Efficacy and safety of adipose tissue-derived cell therapy in the treatment of chronic extremity ulcers: a systematic review and meta-analysis of randomized controlled trials.

CONTEXT: Chronic extremity ulcers represent a major clinical challenge. Adipose-derived stem cells (ADSCs) have emerged as a promising therapeutic option for wound healing; however, their efficacy and safety remain incompletely established.

OBJECTIVES

To evaluate the efficacy and safety of ADSCs compared with conventional treatment.

METHODS

A systematic review and meta-analysis of 11 randomized clinical trials involving 474 patients was conducted. Outcomes included healing rate, mean healing time, pain-related outcomes, and safety. Odds ratios (ORs) and weighted mean differences were used as summary effect measures.

RESULTS

Complete healing rates were significantly higher in the ADSC group than in the conventional treatment group (84.2% vs. 49.0%; OR 5.77; p < 0.00001). Healing time was reduced by 19.39 days on average in ADSC group (p = 0.0004). No statistically significant differences were observed regarding pain outcomes or complication rates (p = 0.22).

CONCLUSION

ADSC therapy increased healing rates and shortened healing time in patients with chronic extremity ulcers, with no evidence of a significant increase in treatment-related risks. However, the heterogeneity of the findings and the limited sample size highlight the need for studies with greater statistical power and methodological standardization to confirm these results.