Hashemi Seyedeh-Sara, Mohammadi Ali Akbar, Moshirabadi Kasra, Zardosht Mitra
Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
J Cosmet Dermatol. 2021 Dec;20(12):4040-4047. doi: 10.1111/jocd.14043. Epub 2021 Apr 25.
Skin wound healing has always been a challenging subject as it involves the coordinated functioning of various cells and molecules. Any disorder in wound healing can cause healing failure and result in chronic wounds. In this study, we hypothesized that co-cultured dermal fibroblasts (DFs) and Wharton's jelly mesenchymal stem cells (WJ-MSCs) seeded on an acellular amniotic membrane scaffold could be used to promote skin regeneration in chronic ulcers.
In this case series, the chronic wounds of five diabetic patients aged between 30 and 60 years were treated with co-cultured WJ-MSCs and DFs seeded on an acellular amniotic membrane. Treatment was applied and the wound healing process was evaluated every three days for nine days, with the patients being subsequently followed up for one month. The wound healing percentage, time taken for the wound to heal, and wound size were monitored.
The mean wound healing rate (WHR) increased progressively in all lesions. The mean percentage of wound healing after transplantation of the biological scaffold enriched with WJ-MSCs and autologous DFs after treatment was 93.92%, respectively. The healing percentage significantly increased after three days; significant decreases in wound size and healing time were recorded after six and nine days of treatment, respectively (p < 0.002); and total skin regeneration and re-epithelialization were achieved by the ninth day of treatment. There were no side effects or complications.
Given the current problems and complications presented by chronic wounds, Novel Clinical approaches involving cell therapy and tissue engineering can be regarded as an attractive therapeutic option for the treatment of chronic and difficult-to-heal wounds.
皮肤伤口愈合一直是一个具有挑战性的课题,因为它涉及多种细胞和分子的协同作用。伤口愈合过程中的任何紊乱都可能导致愈合失败并引发慢性伤口。在本研究中,我们假设接种在脱细胞羊膜支架上的共培养真皮成纤维细胞(DFs)和沃顿胶间充质干细胞(WJ-MSCs)可用于促进慢性溃疡的皮肤再生。
在这个病例系列中,对5名年龄在30至60岁之间的糖尿病患者的慢性伤口,采用接种在脱细胞羊膜上的共培养WJ-MSCs和DFs进行治疗。每三天进行一次治疗并评估伤口愈合过程,持续九天,随后对患者进行为期一个月的随访。监测伤口愈合百分比、伤口愈合所需时间和伤口大小。
所有伤口的平均伤口愈合率(WHR)均逐渐升高。治疗后,富含WJ-MSCs和自体DFs的生物支架移植后的伤口平均愈合百分比分别为93.92%。治疗三天后愈合百分比显著增加;治疗六天和九天后,伤口大小和愈合时间分别显著减小(p < 0.002);治疗第九天时实现了完全皮肤再生和重新上皮化。未出现副作用或并发症。
鉴于慢性伤口目前存在的问题和并发症,涉及细胞治疗和组织工程的新型临床方法可被视为治疗慢性难愈合伤口的一种有吸引力的治疗选择。