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Adipose-derived stem cells for treatment of chronic cutaneous ulcers in patients with critical limb ischemia: a pilot study

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Therapeutic approaches based on stem cells have recently been introduced to treat chronic ulcers, with good results. The aim of this study was to evaluate whether the topical application of adipose-derived stem cells (ASCs) with platelet-rich plasma (PRP) for the treatment of ischemic cutaneous ulcers modified the skin perfusion of the treated areas.

Methods

Perilesional laser Doppler flowmetry (LDF) and transcutaneous oximetry (tcpO2) values were recorded for a 3-month period in seven arteriopathic and diabetic patients with ischemic ulcers of the lower limb candidates to amputation, who had been previously treated with single co-administered perilesional and intralesional injections of ASCs+PRP.

Results

Significant differences were found between pretreatment (T0) and 3 month post-treatment (T3) values regarding both LDF values (basal mean values: T0 30.7; T3 50.4; declivous mean values: T0 23; T3 38.9;) and tcpO2 levels (basal mean values: T0 6.7; T3 45.9; declivous mean values: T0 17.6; T3 47.3).

Conclusions

According to the values of LDF and TcpO2, the multidisciplinary treatment of severe ulcers with ACSs+PRP associated or not with revascularization therapy allowed a perilesional improvement of oxygenation and perfusion such to avoid limb amputation, with complete wound healing. Early treatment with ASCs associated or not with reperfusion therapy is an effective treatment even in severe ulcers in advanced stage once treated with amputation of limb.

Level of evidence: Level V, therapeutic study

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Authors and Affiliations

  1. Department of Medicine and Surgery, Plastic Surgery Division, University of Parma, Via Gramsci 14, 43126, Parma, Italy

    Edoardo Raposio, Nicolò Bertozzi, Eugenio Grignaffini, Francesco Simonacci & Michele Pio Grieco

  2. Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy

    Edoardo Raposio, Nicolò Bertozzi, Eugenio Grignaffini, Francesco Simonacci & Michele Pio Grieco

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  1. Edoardo Raposio
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  2. Nicolò Bertozzi
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  3. Eugenio Grignaffini
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  4. Francesco Simonacci
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  5. Michele Pio Grieco
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Correspondence to Edoardo Raposio.

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Conflict of interest

Edoardo Raposio, Nicolò Bertozzi, Eugenio Grignaffini, Francesco Simonacci, and Michele Pio Grieco declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

 Patients provided written consent before their inclusion in this study

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Raposio, E., Bertozzi, N., Grignaffini, E. et al. Adipose-derived stem cells for treatment of chronic cutaneous ulcers in patients with critical limb ischemia: a pilot study. Eur J Plast Surg 41, 459–464 (2018). https://doi.org/10.1007/s00238-017-1383-y

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  • DOI: https://doi.org/10.1007/s00238-017-1383-y

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