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The role of orthobiologics in chronic wound healing

2024; Wiley; Volume: 21; Issue: 4 Linguagem: Inglês

10.1111/iwj.14854

1742-481X

Rafael Barnabé Domingues, Marita von Rautenfeld, Caroline Mayara Kavalco, Carolina Caliari, Celso Dellagiustina, Lucas Furtado da Fonseca, Fabio Ramos Costa, Andreza da Cruz Silva Reis, Gabriel Silva Santos, Gabriel Ohana Marques Azzini, André Pinto Lemos de Faria, Napoliane Santos, Luyddy Pires, Stephany Cares Huber, Ansar Mahmood, Ignácio Dallo, Peter A. Everts, José Fábio Lana,

Diabetic Foot Ulcer Assessment and Management

Abstract Chronic wounds, characterized by prolonged healing processes, pose a significant medical challenge with multifaceted aetiologies, including local and systemic factors. Here, it explores the complex pathogenesis of chronic wounds, emphasizing the disruption in the normal phases of wound healing, particularly the inflammatory phase, leading to an imbalance in extracellular matrix (ECM) dynamics and persistent inflammation. Senescent cell populations further contribute to impaired wound healing in chronic lesions. Traditional medical management focuses on addressing underlying causes, but many chronic wounds resist to conventional treatments, necessitating innovative approaches. Recent attention has turned to autologous orthobiologics, such as platelet‐rich plasma (PRP), platelet‐rich fibrin (PRF) and mesenchymal stem cells (MSCs), as potential regenerative interventions. These biologically derived materials, including bone marrow aspirate/concentrate (BMA/BMAC) and adipose tissue‐derived stem cells (ADSCs), exhibit promising cytokine content and regenerative potential. MSCs, in particular, have emerged as key players in wound healing, influencing inflammation and promoting tissue regeneration. This paper reviews relevant scientific literature regarding basic science and brings real‐world evidence regarding the use of orthobiologics in the treatment of chronic wounds, irrespective of aetiology. The discussion highlights the regenerative properties of PRP, PRF, BMA, BMAC and SVF, showcasing their potential to enhance wound healing. Despite advancements, further research is essential to elucidate the specific roles of each orthobiologic and determine optimal applications for different wound types. The conclusion underscores the evolving landscape in chronic wound management, with a call for more comprehensive studies to refine treatment strategies and maximize the benefits of regenerative medicine.