Allogeneic mesenchymal stem cell therapy combined with photobiomodulation for neonatal soft-tissue necrosis: A case report

Abstract

A 15-day-old neonate was admitted to a neonatal intensive care unit with peripheral ischemia and a right upper limb abscess following Bacillus Calmette-Guérin (BCG) vaccination. Laboratory findings revealed protein C and S deficiencies with elevated d-dimer levels. Imaging demonstrated a cerebral ischemic lesion secondary to coagulopathy, supporting a diagnosis of purpura fulminans. Initial management included abscess drainage followed by extensive surgical debridement of necrotic tissue, anticoagulation, and partial wound suturing. After the third debridement, the infant received four weekly infusions of 1 × 10⁷ allogeneic adipose-derived mesenchymal stem cells, suspended in 2 mL of saline solution, and administered across 10–15 intralesional and perilesional injection sites. Daily photobiomodulation therapy was used as an adjunctive treatment for analgesia and tissue regeneration. Following the first cell therapy session, progressive reduction in lesion depth and enhanced vascularization were observed, culminating in complete wound closure 70 days after the initial cell therapy session. This approach may support future advances in cell therapy and regenerative medicine for the treatment of difficult-to-heal wounds in neonates and provides a rationale for prospective, randomized, controlled clinical trials.