Adipose-derived stem cell treatment for persistent perineal wound sinus in Crohn's perianal abscess/fistula: OP23


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Abstract

Aim:In order topromote healing of persistent wound sinus after surgical management of complex perianal fistula/abscesses in patients with Crohn's disease (CD), we have used a novel approach consisting of injecting autologous adipose-derived stem cells (ASC).Method:Subcutaneous adipose tissue was obtained by fat tissue extraction from the abdomen of patients and then ASCs isolated from fat tissue were expanded and packaged in single-use vials.Results:After controlling the sepsis with long-term seton drainage and after confirming that internal opening of the fistula has been closed, we injected the ASCs (into the wound wall and sealed off the wound with fibrin glue + ASCs) in six CD patients with seven persistent non-healing cavities resulting from complex perianal abscess/fistula. Duration of persistent wound ranged from 5 to 88 months (mean = 38 months). Complete healing was observed between 4˜8 weeks in five cases (four patients, 71%), and partial healing in two patients. The reasons for failure were aggravation of intestinal CD and activation ofproctitis during healingprocess.Conclusion:Our results indicate that ACS treatment is a good option in selected cases where healing cannot be achieved after conventional operativeprocedures. However, control of intestinal CD and local septicprocess isprerequisite for thisprocedure.

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