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脂肪抽吸物的机械微细化联合 CO 2 点阵激光治疗增生性瘢痕。

Mechanical Micronization of Lipoaspirates Combined with Fractional CO 2 Laser for the Treatment of Hypertrophic Scars.

机构信息

From the Department of Plastic Surgery, Affiliated Hospital of Zunyi Medical University.

出版信息

Plast Reconstr Surg. 2023 Mar 1;151(3):549-559. doi: 10.1097/PRS.0000000000009915. Epub 2022 Nov 22.

Abstract

BACKGROUND

Treating hypertrophic scars remains challenging. Stromal vascular fraction (SVF) gel is produced by a purely mechanical process from lipoaspirates, rich in adipose-derived stem cells, and has showed therapeutic potential on scars. However, controversial effects on hypertrophic scars are emerging. This study aimed to assess the therapeutic effects of SVF gel combined with fractional CO 2 laser on hypertrophic scars.

METHODS

A rabbit ear hypertrophic scar model was established. SVF gel combined with fractional CO 2 laser was conducted for hypertrophic scars in rabbits. Scar alleviation in rabbits was observed based on the appearance and histology of scars, and the underlying mechanism was investigated by tissue immunologic analyses and quantitative real time polymerase chain reaction. At last, six patients with hypertrophic scar were treated by SVF gel combined with fractional CO 2 laser. Therapeutic effects were assessed using the Vancouver Scar Scale.

RESULTS

Following the treatments, hypertrophic scars became less apparent and softer, the dermis became thinner, and collagen fibers appeared looser and arranged in a more organized pattern. The SVF gel plus fractional CO 2 laser group showed the most obvious improvement. In addition, SVF gel combined with fractional CO 2 laser increased adipogenesis in scar tissue, and adipose tissue regeneration was observed. Hypertrophic scars in patients were alleviated after treatment with SVF gel combined with fractional CO 2 laser.

CONCLUSIONS

SVF gel transplantation combined with fractional CO 2 laser showed encouraging therapeutic effects on hypertrophic scars. Although further investigation is necessary, this technique has great potential for clinical application to treat hypertrophic scars.

CLINICAL RELEVANCE STATEMENT

This is a new technique for treating hypertrophic scars.

摘要

背景

治疗增生性瘢痕仍然具有挑战性。基质血管成分(SVF)凝胶是通过脂肪抽吸物的纯机械过程产生的,富含脂肪来源的干细胞,并显示出对瘢痕的治疗潜力。然而,对增生性瘢痕的影响存在争议。本研究旨在评估 SVF 凝胶联合分束 CO2 激光治疗增生性瘢痕的疗效。

方法

建立兔耳增生性瘢痕模型。对兔增生性瘢痕进行 SVF 凝胶联合分束 CO2 激光治疗。根据瘢痕的外观和组织学观察,评估 SVF 凝胶联合分束 CO2 激光治疗兔增生性瘢痕的效果。通过组织免疫分析和实时定量聚合酶链反应探讨其潜在的作用机制。最后,对 6 例增生性瘢痕患者采用 SVF 凝胶联合分束 CO2 激光治疗。采用温哥华瘢痕量表评估治疗效果。

结果

治疗后,增生性瘢痕变得不那么明显,质地变软,真皮变薄,胶原纤维变得更疏松,排列更有序。SVF 凝胶联合分束 CO2 激光组改善最明显。此外,SVF 凝胶联合分束 CO2 激光增加了瘢痕组织中的脂肪生成,并观察到脂肪组织再生。SVF 凝胶联合分束 CO2 激光治疗后,患者的增生性瘢痕得到缓解。

结论

SVF 凝胶移植联合分束 CO2 激光对增生性瘢痕有较好的治疗效果。虽然还需要进一步研究,但该技术在治疗增生性瘢痕方面具有很大的临床应用潜力。

临床相关性声明

这是一种治疗增生性瘢痕的新技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b671/9944742/b50667f683c4/prs-151-549-g001.jpg

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