Publication:

Impact of cellular therapies and tissue bioengineering on skin regeneration for patients with refractory chronic ulcers: a systematic review

Cellular therapies and tissue bioengineering show promise in treating chronic ulcers, including diabetic foot, venous, and pressure ulcers. These conditions affect over 2% of the population and pose serious health risks, including infection and amputation. Conventional treatments often fail, leading to prolonged healing times and increased healthcare costs. This systematic review assesses the effectiveness of regenerative approaches by analyzing their impact on wound closure, skin thickness, pain-free walking, and the ankle–brachial index. A thorough search in PubMed, Embase, and Cochrane Library identified relevant randomized controlled trials and systematic reviews. Studies using stem cells, fibroblasts, keratinocytes, bioengineered skin, and 3D bioprinting were included. Two independent reviewers extracted data and assessed study quality. A random-effects model was applied to account for variability. Findings show that cellular therapies and tissue bioengineering significantly improve wound healing. The systematic review revealed higher wound closure rates (RD=0.36, p<0.01), increased skin thickness (SMD=0.65, p<0.05), and greater pain-free walking distance (SMD=1.27, p<0.001). Adverse events were minimal, with no significant differences between intervention and control groups. These therapies enhance healing and tissue regeneration, supporting their use in clinical practice. Further research is needed to refine treatment protocols and ensure long-term safety and effectiveness.