Ramaut Lisa, Moonen Linde, Geeroms Maxim, Leemans Gaelle, Peters Ellen, Forsyth Ramses, Gutermuth Jan, Hamdi Moustapha
Aesthet Surg J Open Forum. 2024 Aug 30;6:ojae072. doi: 10.1093/asjof/ojae072. eCollection 2024.
The regenerative properties of stromal vascular fraction (SVF) in wound healing and scar formation are a subject of increasing clinical interest.
Although preclinical studies have confirmed the angiogenetic, proliferative, and antifibrotic properties of SVF, there is limited clinical evidence from randomized controlled clinical trials.
Twelve patients who underwent abdominoplasty were included in this clinical study. Nanofat was mechanically obtained intraoperatively and infiltrated intradermally in the sutured surgical wound, randomly assigned to either the left or the right side. The abdominal scar was evaluated with the Patient and Observer Scar Assessment Scale, whereas erythema and pigmentation were measured with a reflectance spectrophotometry device (Mexameter, Courage + Khazaka electronic GmbH, Köln,Germany). Histological analysis and electron scan microscopy of tissue biopsies were performed at 8 months.
The treated side of the scar showed significantly less erythema at 3- and 6-month follow-ups, but this difference reduced after 12 months. Patients reported better scar scores at the 6-month follow-up with a significantly better color at the treated side. Observers reported better overall scar scores at the treated side at 3-, 6-, and 12-month follow-ups, with better vascularization, pigmentation, and thickness. There was no statistically significant difference in terms of histological analysis between the 2 groups. There was no difference in the occurrence of adverse events between both sides.
Infiltration of nanofat exhibited promising results in surgical scar maturation characterized by less erythema and better texture. More clinical trials with a larger sample size are warranted to better elucidate the possible benefits of SVF on surgical scar formation.
基质血管成分（SVF）在伤口愈合和瘢痕形成中的再生特性是临床上日益关注的课题。
尽管临床前研究已证实SVF具有血管生成、增殖和抗纤维化特性，但随机对照临床试验的临床证据有限。
本临床研究纳入12例行腹部整形术的患者。术中机械获取纳米脂肪并将其皮内注射到缝合的手术伤口中，随机分配至左侧或右侧。采用患者和观察者瘢痕评估量表评估腹部瘢痕，同时使用反射分光光度计（Mexameter，德国科隆市Courage + Khazaka电子有限公司）测量红斑和色素沉着情况。在8个月时对组织活检标本进行组织学分析和电子扫描显微镜检查。
在3个月和6个月随访时，瘢痕治疗侧的红斑明显较少，但12个月后这种差异减小。患者报告在6个月随访时瘢痕评分更好，治疗侧颜色明显更佳。观察者报告在3个月、6个月和12个月随访时，治疗侧的总体瘢痕评分更好，血管化、色素沉着和厚度更佳。两组之间的组织学分析无统计学显著差异。两侧不良事件的发生率无差异。
纳米脂肪注射在手术瘢痕成熟方面显示出有前景的结果，表现为红斑较少且质地更佳。需要更多样本量更大的临床试验，以更好地阐明SVF对手术瘢痕形成的潜在益处。
