Evidences of autologous fat grafting for the treatment of keloids and hypertrophic scars

Silva, Vinícius Zolezi da; Neto, Antonio Vieira da Silva; Horácio, Grazielle De Souza; Andrade, Guilherme Augusto Magalhães de; Procópio, Leandro Debs; Coltro, Pedro Soler; Júnior, Jayme Adriano Farina

doi:10.1590/1806-9282.62.09.862

Cited by 19 publications

(21 citation statements)

References 18 publications

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“…Fat grafting has recently been explored as an adjuvant therapy for keloid and hypertrophic scars. 144 It has been shown to improve scar cosmesis and enhance tissue regeneration in burns patients with keloids. 145,146 The underlying mechanisms by which fat grafting augments scar quality are not clear.…”

Section: Emerging Treatmentsmentioning

confidence: 99%

Keloids: Current and emerging therapies

Ojeh

Bharatha

Gaur

et al. 2020

Scars, Burns & Healing

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Keloids are pathological scars that grow over time and extend beyond the initial site of injury after impaired wound healing. These scars frequently recur and rarely regress. They are aesthetically disfiguring, can cause pain, itching, discomfort as well as psychological stress, often affecting quality of life. Many treatment modalities, including surgical and non-surgical, have been explored and have been reported to be beneficial; however, none have been absolutely satisfactory or optimal for the treatment of all keloid subtypes to date. This poses a major challenge to clinicians. Often, a combinational therapeutic approach appears to offer the best results with higher patient satisfaction compared to monotherapy. The aetiopathogenesis of keloids is not fully elucidated; however, with recent advances in molecular biology and genetics, insight is being gained on the complex process of scar formation and hence new therapeutic and management options for keloids. In this paper, we explore the literature and summarise the general concepts surrounding keloid development and review both current (corticosteroids, surgical excision, silicone-based products, pressure therapy, radiotherapy, cryotherapy, laser therapy, imiquimod and 5-fluorouracil) and emerging (stem cell therapy, mitomycin C, verapamil, interferons, bleomycin, botulinum toxin type A and angiotensin-converting enzyme inhibitors) treatments. Increased knowledge and understanding in this area may potentially lead to the discovery and development of novel therapeutic options that are more efficacious for all keloid types. Lay Summary [Formula: see text] Keloids are problematic scars that are difficult to treat and manage. The aetiopathogenesis of keloids is not clear; however, recent advances in molecular biology and genetics are beginning to shed light on the underlying mechanisms implicated in keloid scar formation which will hopefully lead to the development of treatment options for all keloid types. This review summarises current and emerging therapies.

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Section: Emerging Treatmentsmentioning

confidence: 99%

Keloids: Current and emerging therapies

Ojeh

Bharatha

Gaur

et al. 2020

Scars, Burns & Healing

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“…However, their translation into clinical application continues to be limited because of unresolved concerns related to safety, potential tumorigenicity, and effects on fibroblasts 103 . Autologous fat grafting is another method that is being tested because of the lack of adequate results with the current treatments available 104 . Silva and colleagues reviewed the studies of this treatment for hypertrophic scars and keloids 104 .…”

Section: Discussionmentioning

confidence: 99%

Keloids: a review of therapeutic management

et al. 2020

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Keloid scar formation arises from a disorganized fibroproliferative collagen response that extends beyond the original wound margins because of excessive production of extracellular matrix (ECM). Despite treatment options for keloid scars including medical and surgical therapies, such as intralesional steroid injection and surgical excision, the recurrence rate remains high. Herein we consolidate recently published narrative reviews, systematic reviews, and meta‐analyses to provide an overview of updated treatment recommendations for keloidal scar formation. PubMed search engine was used to access the MEDLINE database to investigate updates regarding keloid incidence and treatment. More than 100 articles were reviewed. Keloid management remains a multimodal approach. There continues to be no gold standard of treatment that provides a consistently low recurrence rate; however, the increasing number of available treatments and synergistic combinations of these treatments (i.e., laser‐based devices in combination with intralesional steroids, or 5‐fluorouracil (5‐FU) in combination with steroid therapy) is showing favorable results. Future studies could target the efficacy of novel treatment modalities (i.e., autologous fat grafting or stem cell‐based therapies) for keloid management. This review article provides updated treatment guidelines for keloids and discusses insight into management to assist patient‐focused, evidence‐based clinical decision making.

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“…lipotransfer) for patients with keloids has been exemplified in several studies. [82][83][84] In three clinical cases, fat injection at the dermalhypodermal junction in hemifacial hypertrophic scars and keloids led to substantial improvement in skin texture, softness, thickness and elasticity after a six-month follow-up period. 82 Another study also demonstrated that autologous fat grafting in 18 patients with post-burn hypertrophic scars and keloids improved texture, colour, softness, thickness and elasticity of the treated skin.…”

Section: Fat Graftingmentioning

confidence: 98%

“…It seems that transfer of adipose tissue-derived stem cells (ADSCs) into wounds plays a key role in inhibiting keloid fibroblast proliferation and ECM formation. 84…”

Section: Fat Graftingmentioning

confidence: 99%

Emerging and Novel Therapies for Keloids

Memariani

Moravvej

et al. 2021

Sultan Qaboos Univ Med J

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Keloids are abnormal fibroproliferative scars with aggressive dermal growth expanding beyond the borders of the original injury. Different therapeutic modalities, such as corticosteroids, surgical excision, topical silicone gel sheeting, laser therapy, cryotherapy, photodynamic therapy and radiotherapy, have been used to treat keloids; however, none of these modalities has proven completely effective. Recently, researchers have devised several promising anti-keloid therapies including anti-hypertensive pharmaceuticals, calcineurin inhibitors, electrical stimulation, mesenchymal stem cell therapy, microneedle physical contact and ribonucleic acid-based therapies. The present review summarises emerging and novel treatments for keloids. PubMed® (National Library of Medicine, Bethesda, Maryland, USA), EMBASE (Elsevier, Amsterdam, Netherlands) and Web of Science (Clarivate Analytics, Philadelphia, Pennsylvania, USA) were searched for relevant literature published between January 1987 to June 2020. A total of 118 articles were included in this review. A deeper understanding of the molecular mechanisms underlying keloid scarring pathogenesis would open further avenues for developing innovative treatments. KEYWORDS Keloid; Treatment; Fibroblast; Scar; Dermatology.

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Evidences of autologous fat grafting for the treatment of keloids and hypertrophic scars

Cited by 19 publications

References 18 publications

Keloids: Current and emerging therapies

Keloids: Current and emerging therapies

Keloids: a review of therapeutic management

Emerging and Novel Therapies for Keloids

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