Role of Adipose-Derived Mesenchymal Stem Cells in Full Thickness Wound Healing

Background: Wound healing problems can arise in donor wounds after harvesting a full-thickness graft. Returning Mesenchymal Stem Cells (MSCs) on the wounds may accelerate wound healing. The aim of this study is to analyse the effect of MSCs in the epithelialization process and collagen density on full-thickness wound healing. Methods: The pilot study included 10 patients undergoing excision of a full-thickness skin graft on the groin. Patients were randomly divided into two groups: Mesenchymal Stem Cells (MSCs) and Non-Mesenchymal Stem Cells (Non-MSCs). The MSCs group had previously undergone fat harvesting which was processed into mesenchymal stem cells. Biopsies were taken from both groups on days 14 (proliferative phase) and 45 (maturation phase), and were compared with normal skin (NS; n=5). Epithelial layers of the epidermis were assessed with hematoxylin eosin staining. Collagen density was evaluated with MT staining, and analysed using a light microscope. Result: In the MSCs group and the Non-MSCs group, the number of epithelial layers were significantly higher compared to the NS-group on day 45 (14.7 ± 0.70 and 8.24 ± 0.76 vs 5.43 ± 0.60 respectively; p<0.001 and p<0.001). The collagen density in the MSCs group on day 14 was 33.3 ± 2.46% in the MSCs group and 45.7 ± 5.84% in the non-MSCs group, compared to 54.3 ± 3.71% in the NS-group (p<0.001 and p=0.012 resp.). These values increased on day 45 to 49.2 ± 3.28% in the MSCs group, and 73.4 ± 1.63% in the non-MSCs group. Conclusion: Mesenchymal stem cells increased the number of epithelial layers in the full-thickness wound healing process compared to normal skin. A higher increase was seen in the MSCs-group. On day 45, an increase in collagen density was observed in the MSCs group and Non-MSCs group. Adipose-derived mesenchymal stem cells can be used in the process of full-thickness wound healing. Future randomized controlled trials are needed to confirm these findings.