Keywords
Enterostomal Therapy
Wounds and Injuries
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Abstract
Objective: To analyze the scientific evidence regarding tissue engineering strategies with stem cells for the healing of chronic wounds. Methods: This is an integrative review, conducted in the EMBASE, PubMed, Scopus, and Web of Science databases, using the following descriptors: “mesenchymal stem cells”, “adult stem cells”, “embryonic stem cells”, “erythroid precursor cells”, “stem cell therapies”, “chronic wounds”, and “wounds and injuries”. Studies published between 2018 to 2023 that explored stem cell therapies, either as a primary or adjunctive treatment in human patients, were included. Results: Seven articles made up the final sample of this study, with a higher frequency of randomized clinical trials (n: 02). The results indicate that stem cell therapies, especially those derived from adipose tissue, play a significant role in the healing of chronic wounds. These approaches not only accelerate skin regeneration but also show remarkable safety, evidenced by the absence of side effects or significant complications. Final considerations: The studies in this integrative review highlight the potential of tissue engineering with stem cells for the healing of chronic wounds. Despite the promising results, challenges in standardization and research persist, and future investigations are essential to consolidate these strategies.
References
BACHMANN S, et al. Interacting adipose-derived stem cells and microvascular endothelial cells provide a beneficial milieu for soft tissue healing. Mol. Biol. Rep. 2020; 47 (1): 111–122.
BRASIL. Ministério da Saúde (MS). Lei no 9.610, de 19 de fevereiro de 1998, que altera, atualiza e consolida a legislação sobre direitos autorais e dá outras providências. Diário Oficial da União. Brasília: Ministério da Saúde, 1998.
BRENNAN MB, et al. Diabetic foot ulcer severity predicts mortality among veterans with type 2 diabetes. J Diabetes Complicat. 2017; 31: 556-561.
CAI Y, et al. Long-term follow-up and exploration of the mechanism of stromal vascular fraction gel in chronic wounds. Stem Cell Res Ther. 2023; 14 (1): 163.
CHEN L, et al. Telemedicine in chronic wound management: systematic review and meta-analysis. JMIR mHealth uHealth. 2020; 8: e15574.
CHEN CF, et al. A Multifunctional Polyethylene Glycol/Triethoxysilane-Modified Polyurethane Foam Dressing with High Absorbency and Antiadhesion Properties Promotes Diabetic Wound Healing. Int J Mol Sci. 2023; 24 (15): 12506.
CORREIA EF, et al. Principais fatores de risco para amputação de membros inferiores em pacientes com pé diabético: uma revisão sistemática. Research, Society and Development. 2022; 11 (8): e59511831599.
DARINSKAS A, et al. Stromal vascular fraction cells for the treatment of critical limb ischemia: a pilot study. J Transl Med. 2017; 15: 143.
DENG C, et al. Treatment of human chronic wounds with autologous extracellular matrix/stromal vascular fraction gel: A STROBE-compliant study. Medicine (Baltimore). 2018; 97: e11667.
DENG C, et al. Chronic wound treatment with high-density nanofat grafting combined with negative pressure wound therapy. Int J Clin Exp Med. 2019; 12: 1402–1411.
FALANGA V, et al. Chronic wounds. Nat Rev Dis Primers. 2022; 8 (1): 50.
FARIVAR BS, et al. Prospective study of cryopreserved placental tissue wound matrix in the management of chronic venous leg ulcers. J Vasc Surg Venous Lymphat Disord. 2019; 7: 228–233.
FRYKBERG RG, et al. Challenges in the Treatment of Chronic Wounds. Adv Wound Care (New Rochelle) 2015; 4: 560–582.
GADELKARIM M, et al. Adipose-derived stem cells: Effectiveness and advances in delivery in diabetic wound healing. Biomed Pharmacother. 2018; 107: 625-633.
GETHIN G, et al. Evidence for person-centred care in chronic wound care: a systematic review and recommendations for practice. J Wound Care. 2020; 29 (Sup9b): S1–S22.
GUAN Y, et al. Sustained oxygenation accelerates diabetic wound healing by promoting epithelialization and angiogenesis and decreasing inflammation. Sci. Adv. 2021; 7 (35): eabj0153.
