Plastic, Reconstructive and Aesthetic Surgery Clinic, Second University of Naples, Piazza Miraglia, 80138, Naples, Italy.
Plastic, Reconstructive and Aesthetic Surgery, University of Naples "Federico II", Via Pansini, 80131, Naples, Italy.
Aesthetic Plast Surg. 2017 Aug;41(4):839-844. doi: 10.1007/s00266-017-0904-1. Epub 2017 Jun 8.
Systemic sclerosis (SSc) is an autoimmune disease with multisystem involvement, dominated by a general fibrosis. The early stage of the disease is associated with progressive damage to microcirculation, particularly in the respiratory tract, the gastrointestinal tract and skin. The face assumes a typical appearance characterized by microstomia (reduction of mouth opening) and microcheilia (thinning of the lips). These conditions cause a considerable reduction in performance status of patients. We treated them by fat grafting, rich in adipose stem cells, and we evaluated through time clinical, functional and aesthetic evaluation of oral pathology associated with SSc.
From September 2014 to May 2016, we enrolled and treated seven patients in the plastic, reconstructive and aesthetic surgery clinic. Through time, we evaluated the following parameters: evaluation of mouth opening (maximum opening in superior-inferior and lateral directions) and lip thicknesses, both measured by doctors of the aforementioned operating unit; variation in the quality of life as perceived by patients according to the MHISS scale (Mouth Handicap Systemic Sclerosis); variation in severity of labial fibrosis assessed by microscopic analysis of pre- and post-fat transfer samples in the pathology clinic; safety of the protocol, according to the management of side effects resulting from the procedure; aesthetic evaluation, made by external observers and non-experts in the field, on pre- and post-operative photographs.
We reported satisfying results, both functionally and aesthetically, for all parameters except one, for which the sample size might have proven critical. These data should be a starting point for further experimental research and clinical trials.
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系统性硬化症（SSc）是一种自身免疫性疾病，多系统受累，以广泛纤维化为主。疾病早期与微循环进行性损伤有关，尤其是在呼吸道、胃肠道和皮肤。面部呈现出典型的特征，表现为小口畸形（张口度减小）和小口裂（嘴唇变薄）。这些情况导致患者的生活质量显著下降。我们采用富含脂肪干细胞的脂肪移植进行治疗，并通过时间评估与 SSc 相关的口腔病理学的临床、功能和美学评估。
2014 年 9 月至 2016 年 5 月，我们在整形、重建和美容外科诊所招募并治疗了 7 名患者。通过时间评估以下参数：医生评估张口度（上下和左右方向的最大开口）和嘴唇厚度；患者根据 MHISS 量表（系统性硬化症口腔残疾系统）评估生活质量的变化；通过病理学诊所的脂肪转移前后样本的微观分析评估唇纤维化的严重程度变化；根据手术相关副作用的处理评估方案的安全性；通过外部观察者和非该领域专家对术前和术后照片进行美学评估。
除了一个参数之外，我们报告了所有参数都令人满意的结果，无论是在功能还是美学方面。对于该参数，样本量可能是关键。这些数据应该是进一步实验研究和临床试验的起点。
证据水平 IV：本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南 www.springer.com/00266 。
