The consequent reduction of adipocyte necrosis and the improvement of graft vascularity is probably the key-point that explains the long lasting results obtained. Refined fat injection-manipulation procedures strongly benefit also to adult adipose tissue stem cells, stromal stem cells, contained in the transplanted tissues, that can stimulate growth and angiogenetic factors release [4, 16]. All these components could also play a relevant role during the epidermal cell suspension

PD0325901 clinical trial graft. In this regard, the autologous transplanted fat tissue, not only corrects appropriately facial depressions, but also offers a natural source of nutrients and vascular growth factors to the overlaying dermal tissues [15]. The grafts of epithelial cell suspensions (cultured or non-cultured) have generated interest due to the broad-spectrum of applications such as severe burns, chronic non-healing wounds, vitiligo, and reconstruction after excision of giant congenital nevi [5–7, 17, 18]. These transplantation techniques make easier the choice of an adjacent skin

donor site and greatly reduce the amount of skin to be resected for cell preparation, if compared to other procedures. Moreover, skin substitutes, including autologous cultured cells, are markedly expensive [18], whereas non-cultured autologous epidermal cell suspensions can be low cost prepared in a relatively short time, during the same surgical operation. Nevertheless, this therapeutic approach is still rarely applied in modern clinical practice. In this experimentation, we modified the standard protocol by adding autologous LBH589 concentration plasma as a carrier for keratinocyte-melanocyte

cell suspension instead of the defined chemical cell medium. Plasma components, especially dissolved proteins and hormones, act as a natural source of growth factors and essential nutrients for grafted cells. The preparation of the receiving site by a CO2 laser resurfacing if compared to mechanical dermabrasion is more accurate in sampling the depth with an easily affordable post-operative course. This method seems also to improve Progesterone cellular adhesion and survival. The dressing with an interactive cellulose bio-membrane as a provisional epidermal substitute (Veloderm™), frequently used for the treatment of difficult wounds and burns, offers the advantage to create the ideal microenvironment for optimal re-epithelization and wound infection prevention. Cancer surveillance can be better guaranted using cell transplantation combined to the lipofilling technique where improvement in volume, mini-invasive skin scar debridement, and better vascularization can be obtained without moving the surrounding skin flaps. The risk of skin graft and cartilage necrosis was prevented by a percutaneous multilayer gentle debridment of the recipient site obtained by 1 mm spoon-tip microcannula before fat injection.