Department of Plastic Surgery, La Conception Hospital, Assistance Publique - Hôpitaux de Marseille, France; Aix-Marseille Univ, C2VN, INSERM, INRA, France.
Department of Plastic Surgery, La Conception Hospital, Assistance Publique - Hôpitaux de Marseille, France.
Burns. 2020 Nov;46(7):1641-1652. doi: 10.1016/j.burns.2020.04.020. Epub 2020 May 16.
BACKGROUND: External radiotherapy has become indispensable in oncological therapies. Unfortunately, radiation is responsible for serious side effects, such as radiodermatitis. The skin is weakened and ulcerated. Our study aimed to evaluate the subcutaneous transfer of microfat (MF) alone and two mixes: MF+Platelet-rich plasma (PRP) and MF+stromal vascular fraction (SVF) to treat radiation-induced skin lesions. METHOD: We defined randomly five experimental groups of nine mice: 1 healthy control group and 4 irradiated (60 Grey) and treated groups. The skin lesions were treated 3 months after irradiation by MF, MF+PRP (50%-50%), MF+SVF (90%-10%) or Ringer-lactate subcutaneous injections. Wound healing was evaluated at 1, 2 and 3 months post-injection and histological wound analysis at 3 months, after euthanasia. RESULTS: All the irradiated mice presented with wounds. After sham-injection, the wound area increased by 91.1±71.1% versus a decrease of 15.9±23.1% after MF alone (NS), 27.3±23.8% after MF+SVF (NS) and 76.4±7.7% after MF+PRP (P=0.032). A significative reduction of skin thickness in wound periphery was measured for the three treated groups compared to sham-injection (P<0.05) but not in the healed wounds (NS). The most important subcutaneous neo-vessel density was shown after MF+SVF injection. CONCLUSION: The MF+PRP mix was the most efficient product to increase healing. The MF+SVF mix showed the highest rate of neo-angiogenesis but was disappointing in terms of healing. LEVEL OF EVIDENCE: Not gradable.
背景：外放射治疗已成为肿瘤治疗中不可或缺的手段。然而，辐射会导致严重的副作用，如放射性皮炎。皮肤会变得脆弱并发生溃疡。我们的研究旨在评估单纯脂肪组织（MF）和两种混合物（MF+富含血小板的血浆（PRP）和 MF+基质血管成分（SVF））的皮下移植，以治疗放射性皮肤损伤。
方法：我们随机将 5 组实验小鼠分为 9 只：1 组健康对照组和 4 组辐射（60 格雷）处理组。在照射后 3 个月，通过 MF、MF+PRP（50%-50%）、MF+SVF（90%-10%）或林格乳酸盐进行皮下注射治疗皮肤损伤。在注射后 1、2 和 3 个月评估伤口愈合情况，并在安乐死后 3 个月进行组织学伤口分析。
结果：所有照射的小鼠都出现了伤口。在假注射后，伤口面积增加了 91.1±71.1%，而单独使用 MF 则减少了 15.9±23.1%（无统计学意义），MF+SVF 减少了 27.3±23.8%（无统计学意义），MF+PRP 减少了 76.4±7.7%（P=0.032）。与假注射相比，三种治疗组的伤口周围皮肤厚度均显著减少（P<0.05），但在愈合伤口中无差异（无统计学意义）。MF+SVF 注射后显示出最高的皮下新生血管密度。
结论：MF+PRP 混合物是促进愈合最有效的产品。MF+SVF 混合物显示出最高的新生血管形成率，但在愈合方面令人失望。
证据水平：不可分级。
Stem Cell Res Ther. 2014-12-17
Zhonghua Shao Shang Za Zhi. 2018-12-20
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