Effectiveness of autologous cells of stromal-vascular fraction of adipose tissue depending on transplantation method for skin grafting in patients with extensive deep burns

doi:https://doi.org/10.17116/hirurgia202602163

OBJECTIVE

To analyze different methods for autologous transplantation of stromal-vascular fraction of adipose tissue combined with skin grafting with split-thickness skin graft 1:6 in patients with extensive deep burns.

MATERIAL AND METHODS

Open comparative controlled prospective study was devoted to results of autologous skin grafting with split-thickness skin graft 1:6 and autologous cells of stromal-vascular fraction of adipose tissue. Patients were divided into 4 groups depending on transplantation method: injection, aerosol, combined (aerosol+injection) and comparison group (standard skin grafting with split-thickness perforated transplants).

There were 43 cases. Inclusion criteria: age 18—65 years, total area of skin burn 10—60% of body surface area, deep burn 10—45% of body surface area. Autologous skin grafting was performed on 10—15% of body surface area. Clinical, laboratory, cytological and histological methods were used to evaluate postoperative outcomes.

RESULTS

Combined (injection+aerosol) transplantation method was followed by significantly earlier engraftment (by 5 days, 9.9 ±0.7 days in the main group and 14.5±0.88 days in the control group, Student’s t test 3.518) and reduction of postoperative complications to 6% (in the control group 27%).

CONCLUSION

Analysis of biotechnological methods for surgical treatment of patients with extensive deep burns showed the effectiveness of combined (aerosol+injection) transplantation and skin grafting with split-thickness skin graft. This approach reduced skin recovery time and incidence of postoperative complications.

Keywords:

poorly manipulated cells

stromal vascular fraction

perforated graft

skin grafting

extensive deep burns

shortage of donor sites

Received:

19.06.2025

Accepted:

10.07.2025

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References:

Alekseev AA, Malyutina NB, Bobrovnikov AE, Filimonov KA. Organization and provision of specialized medical care to victims of burns in the Russian Federation. Meditsina katastrof. 2023;1:29-35. (In Russ.). https://doi.org/10.33266/2070-1004-2023-1-29-35
Aronowitz JA, Lockhart RA, Hakakian CS. Mechanical versus enzymatic isolation of stromal vascular fraction cells from adipose tissue. Springerplus. 2015;4:713. https://doi.org/10.1186/s40064-015-1509-2
Oberbauer E, Steffenhagen C, Wurzer C, Gabriel C, Redl H, Wolbank S. Enzymatic and non-enzymatic isolation systems for adipose tissue-derived cells: current state of the art. Cell Regen. 2015;4:7. https://doi.org/10.1186/s13619-015-0020-0
Gatiatulina ER, Manturova NE, Dimov GP. Stromal vascular fraction of adipose tissue: mechanism of action, prospects and risks of local application. Plasticheskaya khirurgiya i esteticheskaya meditsina 2019;2:43-48. (In Russ.). https://doi.org/10.17116/plast.hirurgia201902143
Nguyen A, Guo J, Banyard DA, Fadavi D, Toranto JD, Wirth GA, Widgerow AD. Stromal vascular fraction: a regenerative reality? Part 1: current concepts and review of the literature. J Plast, Reconstruct Aesthet Surg. 2016;69(2):170-179. https://doi.org/10.1016/j.bjps.2015.10.015
Tzouvelekis A, Paspaliaris V, Koliakos G, Ntolios P, Bouros E, Oikonomou A, Antoniadis A. A prospective, non-randomized, no placebo-controlled, phase Ib clinical trial to study the safety of the adipose derived stromal cells-stromal vascular fraction in idiopathic pulmonary fibrosis. J Translat Med. 2013;11(1):171. https://doi.org/10.1186/1479-5876-11-171
Zimmerlin L, Donnenberg VS, Pfeifer ME, Meyer EM, Péault B, Rubin JP, Donnenberg AD. Stromal vascular progenitors in adult human adipose tissue. Cytometry A. 2010;77(1):22-30. Erratum in: Cytometry A. 2010; 77(4):406. https://doi.org/10.1002/cyto.a.20813
Eremin II, Vasil’ev VS, Gurba MA. Methods for Isolation of Stromal-Vascular Fraction of Adipose Tissue. Literature Review. Plasticheskaya khirurgiya i esteticheskaya meditsina. 2023; 4(2): 68-75 (In Russ.). https://doi.org/10.17116/plast.hirurgia202304268
Kupsha EI, Kochina EV, Gordeiko TA. Current aspects of the use of adipose tissue stem cells in regenerative medicine. Mezhdunarodnyi studencheskii nauchnyi vestnik. 2018;1:14. (In Russ.).
Abudusaimi A, Aihemaitijiang Y. Adipose-derived stem cells enhance bone regeneration in vascular necrosis of the femoral head in the rabbit. J Int Med Res. 2011;39:1852-1860.
Zhang Q, Liu LN. Intralesional injection of adipose-derived stem cells reduces hypertrophic scarring in a 7 rabbit ear model. Stem Cell Res Ther. 2015;6(1). https://doi.org/10.1186/s13287-015-0133-y
Alekseev AA, Kostyakov DV, Zinov’ev EV, et al/Possibilities and results of the use of autologous cells of the stromal-vascular fraction in the local treatment of deep burns. MEDLINE.RU, Khirurgiya. 2024;25:674-694. (In Russ.).
Alekseev AA, Zinov’ev EV, Kostyakov DV et al. Efficiency of autodermoplasty in combination with injection of autologous stromal-vascular cell fraction in the treatment of deep burns. Vestnik eksperimental’noi i klinicheskoi khirurgii. 2024;17(2)(63):51-59. (In Russ.). https://doi.org/10.18499/2070-478X-2024-17-2-51-59