Protocol for a systematic review of autologous fat grafting for wound healing

Luck, Joshua; Smith, Oliver J.; Malik, Dean; Mosahebi, Afshin

doi:10.1186/s13643-018-0769-7

Cited by 13 publications

(11 citation statements)

References 24 publications

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“…All authors agreed on the study selection criteria during the protocol stage (PROSPERO ID: CRD42017081499). 12 All primary clinical studies using AFG in human subjects for acute or chronic cutaneous wounds (defined as loss of epithelial continuity) of any depth were included. This included randomized controlled and observational studies with ≥3 participants.…”

Section: Methodsmentioning

confidence: 99%

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A Systematic Review of Autologous Fat Grafting in the Treatment of Acute and Chronic Cutaneous Wounds

Malik

Luck

Smith

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: There is a growing interest in the regenerative potential of autologous fat. Adipose-derived stem cells, within the stromal vascular fraction of lipoaspirate samples, demonstrate anti-inflammatory, immunomodulatory, and angiogenic properties. This systematic review aimed to determine the efficacy and safety of autologous fat therapies for wound healing, with an evaluation of the quality of evidence provided by the literature. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched Ovid Medline, Embase, and Cochrane Library databases from inception to November 2018. We included all human studies where wounds were treated with lipotransfer, cell-assisted lipotransfer, stromal vascular fraction products, or isolated adipose-derived stem cells. Study screening and data extraction were performed by 2 authors. The quality of evidence was evaluated using the GRADE approach. Results: The search strategy returned 5027 citations. From these, 10 observational case series were included in the qualitative synthesis; there were no randomized controlled trials. Patient characteristics, wound etiology, and intervention type differed markedly between studies, precluding formal meta-analysis. Autologous fat grafting was associated with satisfactory wound healing in all studies with low complication rates. However, the quality of evidence was consistently very low. Conclusions: Autologous fat grafting is an emerging therapeutic option for challenging wounds, although there is insufficient evidence to conclusively demonstrate its effectiveness and adverse event profile. Based on the literature to date, it is unclear whether one type of autologous fat therapy is superior. Well-designed, blinded, prospective randomized controlled trials with adequate methodologic details and objective outcome measure reporting are essential. PROSPERO ID: CRD42017081499.

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Section: Methodsmentioning

confidence: 99%

“…The protocol for this systematic review was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO) (PROSPERO ID: CRD42017081499) and published in full before this review was conducted. 12 …”

Section: Introductionmentioning

confidence: 99%

A Systematic Review of Autologous Fat Grafting in the Treatment of Acute and Chronic Cutaneous Wounds

Malik

Luck

Smith

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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“…Clinical trials of SVF in the treatment of wound defects are not numerous at the moment. However, there are descriptions of the effects of accelerating neovascularization and epithelialization, as well as of the stabilization of inflammation, in a number of published studies ( 38 - 40 ).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and Safety of Transplantation of the Stromal Vascular Fraction of Autologous Adipose Tissue for Wound Healing in the Donor Site in Patients with Third-Degree Skin Burns: A Randomized Trial

Ryabkov,

Egorikhina,

Koloshein

et al. 2023

MJIRI

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Background The quality of the wound healing at the donor site significantly determines the overall condition of the burn patient, the extent of wound fluid and protein losses, the severity of any systemic in-flammatory reaction, and the intensity of the pain syndrome. It is known that the stromal vas-cular fraction (SVF) has a beneficial effect on the healing of wound defects. This study is aimed at assessing the safety and effectiveness of the application of the SVF of autologous adipose tis-sue to stimulate wound healing of the donor site in patients with burns. Methods This placebo-controlled clinical study included 38 patients with third-degree thermal skin burns. The patients underwent liposuction, enzymatic isolation of the SVF, and intradermal injection of the preparation into the wounds in the donor site, followed by tewametry, cutome-try, thermography and biopsy after 12 days. Quantitative indicators were compared using the Mann-Whitney test for unrelated groups and the Wilcoxon test for related groups. Spearman's rank correlation coefficient (RS) was used to assess the correlation Results Epithelization of the wounds in all patients was seen over an average area of 88 (84;92) %, there being no significant differences between the actual and the control wound sites for this parameter. Transdermal water loss in the test wound sites was 2 times lower than in the control sites ( P = 0.001). The wound donor sites regained their temperature distribution faster than the control sites ( P = 0.042). Histological preparations of the skin of the wound sites revealed that their epidermal layer was 19% thicker compared to the controls ( P = 0.043). It should be noted that five adverse events related to manipulations in the postoperative period were registered. Conclusion Transplantation of SVF autologous adipose tissue into the wound area in most clinical cases proceeded without complications. The area of epithelialization of wound areas af-ter the introduction of SVF did not change, although a significant decrease in transdermal water loss was observed in the wound areas with an improvement in their thermoregulation and an increase in the thickness of the epidermis.

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“…They also release pro-healing growth factors and anti-inflammatory cytokines [15] as well as healing-related peptides such as leptin and adiponectin that together may enhance wound healing [16]. Several studies have shown that autologous fat grafting may show significant healing qualities in different clinical situations such as chronically scarred tissue after radiotherapy [17], chronic wounds [18], arterial ulcers [19], pressure ulcers, and diabetic foot ulcers [20].…”

Section: Introductionmentioning

confidence: 99%

Lipoaspirate Shows In Vitro Potential for Wound Healing

et al. 2022

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Mesenchymal stem cells (MSCs) are a promising therapy in wound healing, although extensive time and manipulation are necessary for their use. In our previous study on cartilage regeneration, we demonstrated that lipoaspirate acts as a natural scaffold for MSCs and gives rise to their spontaneous outgrowth, together with a paracrine effect on resident cells that overcome the limitations connected to MSC use. In this study, we aimed to investigate in vitro whether the microfragmented adipose tissue (lipoaspirate), obtained with Lipogems® technology, could promote and accelerate wound healing. We showed the ability of resident cells to outgrow from the clusters of lipoaspirate encapsulated in a 3D collagen substrate as capability of repopulating a culture of human skin. Moreover, we demonstrated that the in vitro lipoaspirate paracrine effect on fibroblasts and keratinocytes proliferation, migration, and contraction rate is mediated by the release of trophic/reparative proteins. Finally, an analysis of the paracrine antibacterial effect of lipoaspirate proved its ability to secrete antibacterial factors and its ability to modulate their secretion in culture media based on a bacterial stimulus. The results suggest that lipoaspirate may be a promising approach in wound healing showing in vitro regenerative and antibacterial activities that could improve current therapeutic strategies.

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Protocol for a systematic review of autologous fat grafting for wound healing

Cited by 13 publications

References 24 publications

A Systematic Review of Autologous Fat Grafting in the Treatment of Acute and Chronic Cutaneous Wounds

A Systematic Review of Autologous Fat Grafting in the Treatment of Acute and Chronic Cutaneous Wounds

Effectiveness and Safety of Transplantation of the Stromal Vascular Fraction of Autologous Adipose Tissue for Wound Healing in the Donor Site in Patients with Third-Degree Skin Burns: A Randomized Trial

Lipoaspirate Shows In Vitro Potential for Wound Healing

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