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grafts and fat grafts enriched by progenitor cells via various techniques in burn scars. Despite the fact that
improvements in scar size/texture, enhancement of angiogenesesis, alleviation of inflammation/pain and
improved function were observed, no clear and statistical significant conclusions could be made and ASC
[43]
isolation protocols varied. On the contrary, Gal et al. examined the use of fat grafts in pediatric burn scars
in a prospective, randomized, double-blinded, placebo-controlled pilot study in eight patients and found
[44]
no evidence for scar improvement. Of course, the number of patients in Meng et al. ’s study is low, but its
scientifically sound study design, when compared to most other hitherto published clinical trials, adds to the
strength of the work. Although several preclinical studies analyzed the value of ASCs in diabetic wounds,
most of the clinical trials are still ongoing with no definite results provided by now.

In summary, most of the studies indicate a positive effect of ASCs/fat grafting/cell enriched fat grafts on var-
ious cutaneous wound conditions with no obvious complications, all authors of the afore-mentioned studies
unanimously complain the lack of randomized high quality studies with a sufficient number of patients.

CONCLUSION
Accruing experimental data indicate that ASCs are conductive to normal and pathological cutaneous wound
repair by release of soluble factors, differentiation into various cell lines and facilitating angiogenesis. How-
ever, due to a lack of high quality clinical studies, no conclusive statement is yet possible on the true benefits
of ASCs in the clinical setting.

DECLARATIONS
Authors’ contributions
Conception, design, wrote, revised, final manuscript version: Kim BS, Debye B, Beier JP
Performed literature review: Kim BS
Assisted in literature review: Debye B

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

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5. Neuhof H. The Transplantation of Tissues. New York: D Appleton & Co; 1923.
6. Julien P, Despres JP, Angel A. Scanning electron microscopy of very small fat cells and mature fat cells in human obesity. J Lipid Res