Autologous fat grafting does not improve burn scar appearance: A prospective, randomized, double-blinded, placebo-controlled, pilot study

Gal, Shaili; Ramirez, Jesus I; Maguina, Pirko

doi:10.1016/j.burns.2016.09.019

Cited by 39 publications

(35 citation statements)

References 8 publications

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“…In 2017, Gal et al 56 published an 8-patient pilot trial in pediatric burn patients using a prospective, randomized, double-blinded, placebo-controlled study design. Sites were randomized to treatment with fat grafting or saline at a dose of 0.2 ml/cm 2 , and follow-up ranged from 5 months to 1 year (average 8 months).…”

Section: Discussionmentioning

confidence: 99%

Autologous Fat Transfer for Scar Prevention and Remodeling: A Randomized, Blinded, Placebo-controlled Trial

Brown

Shang

Yang

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: Autologous fat transfer—also referred to as fat grafting—has been reported to provide beneficial effects to overlying scar and skin. Despite procedural frequency, there is a paucity of high-level evidence guiding the surgeon in technique, patient selection, and efficacy. Methods: A multicenter, double-blinded, randomized, internally placebo-controlled trial was performed with an aim to qualitatively and quantitatively evaluate the impact of autologous fat transfer on the quality of overlying scar tissue. Fat-grafted scars were evaluated and compared with paired, saline-injected “control” scars. Subjective and objective metrics were evaluated in treated sites for 12 months after treatment. Results: Blinded qualitative results demonstrated a statistically significant improvement in scar quality over time in fat-grafted scars. However, these improvements were not found to be statistically different from changes noted in scars treated with saline. In addition, objective metrics did not statistically differ between saline-injected and autologous fat-grafted scars. Conclusions: Our results demonstrate that autologous fat grafting can improve the qualitative profile of a scar from both the patient and observer perspectives. However, there was no difference in improvement when compared with scars that were treated with saline in a randomized and blinded fashion. These results demonstrate that any improvements in scar quality related to fat grafting are also achieved using saline and suggest that mechanisms other than cell activity may be at play. Additional randomized, blinded, placebo-controlled trials are required to either corroborate or contest the putative beneficial effect(s) of adipose tissue on scar remodeling.

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Section: Discussionmentioning

confidence: 99%

Autologous Fat Transfer for Scar Prevention and Remodeling: A Randomized, Blinded, Placebo-controlled Trial

Brown

Shang

Yang

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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“…Many studies have demonstrated the benefits of autologous fat grafting in improving scar appearance, skin characteristics, scar related pain, and volume restoration of scarred tissue. 44,45 These benefits are more commonly reported in adult patients, and evidence for these same effects in the pediatric population is relatively scarce. 44,45 A small number of case reports have demonstrated improvements in scar appearance in pediatric patients after treatment with fat transfer combined with other techniques, such as z-plasty, pulsed dye laser, and ablative fractional laser resurfacing.…”

Section: Scarsmentioning

confidence: 99%

“…44,45 These benefits are more commonly reported in adult patients, and evidence for these same effects in the pediatric population is relatively scarce. 44,45 A small number of case reports have demonstrated improvements in scar appearance in pediatric patients after treatment with fat transfer combined with other techniques, such as z-plasty, pulsed dye laser, and ablative fractional laser resurfacing. 46,47 Another study demonstrated improved appearance and functionality of surgical scars in children after fat grafting alone.…”

Section: Scarsmentioning

confidence: 99%

“…48 In contrast, one randomized controlled trial demonstrated that single treatment with autologous fat grafting in pediatric patients did not improve the appearance of mature burn scars compared with normal saline injections. 45 The overall lack of data regarding fat grafting for scar management in the pediatric setting and reports of conflicting outcomes suggest that further investigation is required to better understand this particular application.…”

Section: Scarsmentioning

confidence: 99%

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Applications of Fat Grafting in Pediatric Patients

Shih

Abu‐Ghname

Davis

et al. 2020

Seminars in Plastic Surgery

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Autologous fat grafting has become a widely utilized technique for a variety of cosmetic and reconstructive procedures. Its potential for volume restoration and tissue regeneration has made it a popular method for treating soft tissue defects in both adult and pediatric populations. While autologous fat grafting in the pediatric setting is not as well characterized as it is in the adult setting, various reports have demonstrated the safety and utility of its applications in nonadult patient populations. In this article, we present the first comprehensive review of the current applications of autologous fat grafting in pediatric patients. Specific challenges to fat grafting in the pediatric setting and future applications will also be discussed.

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“…Despite the fact that improvements in scar size/texture, enhancement of angiogenesesis, alleviation of inflammation/pain and improved function were observed, no clear and statistical significant conclusions could be made and ASC isolation protocols varied. On the contrary, Gal et al [43] examined the use of fat grafts in pediatric burn scars in a prospective, randomized, double-blinded, placebo-controlled pilot study in eight patients and found no evidence for scar improvement. Of course, the number of patients in Meng et al [44] 's study is low, but its scientifically sound study design, when compared to most other hitherto published clinical trials, adds to the strength of the work.…”

Section: Clinical Application Of Ascs In Cutaneous Wound Repairmentioning

confidence: 99%

Adipose-derived stem cells in cutaneous wound repair

Kim¹,

Debye²,

Beier³

2018

PAR

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Growing interest in regenerative medicine and advances in adipose tissue research have led to the identification of mesenchymal stem cells in adipose tissue, so called adipose tissue-derived stem cells (ASCs). Due to the simple and safe harvest technique as well as high regenerative capacity, ASCs are regarded as a potential source for various indications including cutaneous wound repair. This review provides a short overview over mechanisms of ASC action in cutaneous wound repair and data regarding its clinical application. Mostly experimental data provide accruing evidence for the supportive effect of ASCs in cutaneous wound healing by secretion of soluble factors, differentiation into keratinocyte and fibroblasts, neovascularization and interaction with myofibroblasts. A number of in vivo experiments also support a positive effect of ASCs in different wound healing models. Furthermore, first clinical data evaluated the feasibility of ASCs in the treatment of different wound healing pathologies, e.g., chronic ulcers and burn wounds. Although the majority of currently available data indicate a beneficial role of ASCs in cutaneous wound repair, additional detailed experimental studies and larger, high-quality clinical trials are required to provide a reliable statement on the true value of ASCs in this context.

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Autologous fat grafting does not improve burn scar appearance: A prospective, randomized, double-blinded, placebo-controlled, pilot study

Cited by 39 publications

References 8 publications

Autologous Fat Transfer for Scar Prevention and Remodeling: A Randomized, Blinded, Placebo-controlled Trial

Autologous Fat Transfer for Scar Prevention and Remodeling: A Randomized, Blinded, Placebo-controlled Trial

Applications of Fat Grafting in Pediatric Patients

Adipose-derived stem cells in cutaneous wound repair

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