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自体脂肪移植治疗瘢痕组织及瘢痕相关病症的系统评价

The Use of Autologous Fat Grafting for Treatment of Scar Tissue and Scar-Related Conditions: A Systematic Review.

作者信息

Negenborn Vera L, Groen Jan-Willem, Smit Jan Maerten, Niessen Frank B, Mullender Margriet G

机构信息

Amsterdam, The Netherlands From the Department of Plastic, Reconstructive, and Hand Surgery and the EMGO+ Institute for Health and Care Research, VU University Medical Center.

出版信息

Plast Reconstr Surg. 2016 Jan;137(1):31e-43e. doi: 10.1097/PRS.0000000000001850.

Abstract

BACKGROUND

Scar tissue can cause cosmetic impairments, functional limitations, pain, and itch. It may also cause emotional, social, and behavioral problems, especially when it is located in exposed areas. 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 symptoms. However, the scientific evidence for its effectiveness remains unclear. This systematic review aims to evaluate the available evidence regarding the effectiveness of autologous fat grafting for the treatment of scar tissue and scar-related conditions.

METHODS

A systematic literature review was performed using MEDLINE, Cochrane Library, EMBASE, and Web of Science. No language restrictions were imposed.

RESULTS

Twenty-six clinical articles were included, reporting on 905 patients in total. Meta-analysis was not performed because of the heterogeneous methodology demonstrated among the articles. Main outcome measures were scar appearance and skin characteristics, restoration of volume and/or (three-dimensional) contour, itch, and pain. All publications report a beneficial effect of autologous fat grafting on scar tissue. There is statistical significant improvement of the scar appearance, skin characteristics, and pain. Itch and restoration of volume and three-dimensional contour also improved.

CONCLUSIONS

Autologous fat grafting is used to improve a variety of symptoms related to scar tissue. This systematic review suggests that autologous fat grafting provides beneficial effects with limited side effects. However, the level of evidence and methodological quality are quite low. Future randomized controlled trials with a methodologically strong design are necessary to confirm the effects of autologous fat grafting on scar tissue and scar-related conditions.

摘要

背景

瘢痕组织可导致外观受损、功能受限、疼痛和瘙痒。它还可能引起情绪、社交和行为问题,尤其是当瘢痕位于暴露部位时。迄今为止,瘢痕组织的治疗尚无金标准。自体脂肪移植已被作为治疗瘢痕组织相关症状的一种有前景的治疗选择引入。然而,其有效性的科学证据仍不明确。本系统评价旨在评估关于自体脂肪移植治疗瘢痕组织及瘢痕相关病症有效性的现有证据。

方法

使用MEDLINE、Cochrane图书馆、EMBASE和科学网进行系统的文献综述。未设语言限制。

结果

纳入了26篇临床文章,共报道905例患者。由于各文章间方法学存在异质性,未进行荟萃分析。主要结局指标为瘢痕外观和皮肤特征、体积和/或(三维)轮廓的恢复、瘙痒和疼痛。所有出版物均报道了自体脂肪移植对瘢痕组织有有益作用。瘢痕外观、皮肤特征和疼痛有统计学显著改善。瘙痒以及体积和三维轮廓的恢复也有所改善。

结论

自体脂肪移植用于改善与瘢痕组织相关的多种症状。本系统评价表明自体脂肪移植疗效良好且副作用有限。然而,证据水平和方法学质量相当低。未来需要设计方法学严谨的随机对照试验来证实自体脂肪移植对瘢痕组织及瘢痕相关病症的作用。

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