HAO Z, et al. Review: Research progress of adipose-derived stem cells in the treatment of chronic wounds. Front Chem. 2023; 11: 1094693.
HASHEMI SS, et al. The healing effect of Wharton's jelly stem cells seeded on biological scaffold in chronic skin ulcers: A randomized clinical trial. J Cosmet Dermatol. 2019; 18: 1961-1967.
HASHEMI SS, et al. Effect of dermal fibroblasts and mesenchymal stem cells seeded on an amniotic membrane scaffold in skin regeneration: A case series. J Cosmet Dermatol. 2021; 20 (12): 4040-4047.
HSU LC, et al. The potential of the stem cells composite hydrogel wound dressings for promoting wound healing and skin regeneration: In vitro and in vivo evaluation. J. Biomed. Mater Res. B Appl. Biomater. 2019; 107 (2): 278–285.
KIM WS, et al. Wound healing effect of adipose-derived stem cells: a critical role of secretory factors on human dermal fibroblasts. J Dermatol Sci. 2007; 48: 15–24.
KWON DS, et al. Treatment with bone marrow-derived stromal cells accelerates wound healing in diabetic rats. Int Wound J. 2008; 5: 453-463.
LIM CY, et al. Randomization in clinical studies. Korean J Anesthesiol. 2019; 72 (3): 221–232.
LONARDI R, et al. Autologous micro-fragmented adipose tissue for the treatment of diabetic foot minor amputations: a randomized controlled single-center clinical trial (MiFrAADiF). Stem Cell Res Ther. 2019; 10 (1): 223.
LOPES L, et al. Stem cell therapy for diabetic foot ulcers: a review of preclinical and clinical research. Stem Cell Res Ther. 2018; 9: 188.
MARINO G, et al. Therapy with autologous adipose-derived regenerative cells for the care of chronic ulcer of lower limbs in patients with peripheral arterial disease. J Surg Res. 2013; 185: 36-44.
MCHUGH ML. Interrater reliability: the kappa statistic. Biochemia Medica, 2012; 22(3): 276-282.
NUNAN R, et al. Clinical challenges of chronic wounds: searching for an optimal animal model to recapitulate their complexity. Dis Model Mech. 2014; 7: 1205-1213.
NUSSBAUM SR, et al. An Economic Evaluation of the Impact, Cost, and Medicare Policy Implications of Chronic Nonhealing Wounds. Value Health. 2018; 21: 27–32.
OLSSON M, et al. The humanistic and economic burden of chronic wounds: a systematic review. Wound Repair Regen. 2019; 27: 114-125.
OLIVEIRA MF, et al. Feridas em membros inferiores em diabéticos e não diabéticos: estudo de sobrevida. Rev. Gaúcha Enferm. 2019; 40: e20180016.
PEREIRA AS, et al. Metodologia da pesquisa científica. (1ª ed.): UFSM, NTE, 2018.
PROTZMAN NM, et al. Placental-Derived Biomaterials and Their Application to Wound Healing: A Review. Bioengineering (Basel). 2023; 10 (7): 829.
SCHMID RD, et al. Biotech in China 2021, at the beginning of the 14th five-year period ("145"). Appl Microbiol Biotechnol. 2021; 105 (10): 3971-3985.
SOUZA MT, et al. Integrative review: what is it? How to do it? Einstein (São Paulo), 2010; 8(1): 102-106.
STILLWELL S, et al. Evidence– based practice: step by step. Am J Nurs, 2010; 110(5): 41-47.
TROTTIER V, et al. IFATS collection: Using human adipose-derived stem/stromal cells for the production of new skin substitutes. Stem Cells. 2008; 26: 2713-2723.
TURNER NJ, et al. The use of biologic scaffolds in the treatment of chronic nonhealing wounds. Adv Wound Care. 2015; 4: 490–500.
YAO ZX, et al. New concept of chronic wound healing: advances in the research of wound management in palliative care. Zhonghua Shao Shang Za Zhi. 2020; 36 (8): 754-757.
ZHANG W, et al. Stem cell-based drug delivery strategy for skin regeneration and wound healing: potential clinical applications. Inflamm Regen. 2023; 43 (1): 33.