Stem cells now considered for supporting plastic surgery results.


Regenerative medicine using stem cells has progressed significantly over the last decade. Plastic surgeons historically have used tissues of human being to restore various defect sites. Multipotent adult stem cells are easily accessed for plastic surgeons during many routine procedures. Stem cell therapy can provide effective treatment modality for the treatment of bony and soft tissue defects like traumatic skin defect and severe burn, non-healing wounds complicated by ischemia like diabetic foor and sore. It also becomes very attractive tool for skin rejuvenation, scar improvement and augmentation of breast. The unwearying rearch work using various stem cells is still ongoing by many plastic surgeons.STEM CELLS ACCELERATES WOUND HEALING.The art and science of wound healing is complex process involving various interactions among cells, cytokines and extracellular matrices. During the last few decades, various wound healing technologies using stem cells have been developed and some are used in the clinical field. When it comes to the wound healing activities, both bone marrow stem cells (BSCs) and fibroblasts has shown superior healing results by high collagen and growth factor production. The angiogenic properties of adipose stem cells (ASCs) could be beneficial in the case of critical limb ischemic wounds.STEM CELLS REDUCE SCAR. The mammalian skin does not regenerate spontaneously, the ultimate outcome of mammalian wound healing is scar formation. Recently, various scar minimizing technologies have been developed. Direct applying a therapeutic number of cells into a target wound is possible, which lead to improved wound healing. The inflammation period in wound healing process is closely associated with the extent of scar formation. ASCs could be a potential therapeutic tool for excessive scarring because they have anti-inflammatory and immunosuppressive effect. This method can resembles scarless wound healing. In the near future, this ASC-based therapy might be a new therapeutic option for the wound management to enable complete healing without any visible scar formation.STEM CELLS INCRESE FAT GRAFT SURVIVAL. Aging process involves a number of different degenerative pathways, specially a soft tissue volume loss. Owing to the aged population, a desire to regain youthful looks, minimal-invasive surgery options, the demand for cosmetic procedures has been increasing. Fat graft technique is one of the most common anti-aging procedures in plastic surgery. It can help restore defect and augment the soft tissue. Using autologous tissue, there have been no specific side effects caused by immune responses have been reported. However, simply grafted fat can be absorbed anytime, and the absorption level is very difficult to anticipate. The survival rate of aspirated fat can be increased using cell-assisted lipotransfer (CAL). CAL is a technique that combines concentrated ASCs with aspirated fat to make ASC-rich fat grafts. This approach allows for marked survival rate improvements implanted fat and decrease in adverse effects of fibrosis and cyst formation. BSCs can make systemic contribution to fat graft survival by new blood vessel sprouting. The bone marrow-derived mesenchymal stem cells (BSC) and circulating progenitor cells, up-regulates vasculogenic growth factor production, and increase the number of new blood vessels formed in the grafted fat leading to improvement of graft survival!During the last decade, patient's own stem cells has been tested and effectively utilized in the plastic surgical field. Overall, clinical advances using various stem cells suggest a promising future for opening a new cell therapeutic strategy in plastic surgery.

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Melvin A. Martinez-Castrillon, MD