Fat Injection for Cases of Severe Burn Outcomes: A New Perspective of Scar Remodeling and Reduction
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ORIGINAL ARTICLE
Fat Injection for Cases of Severe Burn Outcomes: A New Perspective of Scar Remodeling and Reduction M. Klinger Æ M. Marazzi Æ D. Vigo Æ M. Torre
Published online: 28 February 2008 Ó Springer Science+Business Media, LLC 2008
Abstract Background Despite civilization and progress, burns occur frequently in the world. Remarkable discoveries of wound healing mechanisms have been reported. On the other hand, long-term outcomes from burn injuries represent a barrier to improvement of patients’ social, functional, and psychological condition. Lipofilling, described since the 1980s, currently is used for several clinical applications. This study aimed to verify whether lipofilling could ameliorate scar remodeling in three clinical cases. Methods Three adult patients with hemifacial hypertrophic scars and keloids resulting from severe burns 2 to 13 years previously were selected. The patients were treated by injection of adipose tissue harvested from abdominal subcutaneous fat and processed according to Coleman’s technique. Two injections (with a 13-month interval between) were administered at the dermohypodermal junction. Histologic examination of scar tissue This article is being reprinted for ISAPS 50th Anniversary Special Issue. M. Klinger (&) Universita` degli Studi di Milano, Istituto di Chirurgia Plastica, Unita` Operativa di Chirurgia Plastica, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, 20089 Rozzano, Italy e-mail: [email protected] M. Marazzi Centro di Riferimento Regionale Colture Cellulari, Ospedale Niguarda ‘‘Ca’ Granda’’, Milano, Italy D. Vigo Dipartimento di Scienze e Tecnologie Veterinarie per la Sicurezza Alimentare, Universita` degli Studi di Milano, Milano, Italy M. Torre Dipartimento di Chimica Farmaceutica, Universita` degli Studi di Pavia, Pavia, Italy
punch biopsies (hematoxylin-eosin staining) before and after the treatment was performed as well as magnetic resonance scan with contrast. Results The clinical appearance and subjective patient feelings after a 6-month follow-up period suggest considerable improvement in the mimic features, skin texture, and thickness. Histologic examination shows patterns of new collagen deposition, local hypervascularity, and dermal hyperplasia in the context of new tissue, with high correspondence to the original. Conclusions The preliminary results show that lipofilling improves scar quality and suggest a tissue regeneration enhancing process. Keywords Adipose cell Burn Liposuction Scar Stem cell
During the past 20 years, advances in acute burn therapy [25], including cases with involvement of wide surfaces, have been considerable, allowing survival rates to increase significantly thanks to shock, metabolic alteration, and infection management as well as the use of biotechnologies. Despite this, we cannot find the same improvement in long-term burn outcomes, which still are a social, economical, and psychological problem in terms of both functional and aesthetic aspects. The current mainstay treatment for long-term burn outco
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