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[面部烧伤后遗症中的脂肪移植]

[Fat grafting in facial burns sequelae].

作者信息

Viard R, Bouguila J, Voulliaume D, Comparin J-P, Dionyssopoulos A, Foyatier J-L

机构信息

Service de chirurgie plastique réparatrice et esthétique et centre des brûlés, hôpital Saint-Luc-Saint-Joseph, 20 quai Claude-Bernard, Lyon cedex 07, France.

出版信息

Ann Chir Plast Esthet. 2012 Jun;57(3):217-29. doi: 10.1016/j.anplas.2011.06.003. Epub 2011 Jul 30.

Abstract

INTRODUCTION

Fat graft is now part of the armamentarium in face plastic surgery. It is successfully used in burn scars. The aim of our study is the discussion of the value of this technique in optimizing cosmetic result of burns face sequelae.

PATIENTS AND METHOD

Fifteen adult patients (10 females and five males) with scars resulting from severe burns 2 to 9 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 to three injections were administered at the dermohypodermal junction. Ages, sexes, aetiology of burn, facial burn sequelae, recipient sites, quantity of fat injected, aesthetic results are discussed.

RESULTS

Patient age ranged from 21 to 55 years (average: 38). The mean follow-up of the study was 66 months (23-118). Patients received 7.5 (5-11) facial restorative surgeries before fat graft. Patients underwent two sessions of fat transfer, 33cc average per session. We did not report any complications. The clinical appearance, discussed by three surgeons and subjective patient feelings, after a 6-month follow-up period, suggests considerable improvement in the mimic features, skin texture, and thickness. The result is good in 86% of cases and acceptable in the other cases.

DISCUSSION

Burns sequelae offer local conditions which justify special cannula can cross fibrosis and explaining the value of multiplying the sessions. Indications for lipostructure include four distinct nosological situations, sometimes combined. Lipostructure can restore a missing relief, filling a localized depression, reshape a lack of face volume or smooth a scarring skin.

CONCLUSION

Fat graft seems to complete and improve the results of the standard surgical approach in burned face.

摘要

引言

脂肪移植如今是面部整形手术的手段之一。它已成功应用于烧伤瘢痕治疗。我们研究的目的是探讨该技术在优化烧伤面部后遗症美容效果方面的价值。

患者与方法

选取15例成年患者(10例女性,5例男性),他们在2至9年前因严重烧伤留下瘢痕。患者接受了从腹部皮下脂肪获取并按科尔曼技术处理的脂肪组织注射治疗。在真皮与皮下组织交界处进行了两到三次注射。讨论了患者的年龄、性别、烧伤病因、面部烧伤后遗症、受区部位、注射脂肪量及美学效果。

结果

患者年龄在21至55岁之间(平均38岁)。研究的平均随访时间为66个月(23 - 118个月)。患者在脂肪移植前接受了7.5次(5 - 11次)面部修复手术。患者接受了两期脂肪移植,每期平均33立方厘米。未报告任何并发症。经过6个月的随访期,由三位外科医生讨论的临床外观及患者主观感受表明,面部表情特征、皮肤质地和厚度有显著改善。86%的病例效果良好,其他病例效果可接受。

讨论

烧伤后遗症提供了局部条件,使得特殊套管能够穿过纤维化组织,这也解释了增加移植次数的价值。脂肪结构重塑的适应证包括四种不同的病症情况,有时会合并出现。脂肪结构重塑可以恢复缺失的轮廓,填充局部凹陷,重塑面部容量不足或使瘢痕皮肤变平整。

结论

脂肪移植似乎完善并改善了烧伤面部标准手术方法的效果。

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