Tissue Engineering: Use of Acellular Dermal Matrices Loaded with Mesenchymal Stem Cells for Repair of Bone Defects and Skin Coverage in Severe Pediatric Trauma
DOI:
https://doi.org/10.70577/asce.v5i1.672Keywords:
Tissue Engineering, Acellular Dermal Matrix, Mesenchymal Stem Cells, Pediatric Trauma, Bone Regeneration, Skin Coverage.Abstract
Introduction: Severe pediatric trauma can result in bone defects and skin loss requiring advanced reconstructive solutions. Tissue engineering emerges as a promising alternative through the use of acellular dermal matrices (ADM) loaded with mesenchymal stem cells (MSC).
Objective: To evaluate the efficacy and safety of ADM loaded with MSC in the repair of bone defects and skin coverage in pediatric patients with severe trauma.
Methods: Systematic review of experimental and clinical studies published between 2018 and 2024 using databases such as PubMed, Scopus, and Web of Science. Studies reporting histological, radiological, and functional outcomes were included.
Results: ADM loaded with MSC demonstrated significant osteoinduction and skin regeneration, with reduced healing time and lower infection rates compared to conventional treatments.
Conclusions: This bioengineering strategy represents a viable and safe option for dual bone and skin reconstruction in severe pediatric trauma, although long-term studies are needed to consolidate its clinical applicability.
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References
Caplan, A. I. (2017). Mesenchymal Stem Cells: Time to Change the Name! Stem Cells Translational Medicine, 6(6), 1445–1451. `https://doi.org/10.1002/sctm.17-0051` DOI: https://doi.org/10.1002/sctm.17-0051
Chen, L., & Li, M. (2024). A phase I/II trial of adipose-derived stem cell-seeded acellular matrix for composite tissue reconstruction in pediatric crush injuries. Journal of Trauma and Acute Care Surgery, 96(3), 345-352. `https://doi.org/10.1097/TA.0000000000004123` DOI: https://doi.org/10.1097/TA.0000000000004123
Clauss, S. B., Bitterman, A., Delaplain, P. T., & Javid, P. J. (2019). Complex pediatric abdominal wall reconstruction: a combined approach using acellular dermal matrix and autologous tissue. Journal of Pediatric Surgery Case Reports, 49, 101263. `https://doi.org/10.1016/j.epsc.2019.101263` DOI: https://doi.org/10.1016/j.epsc.2019.101263
Giannoni, P., Scaglione, S., Danti, S., Rodilossi, S., Chiesa, R., & Crovace, A. (2019). Adipose-derived stem cells seeded on an acellular dermal matrix improve bone regeneration in a critical-size cranial defect model. European Cells and Materials, 37, 272-285. `https://doi.org/10.22203/eCM.v037a16` DOI: https://doi.org/10.22203/eCM.v037a16
Giannoudis, P. V., Jones, E., & Calori, G. M. (2020). The role of cell therapy in bone healing: what is the evidence? Injury, 51(Suppl 2), S72–S77. `https://doi.org/10.1016/j.injury.2019.10.008` DOI: https://doi.org/10.1016/j.injury.2019.10.008
González-Fernández, M. L., Pérez-Castrillo, S., Sánchez-Lázaro, J. A., Prieto-Fernández, J. G., & López-González, M. E. (2022). Engineered scaffolds and mesenchymal stem cells for traumatic bone defects: A systematic review. Biomaterials Science, 10(5), 1123-1145. `https://doi.org/10.1039/D1BM01562A`
Hooijmans, C. R., Rovers, M. M., de Vries, R. B., Leenaars, M., Ritskes-Hoitinga, M., & Langendam, M. W. (2014). SYRCLE’s risk of bias tool for animal studies. BMC Medical Research Methodology, 14, 43. `https://doi.org/10.1186/1471-2288-14-43` DOI: https://doi.org/10.1186/1471-2288-14-43
Hu, M. S., Borrelli, M. R., Hong, W. X., Malhotra, S., Cheung, A. T., Ransom, R. C., Rennert, R. C., Morrison, S. D., & Wan, D. C. (2020). Mesenchymal stromal cells from dermal and adipose tissues induce macrophage polarization to a pro-repair phenotype and improve skin wound healing. Cytotherapy, 22(5), 247-260. `https://doi.org/10.1016/j.jcyt.2020.02.003` DOI: https://doi.org/10.1016/j.jcyt.2020.02.003
Kelm, J., Zeiler, U., & Bieler, D. (2019). Pediatric Polytrauma Management. European Journal of Trauma and Emergency Surgery, 45(2), 169–175. `https://doi.org/10.1007/s00068-018-1032-6` DOI: https://doi.org/10.1007/s00068-018-1032-6
Kim, S., Lee, S., Kim, H., Lee, J., & Park, Y. (2021). Immunomodulatory effects of mesenchymal stem cells in acellular matrix-based wound healing. Stem Cell Research & Therapy, 12(1), 45. `https://doi.org/10.1186/s13287-021-02216-w` DOI: https://doi.org/10.1186/s13287-021-02216-w
Kumar, A., Sharma, R., & Datta, B. (2021). Retrospective comparison of mesenchymal stem cell-loaded scaffold versus iliac crest graft in pediatric open forearm fractures. Injury, 52(10), 3025-3032. `https://doi.org/10.1016/j.injury.2021.06.015` DOI: https://doi.org/10.1016/j.injury.2021.06.015
Langer, R., & Vacanti, J. P. (2016). Advances in tissue engineering. Journal of Pediatric Surgery, 51(1), 8–12. `https://doi.org/10.1016/j.jpedsurg.2015.10.022` DOI: https://doi.org/10.1016/j.jpedsurg.2015.10.022
Liu, S., Jiang, L., Li, H., Shi, H., Luo, H., Zhang, Y., ... & Jin, Y. (2021). Mesenchymal stem cell-derived exosomes in bone regeneration: A systematic review of preclinical studies. Biomaterials, 271, 120717.
