Adjunctive topical mesenchymal stem cell-derived secretome-enriched biological dressings in pediatric complex wounds:...

Mesenchymal stem cell (MSC)-derived secretome, including extracellular vesicles (EVs), has emerged as a potential cell-free regenerative approach due to its immunomodulatory and tissue repair-associated properties. While topical applications have been explored in adult dermatologic settings, clinical evidence in pediatric patients with complex cutaneous wounds remains scarce.

A retrospective observational case series was conducted at a tertiary referral pediatric hospital. Medical records and photographic documentation of six pediatric patients with complex cutaneous wounds treated with topical biological dressings containing MSC-derived secretome enriched in EVs were reviewed between January 2020 and January 2024. All patients received standard-of-care management in addition to adjunctive application of the biological dressings. Clinical evolution and treatment tolerability were assessed descriptively.

Progressive re-epithelialization and clinical improvement were observed across all cases based on clinical and photographic assessment. Time to complete re-epithelialization ranged from 6 to 14 days across heterogeneous wound etiologies. Estimated wound reduction ranged from approximately 85 to >90% at defined time points. No treatment-related adverse events were documented during follow-up.

In this retrospective case series, progressive re-epithelialization was documented during follow-up in pediatric patients with complex cutaneous wounds receiving adjunctive topical MSC-derived secretome-enriched biological dressings alongside standard care. However, given the observational design, small sample size, heterogeneous diagnoses, and absence of a control group, these findings should be interpreted as descriptive and hypothesis-generating. Prospective, controlled studies are needed to better define the therapeutic role and safety profile of these interventions in pediatric regenerative dermatology.