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The Effect of Antiseptics on Adipose-Derived Stem Cells

Kim, Bong-Sung M.D.; Ott, Veronica; Boecker, Arne Hendrick M.D.; Stromps, Jan-Philipp M.D.; Paul, Nora Emilie Ph.D.; Alharbi, Ziyad M.D., Ph.D.; Cakmak, Ercan M.D.; Bernhagen, Jürgen Ph.D.; Bucala, Richard M.D., Ph.D.; Pallua, Norbert M.D., Ph.D.

Plastic & Reconstructive Surgery: March 2017 - Volume 139 - Issue 3 - p 625–637
doi: 10.1097/PRS.0000000000003125
Experimental: Original Articles
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Background: Although chemical antiseptics are the most basic measure to control wound infection and frequently come into contact with subcutaneous adipose tissue, no studies have evaluated their toxicity on adipose tissue and its cell fractions. In the present study, the effects of five different antiseptics on adipose-derived stem cells were evaluated.

Methods: Human adipose-derived stem cells were harvested from healthy donors. Adipose-derived stem cell viability was measured after treatment with different concentrations of antiseptics over 5 days. Furthermore, the effect on the proliferation, adipogenic differentiation, and apoptosis/necrosis of adipose-derived stem cells was analyzed. Finally, the mRNA expression of the stem cell markers CD29, CD34, CD73, CD90, and CD105 was detected.

Results: Octenisept and Betaisodona significantly reduced cell proliferation and differentiation and led to considerable adipose-derived stem cell necrosis. Octenisept decreased stem cell viability at the lowest concentrations tested, and all stem cell markers were down-regulated by Octeniseptr and Betaisodona. Lavasept and Prontosan both led to reduced stem cell viability, proliferation, and differentiation, and increased apoptosis/necrosis, although the effects were less pronounced compared with Octenisept and Betaisodona. Adipose-derived stem cells survived treatment with mafenide acetate even at high concentrations, and mafenide acetate showed minimal negative effects on their proliferation, adipogenic differentiation, cell death, and stem cell marker expression.

Conclusions: Mafenide acetate may be regarded as a feasible antiseptic for the treatment of wounds with exposed adipose tissue because of its low adipose-derived stem cell toxicity. Lavasept and Prontosan are possible alternatives to mafenide acetate. Octenisept and Betaisodona, by contrast, may be used only in highly diluted solutions.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

Aachen and Munich, Germany; and New Haven, Conn.

From the Department of Plastic and Reconstructive Surgery, Hand Surgery–Burn Center, Medical Faculty, the Institute of Biochemistry and Molecular Cell Biology, RWTH Aachen University; the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University; the Munich Cluster for Systems Neurology (SyNergy); and the Department of Medicine, Yale University School of Medicine.

Received for publication December 5, 2015; accepted June 21, 2016.

Disclosure: None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this article.

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Bong-Sung Kim, M.D., Department of Plastic Surgery and Hand Surgery–Burn Center, University Hospital, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany, bong.kim@rwth-aachen.de

©2017American Society of Plastic Surgeons