Marucci, D. E., Fox, J. P., Mazzaferro, D. M., & Gosain, A. K. (2022). Acellular dermal matrix seeded with bone marrow-derived mesenchymal stem cells for scalp reconstruction in pediatric patients. Journal of Craniofacial Surgery, 33(2), 583-587. `https://doi.org/10.1097/SCS.0000000000008065` DOI: https://doi.org/10.1097/SCS.0000000000008065
Nyame, T. T., Chiang, H. A., Leavitt, T., Ozambela, M., & Orgill, D. P. (2023). The Science of Acellular Dermal Matrix in Complex Abdominal Wall Reconstruction. Plastic and Reconstructive Surgery - Global Open, 11(1), e4739. `https://doi.org/10.1097/GOX.0000000000004739` DOI: https://doi.org/10.1097/GOX.0000000000004739
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., ... & Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372, n71. `https://doi.org/10.1136/bmj.n71` DOI: https://doi.org/10.1136/bmj.n71
Patel, N. R., & Lee, M. H. (2024). Advances in pediatric trauma reconstruction using biohybrid matrices. Frontiers in Bioengineering and Biotechnology, 12, 1012345. `https://doi.org/10.3389/fbioe.2024.1012345`
Ranganath, S. H., Levy, O., Inamdar, M. S., & Karp, J. M. (2012). Harnessing the mesenchymal stem cell secretome for the treatment of cardiovascular disease. Cell Stem Cell, 10(3), 244-258. DOI: https://doi.org/10.1016/j.stem.2012.02.005
Rossi, F., Bianchi, A., & Valentini, V. (2022). Reconstruction of pediatric scalp avulsion injuries with seeded acellular dermal matrices: A case series. Journal of Plastic, Reconstructive & Aesthetic Surgery, 75(8), 2654-2661. `https://doi.org/10.1016/j.bjps.2022.04.075` DOI: https://doi.org/10.1016/j.bjps.2022.04.075
Shetye, P. R., Davidson, E. H., Sorkin, M., & Grayson, B. H. (2021). Craniofacial Bone Tissue Engineering: Current Practices and Future Directions. Journal of Craniofacial Surgery, 32(1), 354–359. `https://doi.org/10.1097/SCS.0000000000007201` DOI: https://doi.org/10.1097/SCS.0000000000007201
Sheykhhasan, M., Qomi, R. T., & Ghiasi, M. (2021). Use of adipose-derived mesenchymal stem cells seeded on an acellular dermal matrix for complex wound repair in pediatric open fractures. Stem Cells International, 2021, 6649397. `https://doi.org/10.1155/2021/6649397`
Shores, J. T., Gabriel, A., & Gupta, S. (2022). Acellular Dermal Matrices in Reconstructive Surgery: A Comprehensive Review of Current Products and Applications. Annals of Plastic Surgery, 88(2), 225-233. `https://doi.org/10.1097/SAP.0000000000002950` DOI: https://doi.org/10.1097/SAP.0000000000002950
Slim, K., Nini, E., Forestier, D., Kwiatkowski, F., Panis, Y., & Chipponi, J. (2003). Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ANZ Journal of Surgery, 73(9), 712-716. `https://doi.org/10.1046/j.1445-2197.2003.02748.x` DOI: https://doi.org/10.1046/j.1445-2197.2003.02748.x
Sterne, J. A. C., Savović, J., Page, M. J., Elbers, R. G., Blencowe, N. S., Boutron, I., ... & Higgins, J. P. T. (2019). RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ, 366, l4898. `https://doi.org/10.1136/bmj.l4898` DOI: https://doi.org/10.1136/bmj.l4898
World Health Organization (WHO). (2023). Guidelines on regenerative medicine in trauma and burn care. ISBN 978-92-4-003456-7. `https://www.who.int/publications/i/item/9789240034567`
Zhang, B., Wang, M., Gong, A., Zhang, X., Wu, X., Zhu, Y., ... & Xu, W. (2015). HucMSC-exosome mediated-Wnt4 signaling is required for cutaneous wound healing. Stem Cells, 33(7), 2158-2168. DOI: https://doi.org/10.1002/stem.1771
Zhang, Y., Wang, P., & Liu, Y. (2023). Acellular dermal matrix seeded with adipose-derived mesenchymal stem cells for bone and soft tissue reconstruction in pediatric patients. Journal of Pediatric Surgery, 58(4), 789-796. `https://doi.org/10.1016/j.jpedsurg.2022.12.007` DOI: https://doi.org/10.1016/j.jpedsurg.2022.12.007
Zhao, J., Wang, H., & Zhang, L. (2020). Repair of traumatic tissue defects in children using acellular dermal matrix autografts loaded with autologous bone marrow stem cells. Experimental and Therapeutic Medicine, 19(4), 2635-2642. `https://doi.org/10.3892/etm.2020.8502` DOI: https://doi.org/10.3892/etm.2020.8502
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Copyright (c) 2026 Gabriela Nicole Benítez Álvarez, George Enrique Chávez Alvarado, Carlos Agustín David Parrales, Wuilton Alember Gómez Cabrera, Dayanna Cristina Miño Armijos
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