Effectiveness of Autodermoplasty in Combination with Injection of Autological Stromal-Vascular Cell Fraction in Treatment of Deep Burns
- Авторлар: Alekseev A.A.1, Zinoviev E.V.2, Kostyakov D.V.2, Manukovskii V.A.2, Filimonov K.A.1, Astrelina T.A.3, Kobzeva I.V.3, Hromnia S.S.1, Derii E.K.2
-
Мекемелер:
- A.V. Vishnevsky National Medical Research Center of Surgery
- I.I. Dzhanelidze Saint-Petersburg Research Institute of Emergency Medicine
- State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency
- Шығарылым: Том 17, № 2 (2024)
- Беттер: 51-59
- Бөлім: Original articles
- URL: https://journal-vniispk.ru/2070-478X/article/view/271718
- DOI: https://doi.org/10.18499/2070-478X-2024-17-2-51-59
- ID: 271718
Дәйексөз келтіру
Толық мәтін
Аннотация
Introduction. The use of autologous stromal-vascular cell fraction of adipose tissue seems to be one of the promising technologies to increase the effectiveness of skin grafting and other skin restoration options in burnt patients. The main regenerative component of the stromal-vascular fraction are mesenchymal stem cells, which have a high reparative potential and low immunogenicity.
The aim of the study was to increase the effectiveness of surgical treatment of patients with skin burns through the injection of autological stromal-vascular cell fraction of the adipose tissue.
Materials and methods. The study was conducted as part of a prospective, open, randomized study involving 61 patients with extensive skin burns treated in burn centers Dzhanelidze Saint-Petersburg Research Institute of Emergency Medicine and Vishnevsky National Medical Research Center of Surgery, Ministry of Health of Russia, in 2021-2023. Cells of the stromal-vascular fraction of the adipose tissue were obtained mechanically and enzymatically. The prepared cell suspension was introduced into the granulation tissue during skin grafting with split autodermal grafts having a high perforation coefficient. During the study, planimetric parameters, as well as the results of histological and immunohistochemical tests, were assessed. The obtained findings were processed using generally accepted algorithms of variation and descriptive statistics. The alternative hypothesis was accepted at p<0.05.
Results. The proposed technique of autologous stromal-vascular cell fraction of the adipose tissue with simultaneous autodermoplasty with a split perforated graft allowed reducing the time of perforating cell epithelization by 28% (p<0.05), the time of final engraftment by 11% (p<0.05), the frequency of infectious complications in the postoperative period by 20% (p<0.05), as well as the frequency of lysis and rejection reactions by 15% (p<0.05). As stated, the introduction of an autologous stromal-vascular fraction during skin grafting resulted in early relief of the inflammatory reaction in the area of a deep burn wound, the fact being supported by clinical, cytological, histological and immunohistochemical tests.
Conclusion. The use of cells from the stromal-vascular fraction of the adipose tissue can significantly increase the effectiveness of surgical treatment of patients with extensive skin burns. The proposed technique to obtain and apply the stromal-vascular fraction of the adipose tissue at the stage of autodermoplasty can be introduced into clinical practice in both burn centers and surgical/trauma departments, since it does not require special equipment.
Негізгі сөздер
Толық мәтін
##article.viewOnOriginalSite##Авторлар туралы
Andrey Alekseev
A.V. Vishnevsky National Medical Research Center of Surgery
Хат алмасуға жауапты Автор.
Email: alexseev@ixv.ru
ORCID iD: 0000-0001-6675-4794
SPIN-код: 4803-3939
M.D., Professor Deputy Director
Ресей, MoscowEvgeniy Zinoviev
I.I. Dzhanelidze Saint-Petersburg Research Institute of Emergency Medicine
Email: evz@list.ru
ORCID iD: 0000-0003-2812-6839
SPIN-код: 4069-2346
M.D., Professor, head of the department
Ресей, Saint-PetersburgDenis Kostyakov
I.I. Dzhanelidze Saint-Petersburg Research Institute of Emergency Medicine
Email: kosdv@list.ru
ORCID iD: 0000-0001-5687-7168
SPIN-код: 5687-7168
Ph.D., leading researcher in the department
Ресей, Saint-PetersburgVadim Manukovskii
I.I. Dzhanelidze Saint-Petersburg Research Institute of Emergency Medicine
Email: vadim@neuro.spb.ru
ORCID iD: 0000-0003-0319-814X
SPIN-код: 4323-4555
M.D., Professor, director
Ресей, Saint-PetersburgKonstantin Filimonov
A.V. Vishnevsky National Medical Research Center of Surgery
Email: doctor-fil@yandex.ru
ORCID iD: 0000-0002-6019-341X
SPIN-код: 6085-8320
Ph.D., Senior Researcher
Ресей, MoscowTatyana Astrelina
State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency
Email: t_astrelina@mail.ru
ORCID iD: 0000-0003-3629-0372
SPIN-код: 3415-8023
M.D., Associate Professor, Head of the Center
Ресей, MoscowIrina Kobzeva
State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency
Email: irina-kobzeva@yandex.ru
ORCID iD: 0000-0002-1499-8954
SPIN-код: 6651-6128
Ph.D., head of the cryobank
Ресей, MoscowSvetlana Hromnia
A.V. Vishnevsky National Medical Research Center of Surgery
Email: hrominas@mail.ru
ORCID iD: 0000-0002-9717-1118
graduate student of the Department
Ресей, MoscowEduar Derii
I.I. Dzhanelidze Saint-Petersburg Research Institute of Emergency Medicine
Email: derii.eduard@gmail.com
ORCID iD: 0000-0002-2493-5498
SPIN-код: 6127-4630
surgeon department of thermal injuries
Ресей, Saint-PetersburgӘдебиет тізімі
- Veremeev AV., Bolgarin RN., Petkova MA., Kats N, Nesterenko VG. Stromal-vascular fraction of adipose tissue as an alternative source of cellular material for regenerative tissue. Geny i kletki. 2016;11(1):35-42. (in Russ.)
- Francis E, Kearney L, Clover J. The effects of stem cells on burn wounds: a review. International journal burns and trauma. 2019;9(1):1-12.
- Han Y, Li X, Zhang Y, Han Y, Chang F, Ding J. Mesenchymal stem cells for regenerative medicine. Cells. 2019;8(8):886. doi: 10.3390/cells8080886
- Johal KS, Lees VC, Reid AJ. Adipose-derived stem cells: selecting for translational success. Regen. Med. 2015;10(1):79-96. doi: 10.2217/rme.14.72
- Mizuno H, Tobita M, Uysal AC. Concise review: Adiposederived stem cells as a novel tool for future regenerative medicine. Stem Cells. 2012;30(5):804-810. doi: 10.1002/stem.1076
- Huang SJ, Fu RH, Shyu WC, Liu SP, Jong GP, Chiu YW, Wu HS, Tsou YA, Cheng CW, Lin SZ. Adipose-derived stem cells: isolation, characterization, and differentiation potential. Cell Transplant. 2013;22(4):701-709. doi: 10.3727/096368912X655127
- Nasti A, Sakai Y, Seki A, Buffa GB, Komura T, Mochida H, Yamato M, Yoshida K, Ho TB, Takamura M, Usui S, Wada T, Honda M, Kaneko S. The CD45+ fraction in murine adipose tissue derived stromal cells harbors immune‐inhibitory inflammatory cells. European Journal of Immunology. 2017; 47(12):2163-2174. doi: 10.1002/eji.201646835
Қосымша файлдар
