Klinger Marco, Caviggioli Fabio, Klinger Francesco Maria, Giannasi Silvia, Bandi Valeria, Banzatti Barbara, Forcellini Davide, Maione Luca, Catania Barbara, Vinci Valeriano
From the *Università degli Studi di Milano-U.O. Chirurgia Plastica 2, Dipartimento di Medicina Translazionale, IRCCS Istituto Clinico Humanitas, Rozzano, Milan, and †Università degli Studi di Milano-U.O. Chirurgia Plastica, Multimedica Holding s.p.a., Sesto San Giovanni, Milan, Italy.
J Craniofac Surg. 2013 Sep;24(5):1610-5. doi: 10.1097/SCS.0b013e3182a24548.
Regenerative medicine is an emerging and rapidly evolving field of research and therapy, thanks to new discoveries on stem cells. Adipose tissue is a connective tissue which contains a reserve of mesenchymal stem cells. Clinical improvements in trophic characteristics of teguments after autologous fat graft are well described in literature. In this paper, we present our observation after 6 years of autologous fat graft experience in scar remodeling.
All patients recruited had retractile and painful scars compromising the normal daily activity/mobility of the joint involved. We performed surgical procedure with Coleman technique. In 20 patients, we performed a clinical assessment using Patient and Observer Scar Assessment Scale (POSAS) and Durometer measurements.
In all treated scars, a qualitative improvement was shown both from an aesthetic and functional point of view. Most importantly, reduction or complete resolution of pain and increases in scar elasticity were objectively assessable in all cases. In patients studied using Durometer and POSAS score, areas treated with autologous fat graft showed statistically significant reduction in hardness measurements in comparison with areas infiltrated with saline solution. POSAS scores showed a statistically significant reduction of a great deal of POSAS parameters as a result of an improvement of both clinical evaluation and patient perception.
Injection of processed autologous fat seems to be a promising and effective therapeutic approach for scars with different origin such as burns and other trauma scars, and post-surgery and radiotherapy outcomes. In general, we can affirm that treated areas regain characteristics similar to normal skin, which are clinically objectivable, leading not only to aesthetic but also functional results.
由于干细胞方面的新发现,再生医学是一个新兴且发展迅速的研究与治疗领域。脂肪组织是一种结缔组织,其中含有间充质干细胞储备。自体脂肪移植后皮肤营养特性的临床改善在文献中有充分描述。在本文中,我们介绍了6年自体脂肪移植治疗瘢痕重塑的观察结果。
所有招募的患者均有影响受累关节正常日常活动/活动能力的挛缩性疼痛瘢痕。我们采用科尔曼技术进行手术操作。对20例患者,我们使用患者和观察者瘢痕评估量表(POSAS)及硬度计测量进行临床评估。
在所有治疗的瘢痕中,从美学和功能角度均显示出质量上的改善。最重要的是,在所有病例中均可客观评估疼痛减轻或完全缓解以及瘢痕弹性增加。在使用硬度计和POSAS评分进行研究的患者中,与用生理盐水浸润的区域相比,自体脂肪移植治疗的区域硬度测量值有统计学意义的降低。由于临床评估和患者感知的改善,POSAS评分显示大量POSAS参数有统计学意义的降低。
注射处理后的自体脂肪似乎是一种有前景且有效的治疗方法,可用于治疗如烧伤和其他创伤瘢痕、手术及放疗后瘢痕等不同来源的瘢痕。总体而言,我们可以肯定,治疗区域恢复了类似于正常皮肤的特征,这在临床上是可观察到的,不仅带来美学效果,还带来功能效果。