Adipose-Derived Stem Cells as Therapeutic Approach in Hypertrophic Scar Formation-A Systematic Review.

Despite numerous therapeutic approaches, the inhibition of hypertrophic scar formation remains a major challenge. Adipose-derived stem cells (ADSCs) have been shown to improve wound healing, including remodelling, in vivo. A systematic review was conducted using the electronic databases PubMed, Web of Science, Embase and Medline. The basic research question was formulated with the PICO framework. The aim of this review is to prove the role of ADSCs in the prevention of hypertrophic scar formation based on in vivo studies. Improved macroscopic outcomes with the use of ADSCs have been shown in nine of 10 studies included. Eight studies report inhibition on fibroblast activation, while all studies highlight the efficacy in promoting the extracellular matrix deposition and remodelling process. The immunomodulatory effects of ADSCs during inflammation have been demonstrated in six studies. One study each investigated the effect on adipogenesis or angiogenesis. In all studies the role of ADSCs in the prevention of hypertrophic scarring was conclusive. However, due to their heterogeneity and weighting of disparate outcomes, several investigations only converged upon distinct endpoints. Further research, preferably in pigs, is urgently required in order to assess the role of ADSCs in the prevention of hypertrophic scar.