Sequential Applications of Adipose Tissue-derived Stem Cells Enhance Healing in Complex Wounds: Experimental Model

Complex wounds represent a challenge to global health, incurring significant healthcare costs and compromising patients' quality of life. Recently, research has investigated the potential of adipose tissue-derived stem cells (ASC) for therapeutic stem cells' immunomodulatory properties. This study aimed to evaluate the effect of sequential applications of ASC in an experimental model of a complex wound.

Thirty male Wistar rats were subjected to a complex wound model of enterocutaneous fistula. After 4 weeks, the rats were divided into 3 groups: control, 2 applications of culture medium, and 2 applications of 1 × 10⁶ allogeneic ASC. The animals were euthanized and analyzed 4 weeks after the first application regarding the macroscopic reduction of the wound, histopathologic changes, and gene expression related to wound healing (Cd68, Il1rap, Il10, Mmp3, Mmp9, and Tnf).

Animals treated with ASC showed a reduction in wound diameter of 68% compared with the control group (P = 0.002) and a reduction of 65% compared with the culture medium group (P = 0.011). The ASC group also showed a more than 100% increase in blood vessel count compared with the control group (P = 0.02). Gene expression analysis showed a decrease in the Mmp9 levels in the ASC group compared with the control group.

This study demonstrated that the treatment with ASC improves the healing of enterocutaneous fistula wounds.