Nanofat in wound healing and scar formation

The discovery of stem cells in fat taught us that regeneration takes place from the matrix of the tissue itself. A specialized group of cells located within that matrix, called the Stromal Vascular Fraction (SVF), appears to be responsible for the clinically observed regenerative properties of adipose tissue on the skin. The question soon arose how Nanofat could assist the skin in processes such as wound healing and scar formation. In vitro, preclinical and clinical studies have now established that the addition of SVF in both fresh wounds and existing scars can be beneficial for regenerative purposes. However, the occurrence of these effects is unpredictable and the precise physiological mechanism behind this phenomenon is still unclear. Furthermore, no consensus has yet been reached on what the optimal isolation and treatment protocol is, especially since the clinical outcomes are measured in a very heterogeneous way. This thesis provides a summary of existing clinical studies, including an analysis of what an optimal study protocol should entail. Based on this knowledge, we conducted a clinical study with Nanofat on surgical wounds, with the resulting scar as the primary outcome. In addition, the Nanofat isolation protocol was investigated in an in vitro analysis by comparing the Nanofat substrate before and after the frequently applied filtration step. It was examined whether this step has an impact on the number of SVF cells. This thesis contributes to the collective effort to standardize clinical scientific studies on Nanofat-based treatments. These are essential to meta-analyze data between clinical studies and to establish early evidence within this domain.