Burn injury management continues to present multiple clinical challenges, including infection, scar formation, and functional restoration. Mesenchymal stem cells (MSCs) and their secretome (exosomes) have emerged as a cell-free therapy with multitarget potential in inflammation regulation, angiogenesis, epithelial regeneration, and extracellular matrix (ECM) remodeling. Rather than classifying by cell origin, this review is guided by clinical needs and translational pathways to propose a framework for productization and translational development. MSC/EVs strategies exhibit unique advantages along the inflammation-regeneration-fibrosis axis, making them suitable for integration into dressings, delivery systems, and combination therapies. Current obstacles include donor and source consistency, Good Manufacturing Practice (GMP) compliance, standardization of Critical Quality Attributes (CQAs), optimization of administration strategies, and selection of clinically meaningful endpoints. Establishing standardized production and quality-control systems, along with promoting multicenter randomized studies, is essential to achieve high-quality translation from research to clinical practice.
Wang et al. (Thu,) studied this question.