Department of Plastic and Cosmetic Surgery, Xiangya Hospital, Central South University, Changsha, PR China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, PR China.
Int Wound J. 2024 Sep;21(9):e70016. doi: 10.1111/iwj.70016.
Wound development and healing involve intricate genetic and molecular processes, posing significant clinical management challenges. The objective of this study was to assess commonly used fat extracts' efficacy and safety (autologous fat, stromal vascular fraction and adipose-derived stem cells) in wound healing, particularly for refractory wounds, with the goal of providing evidence in clinical use. After a systematic review, 21 randomised controlled trials were included in our study. Based on the classification of human fat products, our meta-analysis revealed that the use of human fat products could speed healing rate, shorten healing time and achieve more complete healing, with statistically significant differences in outcome indicators when compared to conventional treatments. The analysis of histological findings across various studies indicated that fat extracts can promote epithelialization, collagen deposition and vascularization, thereby facilitating tissue regeneration and reducing inflammatory reactions. There were potential benefits to reducing patient pain levels after using adipose extracts. Furthermore, we analysed and summarised adverse events indicating the safe and effective clinical use of human fat products in wound treatment. Our research findings supported the efficiency of human fat products and demonstrated a high degree of safety in the clinical practice of wound management.
创伤的发生和愈合涉及复杂的遗传和分子过程，这给临床管理带来了重大挑战。本研究旨在评估在创伤愈合中常用的脂肪提取物（自体脂肪、基质血管成分和脂肪来源的干细胞）的疗效和安全性，特别是针对难治性创面，以期为临床应用提供证据。经过系统评价，我们的研究纳入了 21 项随机对照试验。根据人类脂肪产品的分类，我们的荟萃分析显示，与传统治疗相比，使用人类脂肪产品可以加快愈合速度、缩短愈合时间并实现更完全的愈合，在结局指标上具有统计学显著差异。对不同研究的组织学发现进行分析表明，脂肪提取物可以促进上皮化、胶原沉积和血管生成，从而促进组织再生和减少炎症反应。使用脂肪提取物后，患者的疼痛水平可能会降低，这是潜在的获益。此外，我们还分析和总结了不良事件，表明人类脂肪产品在创面治疗中的临床应用是安全有效的。我们的研究结果支持了人类脂肪产品的有效性，并证明了其在创面管理的临床实践中具有高度的安全性。
