie flat for 4 to 6 hours after the process to sidestep any provisional side-effects such as headaches, nausea, fevers, vomiting and/or pains in the legs. These symptoms are believed to be an outcome the change in fluid volume within the spinal canal. Even lying flat, some patients may still develop this uneasiness. These may last for up to 48 hours. Patients should inform the doctors if they have a very severe headache, unbending neck, loss of sensation under the puncture zone, or any leakage from the injection zone.
An intramuscular (IM) injection is a shot of medicine given into a muscle. Intramuscular injections of stem cells can help patients with muscular dystrophy to get better health advantages. These injections are given direct into the muscles of the affected areas. Upon admission, the physicians will scrutinize the patient and decide how many stem cell packets should be inoculated locally into the affected muscles. The delivery method has also been applied to treat lower limb ischemia and diabetic foot.
- The patient is requested to take the appropriate posture to access the affected muscles fluently.
- The injection location is sanitized. Stem cells are given by a syringe (There are 3 portions of a syringe: the needle to go into the muscle, the barrel to hold the medicine, the nozzle to get medication in and out of the syringe).
- The nurse temperately presses on and pulls the skin around the inoculation site so that it is slightly tight. The needle is inserted in the affected muscle and the stem cells are shot up gradually.
- Once the injection finishes, the injection site is pressed with dry cotton and the needle is dragged out quickly simultaneously. A piece of gauze is then placed at the injection site.
Methods of stem cell implantation
There are sevenelementary methods for conducting stem cell implantation contingent on the condition of the patient’s health. They are revealed as follows:
- Intravenous Administration
- Intrathecal Administration (Lumbar Puncture)
- Intramuscular Administration
- Intra-arterial Administration via catheter
- Retrobulbar Infusion of cells
- Liberation Angioplasty for Multiple Sclerosis CCSVI
- Administration Through Syringes
- Intra-derma administration around wounds: This specific method is used in case of open sores such as diabetic foot or pressure ulcers. It encompasses infusion of stem cells straight into or around the wound zone, i.e. the inoculation into the dermal layer of the skin. This layer is the most favored layer beneath the epidermal layer of the skin, as it is extremely vascularized layer, encompassing dense blood vessels, immune cell sand dermal dendritic cells. This way infused stem cells will quickly elicit and fortify body’s natural healing signals for quicker retrieval.
- Intra-Dermal Administration around the hair follicles: Platelet Rich Plasma is blended with the patient’s own adipose tissue stem cells extract at the time of infusion. The scalp is insensated with the application of local anesthesia and the PRP accompanied by the stem cells is infused around the follicles with the assistance of small micro needles. This intra-dermal, local application of PRP with stem cells can fast-track the healing procedure around the follicles instantaneously. The methodology can stimulate the innate stem cells and provide the strength, support, vivacity and resilience to the follicles; which will be useful in producing new hair strands naturally.
- Intra-Dermal Administration of PRP on face: Platelet Rich Plasma is blended with the patient’s own adipose tissue stem cells extract at the time of infusion. The face is numbed with the application of local numbing cream and the PRP accompanied by the stem cells is infused at diverse points on the face such as around the eyes, lips, chin, etc. with the assistance of small micro needles.This intra-dermal, local application of PRP with stem cells can quicken the healing procedure around instantaneously. The method can stimulate the native cells for the augmented production of collagen, elimination of photo damaged cells, pigmentation’s and wrinkles to give you fresh, tautened and wrinkle-free skin naturally.
At large, maximum of the intradermal injections are delivered inside the skin, via micro needle via mantoux method; in which the needle will be inserted at an angle of 5-15 degree around the region.
- CCSVI Treatment Step 1 – Liberation Angioplasty: Liberation Angioplasty is a very critical procedure. X-ray scanning is used to guide the catheter with the balloon tip to the affected region or veins. Once it reaches the targeted region, the tip inflates occasioning in the broadening of the steno tic region. The whole procedure takes around 90 minutes. Then the patients are kept in retrieval room for around 4 hours to make sure that there is no bleeding from the catheter insertion strip.
- CCSVI Treatment Step 2 – Insertion of Stem Cells: After the first step of liberation angioplasty the blood flows without difficulty via the stenotic veins. This is vitalso as to define the effective potential of the stem cells introduced to transmute into specialized cells essential for regeneration or repair of impaired tissue of the brain or the spinal cord. This process can also lessen the inflammation throughout the body. Several of the patients have reported that the recovery is tremendously quick after this treatment.
Intra-arterial infusion is usually an insertion of cells via a thin catheter inserted into the artery. The infusion is usually done with intense care to evade impairment. Via X-ray imaging, a catheter is directed towards the targeted zone to ensure maximum cell delivery at the site of impairment. This route is usually preferred for vascular organs such as kidney, heart or pancreas.