mesenchymal stromal cell therapy alone does not lead to complete restoration of skin parameters in diabetic foot patients within a 3-year follow-up period

introduction: mesenchymal stromal cells (mscs) administration is an effective option for the treatment of diabetic foot ulcers (dfus). however, to date, studies assessing long-term outcomes and evaluating skin parameters after cell-based therapy are lacking. we presented the clinical outcomes of 3 patients, treated for dfus with the bone marrow mscs 3 years earlier. methods: ultrasound examination was used to compare collagen density and epidermal thickness in areas of healed ulcers in comparison with non-affected skin used as a control. ultrasound and dermatoscopy were used to exclude neoplasm formation, to assess scar contracture and wound recurrence. results: in all patients, no ulcer recurrence was detected, which was lower than the expected 60% rate of re-ulceration in diabetic patients in a 3-year period (od [odds ratio] = 0.095, p = 0.12). no neoplasm formation, no contracture of hypertrophic scar, and adjacent tissue were registered. collagen ultrasound density was decreased by 57% (p = 0.053) and epidermal thickness was increased by 72% (p = 0.01) in the area of healed ulcers in all patients. conclusion: mscs therapy alone did not result in the complete restoration of the skin parameters within a 3-year period. mscs may represent important adjuvant to the therapy, however, other novel approaches are required to achieve better results.