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

干细胞可以成为治疗糖尿病足溃疡等慢性伤口的新型自体疗法的基础。脂肪移植物含有脂肪干细胞 (ADSC)，但移植物中细胞的低存活率是一个主要限制。富含血小板的血浆 (PRP) 可能会增加移植物的存活率。本综述检查了脂肪移植、ADSC 和 PRP 在伤口愈合中的动物研究的组织学。对主要电子数据库进行了文献审查，并进行了叙述合成。包括来自 30 项动物研究的数据。ADSC 在 14 天内增加血管生成，并且通常临床上加速伤口愈合。ADSC 对伤口愈合受损的动物（例如糖尿病）有更大的影响。活化的 PRP 增加了脂肪移植物的活力。尽管研究数量很多，但质量参差不齐，这削弱了证据。它确实表明 ADSC 有好处，尤其是在伤口愈合受损方面。需要高质量的人类证据来确定其临床实用性。