Treatment of depressed scars with a dissecting cannula and an autologous fat graft (original) (raw)
Related papers
Outcome of fat injection in treatment of retracted scars
International Surgery Journal
Background: Fat grafting was developed in recent years with refinement mainly based on Coleman technique. The method consists of taking fat removed by liposuction under low pressure, fat processing and then placement of fat on the treated area.Methods: Patients who presented with depressed or retracted scars were considered. 12 patients were selected for the study as one year. Patients were given fat injection by Coleman’s technique and were evaluated at 1, 3 and 6 months. Patient and observer scar assessment score (POSAS) was used for evaluation.Results: The present study infers that there is a significant decrease in POSAS score on both the patient and observer side after fat injection for retracted scars. The overall patient score decreased from 5.75 (±0.866 SD) pre-operatively to 3.17 (±1.115 SD) post-operatively with a p value of less than 0.005. The difference between the scores is 2.58 which are comparable to other studies. The overall observer score decreased from 4.25 (±1.4...
Plastic and reconstructive surgery, 2017
Nowadays, patients normally survive severe traumas such as burn injuries and necrotizing fasciitis. Large skin defects can be closed but the scars remain. Scars may become adherent to underlying structures when the subcutical fat layer is damaged. Autologous fat grafting provides the possibility of reconstructing a functional sliding layer underneath the scar. Autologous fat grafting is becoming increasingly popular for scar treatment, although large studies using validated evaluation tools are lacking. The authors therefore objectified the effectiveness of single-treatment autologous fat grafting on scar pliability using validated scar measurement tools. Forty patients with adherent scars receiving single-treatment autologous fat grafting were measured preoperatively and at 3-month follow-up. The primary outcome parameter was scar pliability, measured using the Cutometer. Scar quality was also evaluated by the Patient and Observer Scar Assessment Scale and the DSM II ColorMeter. To...
Fat grafting as adjuvant to reduce scars in arm
Plastic and Aesthetic Research, 2018
Aim: Brachioplasty in patients who are normal weight, with moderate skin excess and who are not accepting long scars, remains a challenge for plastic surgeons. Methods: We present our experience in 47 patients with short scar brachioplasty in combination with posterolateral liposuction, fascia anchoring and fat grafting in the inferomedial arm in order to improve skin quality and correct minor irregularities. Patients' satisfaction rates were evaluated after 3 and 6 months following the procedure. Results: Patients (groups IIa, IIb and IIIa according to Rohrich classification) showed high satisfaction rates with the result both after 3 and 6 months after the procedure. The results were maintained. There were 2 cases (4.2%) of isolated wound dehiscence occurred, which were all resolved conservatively with dressings and antibiotics. Conclusion: The technique presented in this paper has shown to be an easy and effective solution for a diverse selection of patients suffering brachial lipodystrophy. Limited scar brachioplasty only has specific applications, and should not be considered a replacement for traditional brachioplasty.
Sustainable effectiveness of single-treatment autologous fat grafting in adherent scars
Wound Repair and Regeneration, 2017
Following severe injury, not just the skin but also the subcutis may be destroyed. Consequently, the developing scar can become adherent to underlying structures. Reconstruction of the subcutis can be achieved by autologous fat grafting. Our aim was to evaluate the long-term scar outcome after single-treatment autologous fat grafting using a comprehensive scar evaluation protocol. Scar assessment was performed preoperatively in 40 patients. A 12-month follow-up assessment was performed in 36 patients, using the Cutometer, the Patient and Observer Scar Assessment Scale, and DSM II ColorMeter. The Cutometer parameters elasticity and maximal extension improved with 28 and 22% (both p < 0.001), respectively. Nearly all scores of the scar assessment scale decreased significantly, which corresponds to improved scar quality. In addition, the mean melanin score was ameliorated over time. Thus, we demonstrated the sustainable effectiveness of single-treatment autologous fat grafting in adherent scars, indicated by improved pliability, and overall scar quality.
Fat Grafting Techniques and Outcome in Scar Face
2020
Control of facial scarring is one of the most difficult challenges in surgical practice, and represents a difficult therapeutic problem facing plastic surgeons to achieve good results. To date, no gold standard exists for the treatment of scar tissue. Autologous fat grafting has been introduced as a promising treatment option for scar tissue related symptomsHowever, those experimental confirmation for its viability remains vague. With assess techniques, results of fat grafting Also its effects once enhancing the facial scars. This study might have been directed for 20 patients for clear facial scars. Patients‟ agdistis went starting with 8 to 60 A long time. Patients were chosen haphazardly will a chance to be dealt with for fat grafting. The abdomen might have been those practically usually decided contributor site. Fat might have been transformed with axis done 10 (group An) and natural in the different 10 cases (group b (. Fat grafting demonstrated should bring a critical part cl...
