{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:16:27Z","timestamp":1787494587080,"version":"build-2736575974"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":296,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T00:00:00Z","timestamp":1617753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T00:00:00Z","timestamp":1617753600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"name":"DRI Foundation"},{"name":"Soffer Family Foundation"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Diabetes affects multiple systems in complex manners. Diabetic foot ulcers (DFUs) are a result of diabetes-induced microarterial vessel disease and peripheral neuropathy. The presence of arteriosclerosis-induced macroarterial disease can further complicate DFU pathophysiology. Recent studies suggest that mesenchymal stromal cell therapies can enhance tissue regeneration. This phase\u2009I study was designed to determine the safety and explore the efficacy of local injections of autologous adipose-derived stromal vascular fraction (SVF) cells to treat nonhealing DFUs greater than 3\u00a0cm in diameter. Sixty-three patients with type\u00a02 diabetes with chronic DFU\u2014all amputation candidates\u2014were treated with 30\u2009\u00d7\u2009106 SVF cells injected in the ulcer bed and periphery and along the pedal arteries. Patients were seen at 6 and 12\u2009months to evaluate ulcer closure. Doppler ultrasounds were performed in a subset of subjects to determine vascular structural parameters. No intervention-related serious adverse events were reported. At 6\u00a0months, 51 subjects had 100% DFU closure, and 8 subjects had \u226575% closure. Three subjects had early amputations, and one subject died. At 12\u2009months, 50 subjects had 100% DFU healing and 4 subjects had \u226585% healing. Five subjects died between the 6- and 12-month follow-up visits. No deaths were intervention related. Doppler studies in 11 subjects revealed increases in peak systolic velocity and pulsatility index in 33 of 33 arteries, consistent with enhanced distal arterial runoff. These results indicate that SVF can be safely used to treat chronic DFU, with evidence of efficacy (wound healing) and mechanisms of action that include vascular repair and\/or angiogenesis.<\/jats:p>","DOI":"10.1002\/sctm.20-0497","type":"journal-article","created":{"date-parts":[[2021,4,7]],"date-time":"2021-04-07T09:04:53Z","timestamp":1617786293000},"page":"1138-1147","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["Treatment of Chronic Diabetic Foot Ulcers with Adipose-Derived Stromal Vascular Fraction Cell Injections: Safety and Evidence of Efficacy at 1\u00a0Year"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9611-252X","authenticated-orcid":false,"given":"Michael H.","family":"Carstens","sequence":"first","affiliation":[{"name":"Wake Forest Institute of Regenerative Medicine \u00a0Wake Forest University, Winston-Salem, North Carolina, USA"},{"name":"Department of Surgery \u00a0Universidad Nacional de Nicaragua, Le\u00f3n, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco J.","family":"Quintana","sequence":"additional","affiliation":[{"name":"Department of Surgery \u00a0Universidad Nacional de Nicaragua, Managua, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santos T.","family":"Calderwood","sequence":"additional","affiliation":[{"name":"Department of Surgery \u00a0Universidad Nacional de Nicaragua, Matagalpa, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan P.","family":"Sevilla","sequence":"additional","affiliation":[{"name":"Department of Surgery \u00a0Universidad Nacional de Nicaragua, Matagalpa, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arlen B.","family":"R\u00edos","sequence":"additional","affiliation":[{"name":"Department of Surgery \u00a0Universidad Nacional de Nicaragua, Matagalpa, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos M.","family":"Rivera","sequence":"additional","affiliation":[{"name":"Department of Radiology \u00a0Universidad Nacional de Nicaragua, Matagalpa, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorian W.","family":"Calero","sequence":"additional","affiliation":[{"name":"Department of Radiology \u00a0Universidad Nacional de Nicaragua, Le\u00f3n, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda L.","family":"Zelaya","sequence":"additional","affiliation":[{"name":"Department of Radiology \u00a0Universidad Nacional de Nicaragua, Le\u00f3n, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Medicine \u00a0Universidad Nacional de Nicaragua, Matagalpa, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth A.","family":"Bertram","sequence":"additional","affiliation":[{"name":"Wake Forest Institute of Regenerative Medicine \u00a0Wake Forest University, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Rigdon","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science \u00a0School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Severiano","family":"Dos-Anjos","sequence":"additional","affiliation":[{"name":"Department of Biology \u00a0University of Le\u00f3n, Le\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Correa","sequence":"additional","affiliation":[{"name":"Diabetes Research Institute and Cellular Transplant Center \u00a0UHealth Sports Medicine Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA"},{"name":"Department of Orthopedics \u00a0UHealth Sports Medicine Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,4,7]]},"reference":[{"key":"2022022811001574700_sct312926-bib-0001","volume-title":"IDF Diabetes Atlas. 9th ed. 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