Stem Cell Therapy Applications In Surgical Wound Repair: A Qualitative Systematic Review

Abstract

Background: Chronic and complex surgical wounds present a persistent clinical challenge, often complicated by ischemia, infection, or comorbidities such as diabetes. Stem cell-based therapies, including mesenchymal stem cells (MSCs), adipose-derived stem cells (ADSCs), and cell-free derivatives, have emerged as promising regenerative strategies to enhance wound healing outcomes.

Objective: To systematically review and synthesize the clinical efficacy, mechanistic basis, safety, and translational barriers of stem cell therapies in surgical wound repair.

Methods: Following PRISMA 2020 guidelines, a comprehensive search of PubMed, Scopus, Web of Science, Embase, and Google Scholar identified studies from January 2000 to December 2024. Eligible studies included human clinical trials, preclinical animal models, and in vitro mechanistic investigations involving stem cell or stem cell-derived interventions for surgical wound healing. Data on study design, population, intervention, outcomes, and safety were extracted and synthesized narratively.

Results: Fifteen studies met inclusion criteria, encompassing randomized controlled trials, cohort studies, pilot trials, and mechanistic experiments. MSCs, ADSCs, PB-MNCs, and exosome-based therapies demonstrated significant improvements in wound closure rates, re-epithelialization, tissue quality, and functional recovery compared to standard care. Mechanisms of action included angiogenesis promotion, inflammation modulation, and extracellular matrix remodeling. Safety profiles were favorable, with no serious adverse events reported. However, outcomes were inconsistent in some trials, particularly where cell mobilization or platelet-derived products were used without optimized delivery strategies.

Conclusion: Stem cell therapies hold substantial promise as adjunctive treatments for surgical wound repair, with MSCs and ADSCs demonstrating the strongest clinical efficacy. Future research should address standardization of protocols, optimize delivery systems, and evaluate long-term safety to support regulatory approval and integration into clinical practice.