Table 3.

Clinical studies considering usage of autologous agents in post-burn scars.

Study	Study Type	Patients and Methods	Outcomes	Conclusion
Piejko [79]	Clinical experiment, case study	Contracting post-burn scar on the neck was qualified for excision. Autogenic AD-SCs were harvested by surgical excision of adipose tissue 3 weeks before the next stage. The cells were isolated, cultured, and seeded into the dermis substitute-matrix based on bovine collagen and sulphite-chondroitin. Four weeks after the scar excision the silicone layer of the matrix was removed and the neodermis was covered with a split-thickness skin graft.	No adverse events reported, good scar quality and texture.	Autologous stem cells can promote “scarless” healing of deep tissue wounds.
Li [81]	Experiment	Adipose and scar tissue was collected from subjects that underwent plastic excision of scars. Adipose-derived stem cells were isolated and cultured. Then, exosomes were isolated. BABL/c mice were randomly divided into groups; 3 days after creating a full-thickness injury, exosomes were injected subcutaneously.	Exosomes inhibited the proliferation and migration of fibroblasts, decreased the expression of Col1, Col3, α-SMA, IL-17RA, and p-Smad2/p-Smad3 and increased the levels of SIP1 in HSFs. miR-192-5p was highly expressed in ADSC-Exo and targeted the expression of IL-17RA to decrease the pro-fibrotic protein levels.	ADSC-Exo have antifibrotic features and improve wound healing.
Zahorec [80]	Clinical experiment	8 patients with post-burn scars: 2 keloid, 6 hypertrophic. Adipose tissue was harvested with the Coleman technique, then ADSCs were isolated and cultured. ADSCs were injected with a 20G needle, subdermally after scar resection.	Improvement in VSS score in a 6-month observation (7.63 to 2.38), elapsing from scar incidence to correction was 79 months	Autologous ADSCs are safe and effective in preventing and treating post-burn scars.
Meng [82]	Experimental	Fibroblasts from hypertrophic scars were co-cultured with umbilical cord stem cells.	Umbilical cord stem cells suppressed the proliferation and migration ability of fibroblasts, with the TGF β1/Smad3 pathway inhibited as well. Additionally, levels of mRNA of collagen type Iα2 (COL1A2), collagen III α1 (COL3A1) and actin α2 smooth muscle (ACTA-2) were lower.	Umbilical cord stem cells have anti-fibrotic potential.