Abstract
Pressure injury (PI) affects quality of life and results in economic and social burdens. Local transplantation of human adipose-derived stem cells (ASCs) is considered an effective treatment. However, ASC suspension alone is vulnerable to the immune system and results in a shortened cell survival. There is increasing evidence of a synergistic effect of platelet-rich plasma (PRP) combined with ASCs on wound healing. This study investigated the effectiveness, synergy, and mechanism of wound healing following local injection of PRP combined with ASCs in a rodent PI model. PRP or ASCs alone were the control intervention. Wound healing, inflammatory infiltration, collagen deposition, angiogenesis, neurogenesis, and cell homing were investigated. PI healing was promoted by the synergistic effects of PRP combined with ASCs. The combination was more effective than ASCs alone for modulating inflammation, increasing collagen deposition, angiogenesis, neurogenesis, and the persistence of the injected ASCs. These data provide a theoretical foundation for the clinical administration of ASCs combined with PRP in PI healing and skin regeneration.
Highlights
Pressure injury (PI), previously called pressure ulcer, involves loss of the integrity of the epidermis and dermis of the skin, subcutaneous tissue, muscle, and bone caused by continual external force [1]
This study showed that local injection of platelet-rich plasma (PRP) and adiposederived stem cells (ASCs), ASCs, or PRP alone promoted would healing in a mouse PI model
Histological evaluation showed faster recovery of the stratified skin structure and more extensive collagen production, angiogenesis, and neurogenesis in mice treated with PRP and ASCs than what was achieved with the other study treatments
Summary
Pressure injury (PI), previously called pressure ulcer, involves loss of the integrity of the epidermis and dermis of the skin, subcutaneous tissue, muscle, and bone caused by continual external force [1]. PI occurs in elderly or young patients with paraplegia or quadriplegia because of trauma [2]. 70% of PIs occur in people older than 70 years of age, and PIs develop in 40% of patients with spinal cord injuries [3, 4]. The estimated cost of preventing PI is 2.65 to 87.57 Euros/person/day. The estimated cost of treatment is 1.71 to 470.49 Euros/person/day [5]. It is important, but difficult, to monitor and manage PI
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