Plastic and Reconstructive Surgery - Global Open, 2020
Background: Autologous fat transfer—also referred to as fat grafting—has been reported to provide beneficial effects to overlying scar and skin. Despite procedural frequency, there is a paucity of high-level evidence guiding the surgeon in technique, patient selection, and efficacy. Methods: A multicenter, double-blinded, randomized, internally placebo-controlled trial was performed with an aim to qualitatively and quantitatively evaluate the impact of autologous fat transfer on the quality of overlying scar tissue. Fat-grafted scars were evaluated and compared with paired, saline-injected “control” scars. Subjective and objective metrics were evaluated in treated sites for 12 months after treatment. Results: Blinded qualitative results demonstrated a statistically significant improvement in scar quality over time in fat-grafted scars. However, these improvements were not found to be statistically different from changes noted in scars treated with saline. In addition, objective metr...
Autologous fat grafting for scars, healing and pain: a review
Scars, burns & healing, 2017
Introduction: Current guidelines suggest a multimodal approach to treating scars but there is no gold standard for treatment; however, there is exciting therapeutic potential for the use of autologous fat grafting (AFG). Functional and aesthetic improvements have been reported, including pain relief and scar quality improvement. Aims: To explore the current evidence regarding the use of AFG in hypertrophic and painful scars. Methods: A systematic review of the literature was conducted using 11 MeSH terms in PubMed, Medline and EMBASE. English studies that used AFG to treat scars in human participants were included. Results: A total of 746 studies were found and 23 studies (from 2008 to 2016) were included: five studies were evidence level V; nine studies were evidence level IV; eight were evidence level III; and one study was evidence level II. A total of 1158 patients were assessed for improvement in scar characteristics including colour, thickness, volume, pain and restoration of function at affected sites, following treatment. Positive outcomes were noted for all parameters and a significant improvement in AFG's analgesic effect was recorded in 567 out of 966 patients, P < 0.05. Discussion: AFG is a minimally invasive and safe approach to treating scars, a promising alternative to surgical excision. The technique of blunt cannula insertion optimises the release of scar retraction, which contributes to the analgesic effect of this treatment method. The evidence supports current theories of mesenchymal stem cell's regenerative and anti-inflammatory properties responsible for scar healing. There are limited high quality studies to support its use and future randomised controlled trials should be conducted.
Surgical & Cosmetic Dermatology, 2016
Patients with scars often seek dermatologists for improving the symptoms (pruritus, pain), aesthetics and functionality (for example, to improve the range of motion in the joints). After anamnesis and description of the scar, the patient should be informed about the best repair techniques, based on scientific evidence and the physician's personal experience. The authors describe the main surgical techniques to treat scars, such as Z-plasty, W-plasty, dermabrasion, among others Palavras-chave: cicatrix; surgery; dermabrasion RESU MO Pacientes frequentemente procuram o dermatologista para melhorar os sintomas (prurido e dor) e os aspectos estéticos e funcionais (amplitude do movimento nas articulaçoes) de suas cicatrizes. Após anamnese e descrição da cicatriz, devemos esclarecer o paciente sobre as melhores técnicas para seu reparo, com base em evidências científicas e em nossa experiência pessoal. Descrevemos as principais técnicas cirúrgicas para a abordagem de cicatrizes, como a z-plastia, w-plastia, dermoabrasão, entre outras.
Fat Injection for Cases of Severe Burn Outcomes: A New Perspective of Scar Remodeling and Reduction
Aesthetic Plastic Surgery, 2008
Background Despite civilization and progress, burns occur frequently in the world. Remarkable discoveries of wound healing mechanisms have been reported. On the other hand, long-term outcomes from burn injuries represent a barrier to improvement of patients' social, functional, and psychological condition. Lipofilling, described since the 1980s, currently is used for several clinical applications. This study aimed to verify whether lipofilling could ameliorate scar remodeling in three clinical cases. Methods Three adult patients with hemifacial hypertrophic scars and keloids resulting from severe burns 2 to 13 years previously were selected. The patients were treated by injection of adipose tissue harvested from abdominal subcutaneous fat and processed according to Coleman's technique. Two injections (with a 13-month interval between) were administered at the dermohypodermal junction. Histologic examination of scar tissue punch biopsies (hematoxylin-eosin staining) before and after the treatment was performed as well as magnetic resonance scan with contrast. Results The clinical appearance and subjective patient feelings after a 6-month follow-up period suggest considerable improvement in the mimic features, skin texture, and thickness. Histologic examination shows patterns of new collagen deposition, local hypervascularity, and dermal hyperplasia in the context of new tissue, with high correspondence to the original. Conclusions The preliminary results show that lipofilling improves scar quality and suggest a tissue regeneration enhancing process.