Application of Adipose-Derived Stem Cells as an Antiscarring Therapy Following Massive Burn Injuries
Abstract
Objectives and rationale: Large burn wounds are difficult to cover with skin from the patient due to a lack of unburned skin. Full coverage relies on multiple surgeries to graft small amounts of skin onto the wounds, delaying wound healing and increasing risk of infection and death; in patients who survive, this delay in healing is associated with the development of extensive burn scars that are painful, itch, and restrict movement. As a result, the patient can experience difficulty with resuming normal daily activities or returning to work after a burn injury. As a result, quality of life is severely reduced. New strategies for closing burn wounds faster and decreasing burn scar are needed. It is now possible to isolate a population of cells from fat tissue that has an abundance of adipose-derived stem cells (ASCs); our preliminary data shows that these stem cells can improve wound healing and decrease burn scarring. We will isolate these ASCs along with other cells from fat tissue (called the stromal vascular fraction, or SVF) from the burn patient, and apply those cells to the burn wound. Currently, the standard of care is to remove the fat tissue surrounding the burn wound and discard it. We will now take this tissue, isolate the SVF, and apply it directly back to the burn wound. We will then cover the SVF-coated wound with one of two temporary biological coverings that improve graft survival, amnion and cadaveric skin. Cadaver skin is the standard of care at our hospital; we have also shown that amnion coverage is beneficial and may provide additional growth factors that could help the SVF improve wound healing and reduce scarring even further. Here we will determine whether these strategies heal burn wounds faster and/or reduce post-burn scarring, leading to increased satisfaction with life in adult patients with massive burns. We will measure wound healing, scar severity, functional and physical endpoints of the skin and scar, and changes within the scar itself; these changes will be correlated with satisfaction with life quality. Fifteen patients will be enrolled at the University of Texas Medical Branch. Burn wounds will be treated with +/- SVF +/- amnion or cadaveric allograft. Ultimate applicability and impact of the research: Options for covering large burn wounds are limited; if this approach works as anticipated, the application of the patient s own cells from the fat tissue will allow faster healing and decreased scarring. The improvements could manifest as reduced wound infections and life-threatening systemic infections, faster discharge from the hospital, a higher percentage of patients returning to work sooner (and resumption of other daily activities), easier movement, and increased patient satisfaction. How the research addresses the intent of the award mechanism: This award mechanism is to support clinical trials of therapies to reduce post-burn scarring. In our trial, we will determine whether the topical application of SVF reduces the development and long-term impact of post-burn scars. What types of patients will it help and how will it help them: The results from this trial will be applicable to any patients with scars from burns, traumatic injuries, or surgeries. Further work would demonstrate whether these therapies are effective in reducing scars from other causes. Potential benefits to Service members with burn scars, clinical applications, and risks: For patients with burn scars, this study will determine whether more rapid wound closure and subsequent attenuation of scar formation will improve the quality of life experienced by burn survivors. The benefits to Service members and other burn patients with scars could include less burn scar, improved mobility and flexibility, and improved satisfaction with life. Families and caregivers would be impacted by successful reintegration of the patients into daily activities, improving family interactions, and increasing patient independenc
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1810818
Entities
People
- Celeste Finnerty
Organizations
- United States Army
- University of Texas Medical Branch