Zivec Katarina, Veber Matija, Pizem Joze, Jez Mojca, Bozikov Kresimir, Svajger Urban
Department of Plastic Surgery, University Medical Center Ljubljana, Zaloska 7, 1000, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia.
Aesthetic Plast Surg. 2022 Dec;46(6):2853-2862. doi: 10.1007/s00266-022-02860-4. Epub 2022 Mar 30.
BACKGROUND: Stem cell therapy is a promising new approach to wound healing. Stromal vascular fraction is a heterogeneous collection of cells, including adipose-derived stem cells, which are traditionally isolated using a manual collagenase-based technique. To our knowledge, this is the first human study that histologically assesses the potential of intraoperative intradermal injection of stromal vascular fraction on skin regeneration. METHODS: In this controlled study, 20 patients undergoing deep inferior epigastric perforator flap breast reconstruction and bilateral flank liposuction were included. Stromal vascular fraction was injected intradermally into one side of the abdominal suture line, while the other side served as a control. Outcome measures included analysis of stromal vascular fraction by flow cytometry, histological analysis of scar tissue, and scar photography. RESULTS: Cell yield for application and cell viability were 55.9 ± 28.5 × 10 and 75.1% ± 14.5%, respectively. Age and body mass index were positively correlated with the number of cells for application and adipose-derived stem cells. Mean vascular density, elastic fiber content, collagen maturity (scar index), epidermal thickness, and number of rete ridges all showed higher values on the treated side. Furthermore, the injected number of adipose-derived stem cells and pericytes positively correlated with vascular density. CONCLUSIONS: It is safe to speculate that intradermal stromal vascular fraction injection at the beginning of the healing process increases vascular density, collagen maturity and organization, elastic fiber content, epidermal thickness, epidermal-dermal anchoring of the scarring skin and is therefore responsible for improved skin regeneration. It is a viable and safe method that can be used as an adjunctive treatment in plastic surgery procedures where suboptimal wound healing is anticipated. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
背景：干细胞疗法是一种很有前景的伤口愈合新方法。基质血管成分是多种细胞的异质性集合，包括脂肪来源干细胞，传统上是使用基于胶原酶的手工技术分离。据我们所知，这是第一项组织学评估术中皮内注射基质血管成分对皮肤再生潜力的人体研究。 方法：在这项对照研究中，纳入了20例行腹壁下深动脉穿支皮瓣乳房重建及双侧腰腹部抽脂的患者。将基质血管成分皮内注射到腹部缝线一侧，另一侧作为对照。观察指标包括通过流式细胞术分析基质血管成分、瘢痕组织的组织学分析以及瘢痕摄影。 结果：应用的细胞产量和细胞活力分别为55.9±28.5×10和75.1%±14.5%。年龄和体重指数与应用的细胞数量及脂肪来源干细胞数量呈正相关。治疗侧的平均血管密度、弹性纤维含量、胶原成熟度（瘢痕指数）、表皮厚度和 rete 嵴数量均显示出较高值。此外，注射的脂肪来源干细胞和周细胞数量与血管密度呈正相关。 结论：可以有把握地推测，在愈合过程开始时皮内注射基质血管成分可增加血管密度、胶原成熟度和排列、弹性纤维含量、表皮厚度、瘢痕皮肤的表皮 - 真皮锚定，因此有助于改善皮肤再生。这是一种可行且安全的方法，可在预期伤口愈合不佳的整形手术中用作辅助治疗。 证据级别IV：本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266 。
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