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• W2519814421 abstract "Sir: We read with interest the Viewpoint redacted by Dr. Condé-Green1 and colleagues regarding the potential use of adipose stem cells to improve wound healing in burned patients. As related by the reported studies, cell-based therapy seems to be interesting for increasing wound regeneration and improving skin autografts in burns management. The concept is seductive: recycling excised tissues considered as an operative waste into a regenerative cocktail composed of stem cells, cytokines, and growth factors. However, after reading carefully the studies cited in this Viewpoint, we noted confusion between the different adipose-derived products and their nomenclature. Three reported experimental studies assessed the efficiency of adipose stem cells produced from débrided skin fat (débrided skin adipose-derived stem cells) in rodent models of wound healing. From the other side, the reported clinical study assessed the efficiency of standard Coleman fat grafting to improve skin autograft, which does not need any enzymatic digestion or cell culture and corresponds to the injection of mature adipocytes surrounded by stromal vascular fraction. It is then confusing to compare in the same review these four studies, which gather under the term “adipose-derived stem cell” both débrided skin adipose-derived stem cells and fat obtained with the Coleman procedure. Since the description of the Coleman procedure2 in 1995, many adipocyte-derived products have been described. Microfat,3 described in 2012, corresponds simply to the harvesting and reinjection of a selected size of adipose lobules because of specific cannulas presenting smaller holes. Nanofat,4 described in 2013, corresponds to the mechanical emulsification of adipose tissue. Regarding cell-based therapy, international societies have published clarification and guidance5 for the nomenclature of stromal vascular fraction and adipose-derived stem cells. Stromal vascular fraction corresponds to a noncultured heterogeneous population of mature and progenitor cells obtained after enzymatic digestion of adipose tissue, whereas adipose-derived stem cells correspond to a homogeneous population of multipotent stem cells obtained after weeks of in vitro culture. Figure 1 summarizes the characteristics of theses different products.Fig. 1.: Different adipose-derived products and their attributes: status, nomenclature, harvesting methods, processing, and macroscopic aspects. SVF, stromal vascular fraction; ASC, adipose-derived stem cells.From a regulatory point of view, Coleman, microfat, and nanofat procedures could be performed extemporaneously in the operating room by surgeons. Their use during the same surgical procedure could improve the final result of the skin autografts. Conversely, stromal vascular fraction manufacturing needs a few hours and débrided skin adipose-derived stem cells need a few weeks because of cell culture. Extending the duration of anesthesia to obtain the stromal vascular fraction or waiting some weeks to obtain the débrided skin adipose-derived stem cells could be detrimental for burned patients and must be reserved for elective treatment protocols. Finally, economic aspects should be emphasized: Coleman, microfat, and nanofat procedures are easier and cheaper to perform inside the operating room, whereas the production of stromal vascular fraction or débrided skin adipose-derived stem cells is more expensive, requires more time for processing, and is subject to pharmaceutical rules. One of the challenges in therapeutic management of burns is currently to assess these different products and compare their strengths to clarify their specific clinical uses. DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication. Baptiste Bertrand, M.D.Department of Plastic SurgeryLa Conception HospitalAssitance PubliqueHôpitaux de Marseille, andAix-Marseille Université INSERMVascular Research Center of Marseille UMRS-1076 Jérémy Magalon, Pharm.D.Aix-Marseille Université INSERMVascular Research Center of Marseille UMRS-1076, andCulture and Cell Therapy LaboratoryINSERM CICBT-1409Assistance PubliqueHôpitaux de Marseille Julie Veran, Ph.D.Culture and Cell Therapy LaboratoryINSERM CICBT-1409Assistance PubliqueHôpitaux de Marseille Cécile Philandrianos, M.D., Ph.D.Department of Plastic SurgeryLa Conception HospitalAssitance PubliqueHôpitaux de Marseille Florence Sabatier, Pharm.D., Ph.D.Aix-Marseille UniversitHô INSERMVascular Research Center of Marseille UMRS-1076, andCulture and Cell Therapy LaboratoryINSERM CICBT-1409Assistance PubliqueHôpitaux de MarseilleMarseille, France" @default.
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• W2519814421 date "2017-01-01" @default.
• W2519814421 modified "2023-10-14" @default.
• W2519814421 title "Adipose Stem Cells Isolated from Excised Burned Tissue" @default.
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• W2519814421 doi "https://doi.org/10.1097/prs.0000000000002879" @default.
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