Klomparens Kara, Simman Richard
School of Medicine, Wayne State University, Detroit, Mich.
College of Medicine and Life Science, University of Toledo, Toledo, Ohio.
Plast Reconstr Surg Glob Open. 2022 Nov 1;10(11):e4543. doi: 10.1097/GOX.0000000000004543. eCollection 2022 Nov.
Autologous fat grafting (AFG) has been used in reconstructive plastic surgery for over a century. Although it has obvious benefits to the aesthetic appearance of many reconstructive surgeries, less appreciated advantages of fat grafting have also been shown in potential pain reduction. This can be seen across the board from head to toe with examples ranging from facial nerve injury to pedal atrophy and foot ulcers. The purpose of this literature review is to evaluate the efficacy of AFG for pain relief in various indications and serve as a reference for clinicians to gain insight on potentially beneficial therapies for their patients.
A broad literature review was performed to analyze the various uses of AFG for pain management by various indications including postmastectomy pain syndrome, scar pain, neuromas, chronic wounds and many more. The PubMed, Science Direct and Scopus online databases were searched using keywords such as "autologous fat grafting," "reconstruction," "pain," and "therapy."
At this point, there is decent evidence to support AFG's role in pain resolution in postmastectomy pain syndrome, neuropathic scar pain, and pedal injury. There is also ample low-level evidence for pain efficacy in autoimmune diseases, neuromas, vulvar lichen sclerosis, burns, and radiation-induced wounds.
While there is a clear lack of higher-level evidence based studies conducted on AFG for all indications, the existing literature shows a definite trend of reconstructive efficacy and pain management that can be clearly appreciated. With the increasing popularity of this procedure for reconstruction, higher-level studies are beginning to take place pertaining to AFG's efficacy not only in reconstruction, but pain management as well.
自体脂肪移植（AFG）在整形重建外科中已应用了一个多世纪。尽管它对许多整形重建手术的美学外观有明显益处，但脂肪移植在潜在减轻疼痛方面的优势却较少受到关注。从头部到脚部，从面神经损伤到足部萎缩和足部溃疡等例子都能体现这一点。这篇文献综述的目的是评估AFG在各种适应症中缓解疼痛的疗效，并为临床医生提供参考，以便他们了解对患者可能有益的治疗方法。
进行了广泛的文献综述，以分析AFG在各种适应症（包括乳房切除术后疼痛综合征、瘢痕疼痛、神经瘤、慢性伤口等）中用于疼痛管理的各种用途。使用“自体脂肪移植”“重建”“疼痛”和“治疗”等关键词在PubMed、Science Direct和Scopus在线数据库中进行搜索。
目前，有充分的证据支持AFG在乳房切除术后疼痛综合征、神经性瘢痕疼痛和足部损伤的疼痛缓解中发挥的作用。在自身免疫性疾病、神经瘤、外阴硬化性苔藓、烧伤和放射性伤口的疼痛疗效方面也有大量低水平证据。
虽然明显缺乏针对AFG所有适应症的基于高级证据的研究，但现有文献显示出一种明确的重建疗效和疼痛管理趋势，这一点是可以清楚认识到的。随着这种重建手术越来越受欢迎，关于AFG疗效的高级研究不仅开始涉及重建方面，也涉及疼痛管理方面。
