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Winthrop University Hospital

Harold Brem, MD, FACS

Chief of Wound Healing and Regenerative Medicine
 

Dr. Brem’s background includes research in the laboratory of Dr. Judah Folkman, collaborating directly with Dr. Folkman on investigations into the role of angiogenesis (blood vessel growth), cell biology and regenerative medicine (the use of growth factors and stem cells) in promoting wound healing. He has been practicing medicine and conducting research in the New York City area for the past 13 years, where he has continued to focus on the complicated problem of treating and ultimately preventing diabetic foot ulcers and other chronic wounds, and salvaging limbs that might otherwise require amputation.

Dr. Brem has published over 100 peer-reviewed articles and book chapters in the area of wound healing. His accomplishments include developing the first evidence-based clinical protocols for diabetic foot ulcers—protocols that are now among the most widely referenced articles in the field, and which have since been adopted by clinicians around the world; identifying, along with his longtime research partner Marjana Tomic-Canic, PhD, the first gene, known as c-myc, demonstrated to impair wound healing; and establishing the first cell bank for patients with diabetic foot ulcers, a resource that continues to play an important role in facilitating the study of wound healing in patients with diabetes among researchers everywhere; and elucidating the molecular mechanisms responsible for impaired wound healing in elderly patients with diabetic foot ulcers—a mechanism that involves a synergy between specific physiological impairments due to diabetes, and other specific impairments due to aging.

With the support of the National Institute on Diabetes and Digestive and Kidney Diseases (NIDDK), Dr. Brem has also led the way in developing innovative surgical debridement techniques that utilize molecular markers to guide removal of wound tissue, in order to maximize wound healing while minimizing the number of debridement procedures required for healing. These debridement procedures, which Dr. Brem disseminated in a series of journal articles and videos, have now become the standard care for treating diabetic foot ulcers that pose a risk of limb loss. In addition, Dr. Brem published the first article describing a new regenerative cellular therapy for patients with diabetic foot ulcers, involving the use of human fibroblast keritanocytes and stem cells—an approach that promises to further decrease the risk of limb loss in patients with diabetes.

Dr. Brem’s current research, which he will be pursuing at Winthrop University Hospital, includes studying the dissemination of these clinical innovations through multi-center clinical trials that employ a new online wound electronic medical record (OWEMR). This OWEMR—which Dr.Brem designed and created with funding from the National Institutes of Health—provides clinical decision support to surgeons and endocrinologists in the field by monitoring the wound healing process and alerting physicians when they need to make changes to current treatment regimen. Dr. Brem’s research efforts will investigate whether this approach can continue to improve outcomes and reduce limb loss for patients with diabetic foot ulcers. Dr. Brem is also lead investigator in a currently ongoing research project, being carried out in collaboration with Loretta Vileikyte, MD, PhD, on the role of stress in wound healing. In addition, he will be investigating innovative stem cell therapies that have the potential to be powerful new tools for the healing of diabetic foot ulcers and reduction of limb loss.

In addition to his own research activities, Dr. Brem mentors a number of clinical diabetes researchers in training, including research fellows, medical students pursuing sub-specialties in clinical research and diabetes, and junior faculty members who will be learning to apply their own specialty areas to help improve outcomes for patients with diabetic foot ulcers. He also has extensive clinical experience as a surgeon operating on patients with diabetic foot ulcers and other chronic wounds, and has compiled a notable safety record of salvaging limbs and saving lives of patients with even the most complex wounds. Working with Bruce Vladeck, PhD, the former director of Medicare and Medicaid for the Health Care Financing Administration, Dr. Brem has made significant contributions not only to the treatment of diabetic foot ulcers, but also venous ulcers, pressure ulcers, sickle-cell ulcers, non-healing abdominal wounds, non-healing radiation wounds, and wounds related to complications of cancer.

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