Transcutaneous oximetry and laser Doppler flowmetry values in patients with chronic skin ulcers treated with platelet rich plasma and stromal vascular fraction cells: a pilot study

Expanding Clinical Indications of Mechanically Isolated Stromal Vascular Fraction: A Systematic Review

BACKGROUND

Mechanically isolated stromal vascular fraction (tSVF, tissue SVF) is a potent regenerative solution, increasingly used as a therapeutic modality for a variety of pathologies. With recent evidence conclusively favoring mechanical isolation over enzymatic alternatives, the therapeutic share and indications of tSVF are expected to grow even further.

OBJECTIVES

The aim of this study was to provide a systematic review of all studies reporting on the use of tSVF.

METHODS

A systematic search was undertaken of the Embase, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials databases. Outcome measures included clinical indications, such as recipient area, adverse events, clinical results recipient area, method of application, follow-up duration and evaluation methods.

RESULTS

Of the total of 4505 articles identified, 186 full-texts were screened. Thirty-four studies, reporting on 1443 patients were included. tSVF-based therapy was observed for 10 different pathologies, including aged skin (8 studies), scars (5), wounds (6), osteoarthritis (6), tendinopathy (2), temporomandibular joint disorders (1), androgenic alopecia (1), perianal fistula (3), migraine (1), and vocal fold scarring (1). Across all studies, tSVF-based therapy resulted in favorable clinical results. Overall, 50 (3.43%) minor and one (0.07%) major adverse events were observed, mainly related to the liposuction procedure.

CONCLUSIONS

tSVF offers a safe, easy and legal treatment modality for a range of indications. Future research is indicated to identify the optimal isolation protocol, dose and timing. In addition, basic research remains crucial to identify the mechanism of action of SVF within different pathologies.

LEVEL OF EVIDENCE: 4

Potential of Laser Doppler Flowmetry in the Medical Needle Insertion Procedures

Medical needle insertion procedures possess the risk of life-threatening blood vessel rapture. Here we report a compact laser Doppler Flowmetry (LDF) based system that has a potential of blood vessel detection in the vicinity of the moving needle. The developed LDF system comprises two optical fibers inserted into the needle (the probe), a laser unit and a photodetector. The latter collects the signal produced by photons, scattered from the moving red blood cells that is further converted into perfusion value. Using LDF system, we have been able to detect the flow independently from the needle penetration angle, site or depth. Moreover, we showed that the blood vessel can be identified inside the tissue phantom while the probe is moving. Our results demonstrate that the developed LDF system is flexible and compatible with different types of needles and thus has a potential in the needle insertion procedures.