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Autologous mesenchymal stem cells application in post-burn scars treatment: a preliminary study

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Abstract

Mesenchymal stem cells (MSCs) are multi-potent cells characterized by long term self-renewal and by potential for differentiation into cells of different mesenchymal tissue types such as fibroblasts, osteocytes, chondrocytes, and adipocytes. Their unique properties offer broad therapeutic potentials. Bone marrow has been used as the most common MSCs source, but it is gradually going to be replaced by adipose tissue which showed to contain more MSCs per unit than the bone marrow and clinical application of MSCs procured from the adipose tissue have been demonstrating at least similar results. Post-burn scars result frequently in severe both functional and aesthetic impairments in restitution and rehabilitation periods of the burn disease. Despite extensive research in the last decades, the exact mechanisms of scar formation remains unclear. The development of post-burn scars is influenced by multiple factors such as initial depth of the burn, methods of burn wound therapy, duration of the open wound until final wound closure, burn wound infection, genetic predisposition, and many others in both acute and rehabilitation periods. The aim of this study was to point out versatility of the implementation of this method with respect to different types of scars (atrophic scars, hypertrophic scars, keloids). Autologous adipose tissue derived MSCs were applied to post-burn scars in all 8 patients undergoing surgical scar reconstructions at the Department of Burns and Reconstructive Surgery of the University Hospital in Bratislava. The study was approved by Ethical Committee of Ruzinov Hospital. The procedures used for scar reconstructions included dermabrasion, scar excisions, contractures corrections and local plasties combined by lipografting of lipoaspirate containing parenchymal adipocytes and stromal vascular fraction including MSCs, or application of separated autologous MSCs isolated from lipoaspirates. Based on desired result one of these MSCs application methods was selected depending on characteristics of reconstructed scar and required volume of transferred fat. Isolation of MSCs following procurement was provided by the Central Tissue Bank cell culture laboratory which is one of the parts of the burn department. The average time of scars duration was 79 months, ranging from 6 to 216 months. The postburns scars were assessed clinically according to Vancouver Scar Scale (VSS) prior to surgery, including photo documentation, and re-evaluated after 6 months following MSCs application. As the results have shown, the average VSS score before treatment was 7.88 points ranging from 4 to 11 points. The average VSS 6 months after surgical procedure and MSCs application was 2.34 points ranging from 1 to 4 points. According to the results obtained, the favourable effect of adipose tissue derived autologous MSCs application on scar remodelling following surgical reconstruction of post-burn scars could be promising.

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Acknowledgements

This work was supported by Ministry of Health of Slovak Republic under the project No. 2019/17-LFUK-5 (301/2019).

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Authors and Affiliations

  1. Department of Burns and Reconstructive Surgery, Faculty of Medicine, Comenius University, University Hospital, Pazitkova 4, 821 01, Bratislava, Slovakia

    Peter Zahorec, Nina Sarkozyova, Nikola Ferancikova, Peter Bukovcan & Jan Koller

  2. Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Comenius University in Bratislava, University Hospital, Pazitkova 4, 821 01, Bratislava, Slovakia

    Martin Bohac

  3. Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, 811 08, Bratislava, Slovakia

    Lubos Danisovic

  4. Department of Surgical Oncology, National Cancer Institute Bratislava, Klenová 1, 833 10, Bratislava, Slovakia

    Miroslav Tomas

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  1. Peter Zahorec
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  2. Nina Sarkozyova
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  3. Nikola Ferancikova
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  4. Peter Bukovcan
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  5. Lubos Danisovic
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  6. Martin Bohac
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  7. Miroslav Tomas
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  8. Jan Koller
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Correspondence to Peter Zahorec.

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Zahorec, P., Sarkozyova, N., Ferancikova, N. et al. Autologous mesenchymal stem cells application in post-burn scars treatment: a preliminary study. Cell Tissue Bank 22, 39–46 (2021). https://doi.org/10.1007/s10561-020-09862-z

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  • DOI: https://doi.org/10.1007/s10561-020-09862-z

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