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Fat grafting associated with negative pressure wound therapy

PURPOSE: To describe a case report of FG associated with NPWT in the treatment of complex wound on the distal third of the lower limb with bone exposure. CASE REPORT: A 59-year-old patient with chronic left tibial osteomyelitis since childhood underwent extensive debridement of the distal tibial dia...

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Autores principales: de Souza, Gustavo Moreira Costa, Amorim, Camila Camargos Bizzotto, Vallejo, Cristian Esteban Astudillo, Sternick, Marcelo Back, da Costa, Sergio Moreira, Sobral, Christiane Steponavicius, Ferreira, Lydia Masako
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889860/
https://www.ncbi.nlm.nih.gov/pubmed/31800680
http://dx.doi.org/10.1590/s0102-865020190090000007
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author de Souza, Gustavo Moreira Costa
Amorim, Camila Camargos Bizzotto
Vallejo, Cristian Esteban Astudillo
Sternick, Marcelo Back
da Costa, Sergio Moreira
Sobral, Christiane Steponavicius
Ferreira, Lydia Masako
author_facet de Souza, Gustavo Moreira Costa
Amorim, Camila Camargos Bizzotto
Vallejo, Cristian Esteban Astudillo
Sternick, Marcelo Back
da Costa, Sergio Moreira
Sobral, Christiane Steponavicius
Ferreira, Lydia Masako
author_sort de Souza, Gustavo Moreira Costa
collection PubMed
description PURPOSE: To describe a case report of FG associated with NPWT in the treatment of complex wound on the distal third of the lower limb with bone exposure. CASE REPORT: A 59-year-old patient with chronic left tibial osteomyelitis since childhood underwent extensive debridement of the distal tibial diaphysis (40% of bone thickness per 10 cm extension) and placement of bioactive glass S53P4. Distal necrosis occurred in the fasciocutaneous flap used as the primary bone coverage. After flap debridement, the case was resolved with FG, directly on the exposed bone and biomaterial, associated with NPWT. Three weeks after the first FG session over bony tissue, 100% granulation was achieved with NPWT. The closure was completed with thin laminated skin graft over the granulated wound area. DISCUSSION: The association of FG and NPWT is not known in the clinical practice. Except for the only one experimental study described by Kao et al. (4) , the theme was not addressed in the medical literature before. In this clinical case, the result obtained regarding the granulation tissue formation drew attention and prevented the use of more complex flaps such as the microsurgical ones. Accelerated granulation tissue formation was observed, filling an extensive and deep bone defect, even with infected bone and biomaterial. Low morbidity and no complications were observed with the use of FG associated with NPWT. When the grafted fat was compacted with the NPWT, it seemed to behave as a true autologous biological matrix with large amount of cells. To date, scientific studies on fat grafting have focused on the cellular aspect (adipocytes and mesenchymal cells), growth factors and fat differentiation in different tissues. The property of aspirated adipose tissue as a biological matrix seemed to be revealed by the application of NPWT in association with FG. This new roll for the aspirated fat tissue may represent a new research field in plastic surgery.
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spelling pubmed-68898602019-12-11 Fat grafting associated with negative pressure wound therapy de Souza, Gustavo Moreira Costa Amorim, Camila Camargos Bizzotto Vallejo, Cristian Esteban Astudillo Sternick, Marcelo Back da Costa, Sergio Moreira Sobral, Christiane Steponavicius Ferreira, Lydia Masako Acta Cir Bras Short Communication PURPOSE: To describe a case report of FG associated with NPWT in the treatment of complex wound on the distal third of the lower limb with bone exposure. CASE REPORT: A 59-year-old patient with chronic left tibial osteomyelitis since childhood underwent extensive debridement of the distal tibial diaphysis (40% of bone thickness per 10 cm extension) and placement of bioactive glass S53P4. Distal necrosis occurred in the fasciocutaneous flap used as the primary bone coverage. After flap debridement, the case was resolved with FG, directly on the exposed bone and biomaterial, associated with NPWT. Three weeks after the first FG session over bony tissue, 100% granulation was achieved with NPWT. The closure was completed with thin laminated skin graft over the granulated wound area. DISCUSSION: The association of FG and NPWT is not known in the clinical practice. Except for the only one experimental study described by Kao et al. (4) , the theme was not addressed in the medical literature before. In this clinical case, the result obtained regarding the granulation tissue formation drew attention and prevented the use of more complex flaps such as the microsurgical ones. Accelerated granulation tissue formation was observed, filling an extensive and deep bone defect, even with infected bone and biomaterial. Low morbidity and no complications were observed with the use of FG associated with NPWT. When the grafted fat was compacted with the NPWT, it seemed to behave as a true autologous biological matrix with large amount of cells. To date, scientific studies on fat grafting have focused on the cellular aspect (adipocytes and mesenchymal cells), growth factors and fat differentiation in different tissues. The property of aspirated adipose tissue as a biological matrix seemed to be revealed by the application of NPWT in association with FG. This new roll for the aspirated fat tissue may represent a new research field in plastic surgery. Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia 2019-11-28 /pmc/articles/PMC6889860/ /pubmed/31800680 http://dx.doi.org/10.1590/s0102-865020190090000007 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Short Communication
de Souza, Gustavo Moreira Costa
Amorim, Camila Camargos Bizzotto
Vallejo, Cristian Esteban Astudillo
Sternick, Marcelo Back
da Costa, Sergio Moreira
Sobral, Christiane Steponavicius
Ferreira, Lydia Masako
Fat grafting associated with negative pressure wound therapy
title Fat grafting associated with negative pressure wound therapy
title_full Fat grafting associated with negative pressure wound therapy
title_fullStr Fat grafting associated with negative pressure wound therapy
title_full_unstemmed Fat grafting associated with negative pressure wound therapy
title_short Fat grafting associated with negative pressure wound therapy
title_sort fat grafting associated with negative pressure wound therapy
topic Short Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6889860/
https://www.ncbi.nlm.nih.gov/pubmed/31800680
http://dx.doi.org/10.1590/s0102-865020190090000007
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