Abstract
Healing the large skin defects is a relevant and very complicated problem in pediatric surgery. Applying of mesenchimal stem cells (MSCs) is a promising solution. MSCs are multipotent stem cells that have proliferative and self-renewal potential and that can differentiate into multi-lineage cell types including all dermal components. The mechanisms of MSCs effect arise from their ability to differentiate, transdifferentiate and exert paracrine or immunomodulatory effects. We present a case of a 2,5 year old boy developed a fulminant purpura followed by an extensive skin and soft tissues necrosis (~20% of skin surface). Necrectomy led to large skin defects and the question of further tactics. The decision to transplant allogenic adipose derived MSCs was made. After two transplantations we observed reduction of wound surface, granulation tissue growth and peripheral epithelization. Subsequently two stages of split thickness skin grafting were performed. Children with large skin defects require an individual approach. Transplantation of allogenic MSCs allows to reduce wound surface and improve outcome and should be considered as a promising in combination with traditional methods.