425698Services Institute of Medical Sciences, Lahore, Pakistan.
Services Institute of Medical Sciences and Surgimed Hospital, Lahore, Pakistan.
Int J Low Extrem Wounds. 2022 Dec;21(4):647-650. doi: 10.1177/15347346211073388. Epub 2022 Jan 12.
Autologous fat grafting (AFG) is an emerging therapeutic option for wounds that are not ready for grafting. The regenerative potential of autologous fat lies in the adipose derived stem cells (ADSCs) contained within the stromal vascular fraction (SVF), which are capable of differentiating into multiple cell lineages. However to date, there has been no comprehensive evaluation of its efficacy in acute complicated wounds. This study aims to critically evaluate the efficacy and safety of AFG in cutaneous wound healing. This prospective, quasi experimental study was conducted in the Department Of Plastic Surgery, SIMS, Lahore, between June 2020 and June 2021. Thirty patients with pale granulation, not ready for grafting with no vital structure exposed were included in the study after detailed history, examination and were photographed pre and postoperatively. The procedure was performed under local anaesthesia. 40 to 80 ml fat was harvested from lower abdomen and after emulsification, placed over the wound wrapped in sufra tulle dressing. The dressing was changed on third postoperative day and outcome was assessed on clinical grounds. Thirty patients (M:F Ratio 1.75:1) with mean age 30 years (Range 13-45 years) were included in this study with post traumatic (n = 23) and post infective (n = 7). Of 27 patients who completed their follow up, all had healthy granulation tissue which was later on grafted. Mean number of fat dressing sessions were 2 (Range 1-3). Autologous fat grafting has shown promising results for cutaneous wounds without any unacceptably high complication rates reported so far. Randomised controlled trials should be done on a larger scale to prove its efficacy in the management of complicated wounds.
自体脂肪移植（AFG）是一种新兴的治疗方法，适用于尚未准备好进行移植的伤口。自体脂肪的再生潜力在于基质血管部分（SVF）中包含的脂肪来源干细胞（ADSCs），这些干细胞能够分化为多种细胞谱系。然而，迄今为止，还没有对其在急性复杂伤口中的疗效进行全面评估。本研究旨在批判性地评估 AFG 在皮肤伤口愈合中的疗效和安全性。
这项前瞻性、准实验研究在拉合尔 SIMS 整形外科系进行，时间为 2020 年 6 月至 2021 年 6 月。30 名患者因苍白肉芽组织、尚未准备好进行移植且无重要结构暴露而纳入研究，详细病史、检查并在术前和术后拍照。手术在局部麻醉下进行。从下腹部采集 40 至 80ml 脂肪，乳化后放置在伤口上，用舒肤特纱布敷料包裹。术后第 3 天更换敷料，并根据临床情况评估结果。
这项研究纳入了 30 名患者（男女比例为 1.75:1），平均年龄 30 岁（范围 13-45 岁），其中创伤后（n=23）和感染后（n=7）各占一半。27 名完成随访的患者中，所有人的肉芽组织均健康，随后进行了移植。脂肪敷料的使用次数平均为 2 次（范围 1-3 次）。
到目前为止，自体脂肪移植在治疗无不可接受高并发症率的皮肤伤口方面显示出了良好的效果。应该进行更大规模的随机对照试验，以证明其在治疗复杂伤口方面的疗效。
