Review Article

Skin Tissue Engineering: Application of Adipose-Derived Stem Cells

Table 1

Clinical applications of autologous fat and SVF/ASCs.

Medical conditionStudyApplicationTotal number of patients and sex if mentionedOutcome

Soft tissue

Breast augmentation/reconstruction/ soft tissue defect

Cosmetic breast augmentationYoshimura et al. 2008 [50]Cell assisted lipotransfer (CAL) of SVF/ASCs and lipoinjection40 (female)Preliminary results suggest efficacy and safety

Breast augmentation after breast implant removalYoshimura et al. 2010 [51]Cell assisted lipotransfer of SVF/ASCs and lipoinjection15 (female)Very satisfactory outcome 12 months after application

Breast augmentationKamakura and Ito [52]Cell assisted lipotransfer of SVF and lipoinjection20 (female)Patient satisfaction was 75% and physician satisfaction 69%

Breast augmentationWang et al. 2012 [40]Cell assisted lipotransfer of ASCs/SVF and lipoinjection18 (10 patients completed, 6 months' follow-up)6-month postoperative, the breast volume is significantly increased and the breasts’ contour is improved

Breast reconstructionGentile et al. 2012 [53]Cell assisted lipotransfer of SVF and lipoinjection10 (out of total 23)1 year postoperative, 63% maintenance of the contour restoring and of three-dimensional volume compared with the control patients treated with fat graft only

Breast augmentationPeltoniemi et al. 2013 [54]Water assisted lipotransfer (WAL) enriched with SVF10 (out of total 18 patients, females)No advantage in SVF stem cell enrichment in cosmetic fat transplantation observed: breast augmentation by WAL alone was faster, cheaper, with lower risk of contamination, offered at least an equal take rate

Healthy participantsKølle et al. 2013 [55]Fat grafting after liposuction enriched with ASCs10 (females)ASCs enriched fat grafts had significantly higher residual volumes; no serious adverse events were noted; procedure of ASCs-enriched fat grafting had excellent feasibility and safety

Secondary breast reconstructionTissiani and Alonso 2016 [56]Fat grafts enriched with SVF11 (out of total 19, females)SVF enriched fat grafts have proven to be safe in a 3-year follow-up

Various including breast reconstruction, scarring, Parry-Romberg disease, gluteal soft tissue defect, pectus excavatum, polio infection sequel, and dermatofibromatosisTiryaki et al. 2011 [57]Fat grafts enriched with SVF29Preliminary results suggest SVF enriched fat grafting was safe and may provide superior results compared to traditional fat grafting

Burns sequelae and posttraumatic scarsGentile et al. 2014 [58]Fat grafts enriched with SVF10 (out of total 30)No complications in any patient; the results were lasting in all cases; all patients were satisfied with the resulting texture, softness, contour; MRI confirmed absence of cyst formation and microcalcification

Systemic sclerosisGranel et al. 2015 [59]Autologous SVF injection in the finger of systemic sclerosis patients12 (females)6 month after procedure no severe adverse events occurred; four minor adverse events were reported and resolved spontaneously; significant improvement in hand disability and pain, Raynaud’s phenomenon, finger oedema, and quality of life was observed

Systemic sclerosisGuillaume-Jugnot et al. 2016 [60]Autologous SVF injection in the finger of systemic sclerosis patients12 (female)12 months after procedure a significant improvement of finger oedema, skin sclerosis, motion, strength of the hands, and of vascular suppression score was noted

Facial lipoatrophy/facial defects

Congenital or acquired facial tissue defects (Barraquer-Simons syndrome; Parry Romberg syndrome; traumatic; facial atrophy; lupus erythematosus)Sterodimas et al. 2011 [61]Lipografts enriched with SVF10 (out of total 20)Analysis of patient satisfaction in the first six months clearly demonstrated better results using SVF; by the 18-month evaluation, no statistical difference between the lipograft only or lipograft/SVF treatment in terms of patient satisfaction noted

Progressive
hemifacial atrophy (Parry-Romberg disease)
Castro-
Govea et al. 2012 [62]
Cell
assisted lipotransfer of SVF and lipoinjection
1 (male)1 and 12
months postoperative evolution of patient was satisfactory; reduction of severe depression of the frontotemporal region, better volume, and symmetry provided

Progressive hemifacial atrophy (Parry-Romberg disease)Koh et al. 2012 [63]Microfat grafting enriched with ASCs5 (3 females, 2 males) (out of total 10, 5 females, 5 males)Successful outcomes were evident in all 5 patients receiving microfat grafts and ASCs; survival of grafted fat was better than in patients receiving microfat grafts alone

Progressive hemifacial atrophy (Parry-Romberg disease)Chang et al. 2013 [64]Fat grafts enriched with SVF10 (out of total 20)After 6 months fat survival and clinical improvement were greater with SVF-supplemented grafting than fat grafting alone

Wound healing

Radiation atrophy

Therapy for side effects of radiation treatment with severe symptoms or irreversible function damageRigotti et al. 2007 [65]Repeated lipoaspirate (SVF) injection22 (females)Clinical outcomes led to a systematic improvement or remission of symptoms in all evaluated patients, including otherwise untreatable patients exhibiting initial irreversible functional damage

Ischaemic wounds

Critical limb ischemia (CLI) patients with ischemic resting pain in 1 limb with/without nonhealing ulcers and necrotic footLee et al. 2012 [66]Intramuscularly injection of ASCs15 (male)6 months after application: significant improvement was noted on pain rating scales and in claudication walking distance; digital subtraction angiography showed formation of numerous vascular collateral networks across affected arteries

Chronic ulcers of the lower limbsMarino et al. 2013
[67]
Injection of SVF to the edges of ulcers10 (3 females, 7 males) (out of total 20, 14 males, 6 females)Reduction in diameter and depth of the ulcer, decrease in pain associated with the ulcer process; in six of 10 cases there was complete healing of the ulcer