A prospective study on application of human umbilical cord mesenchymal stem cells combined with autologous Meek microskin transplantation in patients with extensive burns.
10.3760/cma.j.cn501225-20220728-00319
- VernacularTitle:人脐带间充质干细胞联合自体Meek微型皮片移植在大面积烧伤患者中应用的前瞻性研究
- Author:
Tian Tian YAN
1
;
Rong XIAO
1
;
Ying WANG
2
;
Guo An LIN
1
;
Yin ZHENG
1
;
Hui ZHAO
3
;
Wen Jun LI
1
;
Xin Zhi SHANG
1
;
Jin Song MENG
1
;
Dong Sheng HU
1
;
Song LI
1
;
Chao WANG
1
;
Zhi Chen LIN
1
;
Hong Chang CHEN
1
;
Dong Yan ZHAO
1
;
Di TANG
4
Author Information
1. Military Burn Center, the 990th Hospital of PLA Joint Logistics Support Force, Zhumadian 463002, China.
2. Beijing Zhongjing Hi-Tech Biotechnology Co., Beijing 100089, China.
3. Henan Cellular Industry Technology Research Institute Co., Zhengzhou 450121, China.
4. Department of Burns & Plastic Surgery, PLA General Hospital of Central Theater Command, Wuhan 430012, China.
- Publication Type:Journal Article
- MeSH:
Female;
Humans;
Male;
Burns/surgery*;
Cicatrix;
Eosine Yellowish-(YS);
Hyaluronic Acid/therapeutic use*;
Hyperplasia;
Ki-67 Antigen;
Prospective Studies;
Umbilical Cord;
Vimentin;
Young Adult;
Adult;
Middle Aged
- From:
Chinese Journal of Burns
2023;39(2):114-121
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the effects of human umbilical cord mesenchymal stem cells (hUCMSCs) combined with autologous Meek microskin transplantation on patients with extensive burns. Methods: The prospective self-controlled study was conducted. From May 2019 to June 2022, 16 patients with extensive burns admitted to the 990th Hospital of PLA Joint Logistics Support Force met the inclusion criteria, while 3 patients were excluded according to the exclusion criteria, and 13 patients were finally selected, including 10 males and 3 females, aged 24-61 (42±13) years. A total of 20 trial areas (40 wounds, with area of 10 cm×10 cm in each wound) were selected. Two adjacent wounds in each trial area were divided into hUCMSC+gel group applied with hyaluronic acid gel containing hUCMSCs and gel only group applied with hyaluronic acid gel only according to the random number table, with 20 wounds in each group. Afterwards the wounds in two groups were transplanted with autologous Meek microskin grafts with an extension ratio of 1∶6. In 2, 3, and 4 weeks post operation, the wound healing was observed, the wound healing rate was calculated, and the wound healing time was recorded. The specimen of wound secretion was collected for microorganism culture if there was purulent secretion on the wound post operation. In 3, 6, and 12 months post operation, the scar hyperplasia in wound was assessed using the Vancouver scar scale (VSS). In 3 months post operation, the wound tissue was collected for hematoxylin-eosin (HE) staining to observe the morphological changes and for immunohistochemical staining to observe the positive expressions of Ki67 and vimentin and to count the number of positive cells. Data were statistically analyzed with paired samples t test and Bonferronni correction. Results: In 2, 3, and 4 weeks post operation, the wound healing rates in hUCMSC+gel group were (80±11)%, (84±12)%, and (92±9)%, respectively, which were significantly higher than (67±18)%, (74±21)%, and (84±16)% in gel only group (with t values of 4.01, 3.52, and 3.66, respectively, P<0.05). The wound healing time in hUCMSC+gel group was (31±11) d, which was significantly shorter than (36±13) d in gel only group (t=-3.68, P<0.05). The microbiological culture of the postoperative wound secretion specimens from the adjacent wounds in 2 groups was identical, with negative results in 4 trial areas and positive results in 16 trial areas. In 3, 6, and 12 months post operation, the VSS scores of wounds in gel only group were 7.8±1.9, 6.7±2.1, and 5.4±1.6, which were significantly higher than 6.8±1.8, 5.6±1.6, and 4.0±1.4 in hUCMSC+gel group, respectively (with t values of -4.79, -4.37, and -5.47, respectively, P<0.05). In 3 months post operation, HE staining showed an increase in epidermal layer thickness and epidermal crest in wound in hUCMSC+gel group compared with those in gel only group, and immunohistochemical staining showed a significant increase in the number of Ki67 positive cells in wound in hUCMSC+gel group compared with those in gel only group (t=4.39, P<0.05), with no statistically significant difference in the number of vimentin positive cells in wound between the 2 groups (P>0.05). Conclusions: The application of hyaluronic acid gel containing hUCMSCs to the wound is simple to perform and is therefore a preferable route. Topical application of hUCMSCs can promote healing of the autologous Meek microskin grafted area in patients with extensive burns, shorten wound healing time, and alleviate scar hyperplasia. The above effects may be related to the increased epidermal thickness and epidermal crest, and active cell proliferation.
