EFFECT OF FAT GRAFTING ON IMPROVEMENT OF SCAR-AN INTERVENTIONAL STUDY
DOI:
https://doi.org/10.55519/JAMC-04-13211Keywords:
Fat grafting; Scar improvement; Patient and Observer Scar Assessment Scale (POSAS); Regenerative medicine; Facial scarsAbstract
Background: Scars are inevitable after effect of wound healing, a natural process that restores tissue integrity following injury, burns or surgery. They can be aesthetically displeasing and functionally impairing, depending on their location, size, and depth. Depending on the severity of the injury, scars can be hypertrophic, atrophic, or keloid. These variations can lead to pain, itching, contractures (limited movement), and psychological distress, impacting a patient's quality of life. Objective was to evaluate the efficacy of autologous fat grafting in improving the appearance and quality of scars, with a focus on patients presenting with facial scars due to burns, trauma, surgery or acne at a tertiary care hospital in Karachi, Pakistan. Methods: In this quasi-experimental study, 30 patients of age 18 years to 60 years, irrespective of gender having facial scar because of burn, trauma, surgery or acne were included in the study. A comprehensive scar assessment was performed using the Patient and Observer Scar Assessment Scale (POSAS) before treatment, and follow-up evaluations were conducted on the seventh day, at three months, and at six months post-fat grafting. Fat grafting was executed using a tumescent technique based on Klein's formula, with the aspirated fat injected into the subdermal plane of the scar. Data analysis was performed using SPSS version 23. Results: The patient cohort had a mean age of 26.77 years, with a predominance of female participants (73.3%). Trauma was the most common cause of scars (50%), with the forehead being the most frequent location (36.67%). Significant improvements in scar quality were observed, with both patient and observer POSAS scores showing notable reductions from baseline to 6 months (p<0.05). All patients (100%) demonstrated an improvement in scar appearance. Conclusion: Fat grafting presents a promising treatment for improving the appearance and quality of facial scars.
References
1. To K, Crowley C, Lim SK, Khan WS. Autologous adipose tissue grafting for the management of the painful scar. Cytotherapy 2019;21(11):1151–60.
2. Brown JC, Shang H, Yang N, Pierson J, Ratliff CR, Prince N, et al. Autologous Fat Transfer for Scar Prevention and Remodeling: A Randomized, Blinded, Placebo-controlled Trial. Plast Reconstr Surg Glob Open 2020;8(5):e2830.
3. Parikh N, Darshan J. An intervention study of autologous fat transfer for scar tissue rejuvenation in the setup. Int Surg J 2018;5(3):815–22.
4. Klinger M, Caviggioli F, Klinger FM, Giannasi S, Bandi V, Banzatti B, et al. Autologous fat graft in scar treatment. J Craniofac Surg 2013;24(5):1610–5.
5. Kim SW. Management of keloid scars: noninvasive and invasive treatments. Arch Plast Surg 2021;48(2):149–57.
6. Puri N, Talwar A. The efficacy of silicone gel for the treatment of hypertrophic scars and keloids. J Cutan Aesthet Surg 2009;2(2):104–6.
7. Yuan B, Upton Z, Leavesley D, Fan C, Wang XQ. Vascular and Collagen Target: A Rational Approach to Hypertrophic Scar Management. Adv Wound Care (New Rochelle) 2023;12(1):38–55.
8. Zhang X, Li G. Effectiveness of fat grafting in scar reduction: A systematic review and meta-analysis. J Cosmet Dermatol 2022;21(11):5804–10.
9. Gal S, Ramirez JI, Maguina P. Autologous fat grafting does not improve burn scar appearance: A prospective, randomized, double-blinded, placebo-controlled, pilot study. Burns 2017;43(3):486–9.
10. Yinpu Z, Jingming T. Research progress of autologous fat transplantation in the treatment of cicatrix. J Med Postgrad 2021;34(7):780–4.
11. Rinker BD, Vyas KS. Do Stem Cells Have an Effect When We Fat Graft? Ann Plast Surg 2016;76(Suppl 4):S359–63.
12. Strong AL, Cederna PS, Rubin JP, Coleman SR, Levi B. The Current State of Fat Grafting: A Review of Harvesting, Processing, and Injection Techniques. Plast Reconstr Surg 2015;136(4):897–912.
13. Sardesai MG, Moore CC. Quantitative and qualitative dermal change with microfat grafting of facial scars. Otolaryngol Head Neck Surg 2007;137(6):868–72.
14. Ishaque MA, Mirza MAR, Sharif M, Arshad AW, editors. Facial and Hand Scars Appearance after Autologous Nanofat Grafting in Patients with Post Burn Scars. Proceedings 2020;34(1):25–9.
15. Han SK. Innovations and advances in wound healing. 3rd ed. Singapore: Springer Nature; 2023.
16. Fernández-Guarino M, Bacci S, Pérez González LA, Bermejo-Martínez M, Cecilia-Matilla A, Hernández-Bule ML. The Role of Physical Therapies in Wound Healing and Assisted Scarring. Int J Mol Sci 2023;24(8):7487.
17. Piccolo NS, Piccolo MS, de Paula Piccolo N, de Paula Piccolo P, de Paula Piccolo N, Daher RP, et al. Fat grafting for treatment of facial burns and burn scars. Clin Plast Surg 2020;47(1):119–30.
18. Krastev TK, Schop SJ, Hommes J, Piatkowski A, van Der Hulst RR. Autologous fat transfer to treat fibrosis and scar-related conditions: a systematic review and meta-analysis. J Plast Reconstr Aesthet Surg 2020;73(11):2033–48.
19. Bhooshan LS, Devi MG, Aniraj R, Binod P, Lekshmi M. Autologous emulsified fat injection for rejuvenation of scars: A prospective observational study. Indian J Plast Surg 2018;51(1):77–83.
20. Gargano F, Schmidt S, Evangelista P, Robinson-Bostom L, Harrington DT, Rossi K, et al. Burn scar regeneration with the "SUFA" (Subcision and Fat Grafting) technique. A prospective clinical study. JPRAS Open 2018;17:5–8.
21. Klinger M, Klinger F, Caviggioli F, Maione L, Catania B, Veronesi A, et al. Fat Grafting for Treatment of Facial Scars. Clin Plast Surg 2020;47(1):131–8.
22. Condé-Green A, Marano AA, Lee ES, Reisler T, Price LA, Milner SM, et al. Fat Grafting and Adipose-Derived Regenerative Cells in Burn Wound Healing and Scarring: A Systematic Review of the Literature. Plast Reconstr Surg 2016;137(1):302–12.
23. Cheng C, Xie Y, Li Q. Current state and exploration of fat grafting. Chin J Plast Reconstr Surg 2021;3(4):209–12.
24. Varghese J, Griffin M, Mosahebi A, Butler P. Systematic review of patient factors affecting adipose stem cell viability and function: implications for regenerative therapy. Stem Cell Res Ther 2017;8(1):45.
25. Shukla L, Yuan Y, Shayan R, Greening DW, Karnezis T. Fat Therapeutics: The Clinical Capacity of Adipose-Derived Stem Cells and Exosomes for Human Disease and Tissue Regeneration. Front Pharmacol 2020;11:158.
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Sumaira Abdul Sattar, Faisal Akhlaq, Waqas Sami, Maryam Noor, Farhan Zahid, Unza Sheikh
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
