ABSTRACT

Stem cells could form the basis of a novel, autologous treatment for chronic wounds like diabetic foot ulcers. Fat grafts contain adipose-derived stem cells (ADSC) but low survival of cells within the grafts is a major limitation. Platelet-rich plasma (PRP) may increase graft survival. This review examines the histology from animal studies on fat grafting, ADSC and PRP in wound healing. A literature review of major electronic databases was undertaken, and narrative synthesis performed. Data from 30 animal studies were included. ADSC increase angiogenesis over 14 days and often clinically accelerated wound healing. ADSC had a greater effect in animals with impaired wound healing (e.g. diabetes). Activated PRP increased viability of fat grafts. Despite the high number of studies, the quality is variable which weakens the evidence. It does suggest there is a benefit of ADSC, particularly in impaired wound healing. High-quality evidence in humans is required, to establish its clinical usefulness.

摘要

干细胞可以构成针对糖尿病性足溃疡等慢性伤口的新型自体治疗的基础。脂肪移植物包含脂肪干细胞（ADSC），但移植物中细胞的低存活率是主要限制。富含血小板的血浆（PRP）可能会增加移植物的存活率。这篇综述检查了动物研究中有关脂肪移植，ADSC和PRP在伤口愈合中的组织学。对主要电子数据库进行了文献综述，并进行了叙述性综合。包括来自30个动物研究的数据。ADSC在14天之内增加血管生成，并且通常在临床上加速伤口愈合。ADSC在伤口愈合受损的动物（例如糖尿病）中具有更大的作用。活化的PRP可增加脂肪移植物的活力。尽管有大量的研究，但质量是可变的，这削弱了证据。它确实表明ADSC有好处，尤其是在伤口愈合不良的情况下。需要人类的高质量证据来确定其临床用途。