The Use of Adipose Tissue-Derived Stem Cells within a Dermal Substitute Improves Skin Regeneration by Increasing Neoangiogenesis and Collagen Synthesis

Background: Surgical treatment of injuries with loss of skin tissue has improved significantly with the advent of regenerative medicine and tissue bioengineering, and the use of stem cells and dermal substitutes. The success of tissue regeneration depends on optimal local vascularization and the successful integration of the artificial skin. The present study combines the use of autologous adipose-derived stem cells with a commercially available dermal substitute (Integra) for skin regeneration. Methods: Adipose-derived stem cells were isolated from the inguinal region of eight Sprague-Dawley adult rats, seeded onto a piece of dermal substitute for 48 hours, and then implanted into the same rat, followed by comparison of the evolution with a contralateral implant without adipose-derived stem cells. After 1, 2, and 3 weeks of regeneration in vivo, implants were removed for histologic evaluation. Results: Adipose-derived stem cells adhere properly to the dermal matrix, and autologous tissue integration in the rat was good. The histologic evaluation showed that adipose-derived stem cells significantly increased microvascular density (7.7 +/- 0.6 percent versus 5.3. +/- 0.5 percent, as assessed by immunohistochemical staining of factor VIII) and the synthesis of collagen type I (24 +/- 3 percent versus 16 +/- 2 percent, as assessed by Sirius red staining). Although there was greater epithelialization on the side treated with adipose-derived stem cells (2530 +/- 939 mu m versus 1911 +/- 763 mu m), as assessed by anticytokeratin immunohistochemistry staining 34 beta E12, this difference was not statistically significant. Conclusions: The authors' data suggest that the seeding of adipose-derived stem cells onto a dermal substitute improves skin regeneration and tissue integration by increasing vascularity and collagen synthesis. Further studies are necessary to achieve complete epithelialization with the use of adipose-derived stem cells. (Plast. Reconstr. Surg. 130: 53, 2012.)