The Role of Adipose-Derived Stem Cells, Dermal Regenerative Templates, and Platelet-Rich Plasma in Tissue Engineering-Based Treatments of Chronic Skin Wounds.

Massimo Conese,Antonella Angiolillo,Lorenzo Lo Muzio,Luigi Annacontini,Aurelio Portincasa,Elisa Beccia,Sante Di Gioia,Annalucia Carbone,Fedele Lembo,Liberato Roberto Cecchino,Filiberto Mastrangelo,Domenico Parisi

doi:10.1155/2020/7056261

Abstract

The continuous improvements in the field of both regenerative medicine and tissue engineering have allowed the design of new and more efficacious strategies for the treatment of chronic or hard-to-heal skin wounds, which represent heavy burden, from a medical and economic point of view. These novel approaches are based on the usage of three key methodologies: stem cells, growth factors, and biomimetic scaffolds. These days, the adipose tissue can be considered the main source of multipotent mesenchymal stem cells, especially adipose-derived stem cells (ASCs). ASCs are easily accessible from various fat depots and show an intrinsic plasticity in giving rise to cell types involved in wound healing and angiogenesis. ASCs can be found in fat grafts, historically used in the treatment of chronic wounds, and have been evaluated as such in both animal models and human trials, to exploit their capability of accelerating wound closure and inducing a correct remodeling of the newly formed fibrovascular tissue. Since survival and fitness of ASCs need to be improved, they are now employed in conjunction with advanced wound dressings, together with dermal regenerative templates and platelet-rich plasma (as a source of growth and healing factors). In this work, we provide an overview of the current knowledge on the topic, based on existing studies and on our own experience.

Highlights

Tissue engineering is an interdisciplinary field of biomedical research which focuses on the restoration of tissue defects, up to the replacement of a complete organ [1, 2]
Nonhealing skin wounds are commonly related to peripheral vascular disease, infection, trauma, neurologic, and immunologic conditions, as well as neoplastic and metabolic disorders, and do represent a challenging problem in the medical practice
The improvement seen by the usage of this technique has been mainly attributed to the enhancement of angiogenesis, while the secretion of growth factors improves tissue survival

Summary

Introduction

Tissue engineering is an interdisciplinary field of biomedical research which focuses on the restoration of tissue defects, up to the replacement of a complete organ [1, 2]. One of the main sources of stem cells is adipose tissue, which, in recent studies, has been reported to contain multipotent and pluripotent stem cells able to regenerate themselves and to differentiate in a variety of specialized cell types [12, 13]. Autologous fat transfer ( called “lipofilling”), has proven to be an easy technique, minimally invasive, and which can be completed in an outpatient way It has been used for in a variety of indications, including treatment of tissue discontinuities, burns, scars, restoration of either facial or body volume in cosmetic surgery, breast reconstruction or aesthetic surgery, and treatment of difficult wounds [14,15,16]. We aim to give an overview about the role of ASCs, dermal regeneration templates, and growth factors as supplied by platelet-rich plasma (PRP) in the treatment of skin wounds having different etiology

Adipose-Derived Stem Cells

Platelet-Rich Plasma

Findings

Conclusions