The Use of Adipose Tissue-Derived Stem Cells within a Dermal Substitute Improves Skin Regeneration by Increasing Neoangiogenesis and Collagen Synthesis

Abstract

Sir:FigureWe read with great interest the special report by Dr. Meruane et al. entitled “The Use of Adipose Tissue-Derived Stem Cells within a Dermal Substitute Improves Skin Regeneration by Increasing Neoangiogenesis and Collagen Synthesis.”1 This article highlights a new method combining adipose-derived stem cells and Integra (Integra LifeSciences, Plainsboro, N.J.) for treating full-thickness tissue injury on Sprague-Dawley rats. This animal model significantly shows that the adipose-derived stem cells can help with the healing of wounds. Our study group also conducted some basic studies on the use of adipose-derived stem cells for wound healing. There are a number of issues in the articles that are summarized in the following general and specific comments. In emergency circumstances, the human body's full-thickness skin injury is often combined with bone exposure and injury to tendons, nerves, and vital vessels. We clinical doctors usually choose local flap transplantation of the nearby healthy skin, but this will result in additional damage. We have attempted to use adipose-derived stem cells to help with replantation of in situ full-thickness skin in 1-cm2 wounds on the face, but we need at least 4 hours to extract adipose-derived stem cells from abdominal fat. Even by using Integra, we cannot avoid skin contraction. Thus, we think there are still obstacles before the authors' methods can be used clinically. Lu et al.2 also discussed this problem in their article. Their findings suggest that adipose-derived stem cells have a potential for enhancing the blood supply of random pattern skin flaps. This mechanism might be both the direct differentiation of adipose-derived stem cells into endothelial cells and the indirect effect of angiogenic growth factor released from adipose-derived stem cells. The experiment was also conducted on mice. We feel that clinical physicians and researchers should establish the criteria and guidelines for clinical application of adipose-derived stem cells. Peng Chang, M.D. Kai Tao, Ph.D. Department of Plastic and Reconstructive Surgery, General Hospital of Shenyang Military Area Command, Shenhe District, Shenyang, People's Republic of China DISCLOSURE The authors have no commercial associations that might create a conflict of interest in connection with this communication.