Plastic Surgery, Policlinico di Sant'Orsola, DIMES, University of Bologna, Bologna, Italy.
Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy.
Aesthetic Plast Surg. 2020 Oct;44(5):1820-1832. doi: 10.1007/s00266-020-01848-2. Epub 2020 Jul 6.
Systemic sclerosis is a connective tissue disease. Skin involvement of the mouth and hand may compromise function and quality of life. Autologous fat grafting has been described as a specific treatment of these clinical features. We report the results of our prospective study designed to treat and prevent skin complications in systemic sclerosis.
We treated 25 patients with mouth and/or hand involvement (microstomia, xerostomia, skin sclerosis, Raynaud's phenomenon and long-lasting digital ulcers) with autologous fat grafting, according to the Coleman's technique, around the mouth and/or at the base of each finger. The surgical procedures were repeated in each patient every 6 months for a total of two or three times. Clinical data were collected before the first surgery and again 6 months after each surgical procedure. Pain, skin thickness, saliva production and disability were assessed with validated tests.
Overall we performed 63 autologous fat grafting sessions (either on the mouth, on the hands or on both anatomical areas). Results at 6 moths after the last session included improvement of xerostomia evaluated with a sialogram, reduction of the skin tension around the mouth and, in the hands, reduction of the Raynaud phenomenon as well as skin thickness. Pain was reduced while the perception of disability improved. Digital ulcers healed completely in 8/9 patients.
Our results confirm the efficacy and safety of autologous fat grafting for the treatment of skin complications and digital ulcers due to systemic sclerosis. In addition, the patients' subjective well-being improved. Level of evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
系统性硬化症是一种结缔组织疾病。口腔和手部皮肤受累可能会影响功能和生活质量。自体脂肪移植已被描述为治疗这些临床特征的特定方法。我们报告了一项旨在治疗和预防系统性硬化症皮肤并发症的前瞻性研究结果。
我们根据 Coleman 技术，用自体脂肪移植治疗了 25 例口腔和/或手部受累（小口畸形、口干、皮肤硬化、雷诺现象和长期手指溃疡）的患者。每位患者每 6 个月重复手术，总共进行 2 或 3 次。在第一次手术前和每次手术后 6 个月收集临床数据。使用经过验证的测试评估疼痛、皮肤厚度、唾液产生和残疾。
我们总共进行了 63 次自体脂肪移植手术（口腔、手部或两者的解剖区域）。最后一次手术后 6 个月的结果包括唾液造影评估的口干改善、口腔周围皮肤张力降低，以及手部雷诺现象和皮肤厚度减少。疼痛减轻，残疾感改善。8/9 例患者的手指溃疡完全愈合。
我们的结果证实了自体脂肪移植治疗系统性硬化症皮肤并发症和手指溃疡的疗效和安全性。此外，患者的主观幸福感得到了改善。证据等级 V 本杂志要求作者为每篇文章分配一个证据等级。有关这些循证医学评级的完整描述，请参考目录或在线作者指南 www.springer.com/00266 。
