Cargando…

Burn scar regeneration with the “SUFA” (Subcision and Fat Grafting) technique. A prospective clinical study

BACKGROUND: Treatment of burn scars with traditional surgical techniques is challenging due to recurrent contractures. Fat grafting has been previously used in small clinical series and results are often biased by lack of scientific validating methods. Fat grafting in clinical practice is often eval...

Descripción completa

Detalles Bibliográficos
Autores principales: Gargano, Francesco, Schmidt, Scott, Evangelista, Peter, Robinson-Bostom, Leslie, Harrington, David T., Rossi, Kristie, Guo, Yfan, Liu, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061675/
https://www.ncbi.nlm.nih.gov/pubmed/32158824
http://dx.doi.org/10.1016/j.jpra.2018.05.001
_version_ 1783504436597882880
author Gargano, Francesco
Schmidt, Scott
Evangelista, Peter
Robinson-Bostom, Leslie
Harrington, David T.
Rossi, Kristie
Guo, Yfan
Liu, Paul
author_facet Gargano, Francesco
Schmidt, Scott
Evangelista, Peter
Robinson-Bostom, Leslie
Harrington, David T.
Rossi, Kristie
Guo, Yfan
Liu, Paul
author_sort Gargano, Francesco
collection PubMed
description BACKGROUND: Treatment of burn scars with traditional surgical techniques is challenging due to recurrent contractures. Fat grafting has been previously used in small clinical series and results are often biased by lack of scientific validating methods. Fat grafting in clinical practice is often evaluated for its filler properties and rarely scientifically validated for its potential in dermal regeneration. Animal studies have shown dermal regeneration with new deposition and reorientation of the collagen fiber. Our study aims to apply the validity of in vitro studies to clinical practice. METHODS: Our study prospectively evaluated outcomes in 12 patients treated with the “SUFA” technique (Subcision and Fat Grafting) for debilitating contracted burns scars limiting range of motion. Results were evaluated clinically with the Vancouver scale and by range of motion at 1, 3, 6 and 12 months. Dermal regeneration was evaluated by looking at dermis thickening using high definition ultrasound and scar remodeling looking at reorientation and new deposition of collagen fibers with hematoxylin-eosin histology and monoclonal antibodies against collagen type 1 and 3. RESULTS: Statistically significant clinical improvements in range of motion of the affected joints was observed (P<0.05). Fat reabsorption occurred with a mean of 40%. Thickening of dermis and redistribution and reorientation of the collagen fibers within the dermis was also demonstrated. CONCLUSIONS: Our results present the first clinical scientific evidence of dermal regeneration in fat grafting. Using monoclonal antibodies and high definition ultrasounds, we demonstrate the first evidence of dermis regeneration in a clinical scenario.
format Online
Article
Text
id pubmed-7061675
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-70616752020-03-10 Burn scar regeneration with the “SUFA” (Subcision and Fat Grafting) technique. A prospective clinical study Gargano, Francesco Schmidt, Scott Evangelista, Peter Robinson-Bostom, Leslie Harrington, David T. Rossi, Kristie Guo, Yfan Liu, Paul JPRAS Open Case Reports and Short Communication BACKGROUND: Treatment of burn scars with traditional surgical techniques is challenging due to recurrent contractures. Fat grafting has been previously used in small clinical series and results are often biased by lack of scientific validating methods. Fat grafting in clinical practice is often evaluated for its filler properties and rarely scientifically validated for its potential in dermal regeneration. Animal studies have shown dermal regeneration with new deposition and reorientation of the collagen fiber. Our study aims to apply the validity of in vitro studies to clinical practice. METHODS: Our study prospectively evaluated outcomes in 12 patients treated with the “SUFA” technique (Subcision and Fat Grafting) for debilitating contracted burns scars limiting range of motion. Results were evaluated clinically with the Vancouver scale and by range of motion at 1, 3, 6 and 12 months. Dermal regeneration was evaluated by looking at dermis thickening using high definition ultrasound and scar remodeling looking at reorientation and new deposition of collagen fibers with hematoxylin-eosin histology and monoclonal antibodies against collagen type 1 and 3. RESULTS: Statistically significant clinical improvements in range of motion of the affected joints was observed (P<0.05). Fat reabsorption occurred with a mean of 40%. Thickening of dermis and redistribution and reorientation of the collagen fibers within the dermis was also demonstrated. CONCLUSIONS: Our results present the first clinical scientific evidence of dermal regeneration in fat grafting. Using monoclonal antibodies and high definition ultrasounds, we demonstrate the first evidence of dermis regeneration in a clinical scenario. Elsevier 2018-05-22 /pmc/articles/PMC7061675/ /pubmed/32158824 http://dx.doi.org/10.1016/j.jpra.2018.05.001 Text en © 2018 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Reports and Short Communication
Gargano, Francesco
Schmidt, Scott
Evangelista, Peter
Robinson-Bostom, Leslie
Harrington, David T.
Rossi, Kristie
Guo, Yfan
Liu, Paul
Burn scar regeneration with the “SUFA” (Subcision and Fat Grafting) technique. A prospective clinical study
title Burn scar regeneration with the “SUFA” (Subcision and Fat Grafting) technique. A prospective clinical study
title_full Burn scar regeneration with the “SUFA” (Subcision and Fat Grafting) technique. A prospective clinical study
title_fullStr Burn scar regeneration with the “SUFA” (Subcision and Fat Grafting) technique. A prospective clinical study
title_full_unstemmed Burn scar regeneration with the “SUFA” (Subcision and Fat Grafting) technique. A prospective clinical study
title_short Burn scar regeneration with the “SUFA” (Subcision and Fat Grafting) technique. A prospective clinical study
title_sort burn scar regeneration with the “sufa” (subcision and fat grafting) technique. a prospective clinical study
topic Case Reports and Short Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061675/
https://www.ncbi.nlm.nih.gov/pubmed/32158824
http://dx.doi.org/10.1016/j.jpra.2018.05.001
work_keys_str_mv AT garganofrancesco burnscarregenerationwiththesufasubcisionandfatgraftingtechniqueaprospectiveclinicalstudy
AT schmidtscott burnscarregenerationwiththesufasubcisionandfatgraftingtechniqueaprospectiveclinicalstudy
AT evangelistapeter burnscarregenerationwiththesufasubcisionandfatgraftingtechniqueaprospectiveclinicalstudy
AT robinsonbostomleslie burnscarregenerationwiththesufasubcisionandfatgraftingtechniqueaprospectiveclinicalstudy
AT harringtondavidt burnscarregenerationwiththesufasubcisionandfatgraftingtechniqueaprospectiveclinicalstudy
AT rossikristie burnscarregenerationwiththesufasubcisionandfatgraftingtechniqueaprospectiveclinicalstudy
AT guoyfan burnscarregenerationwiththesufasubcisionandfatgraftingtechniqueaprospectiveclinicalstudy
AT liupaul burnscarregenerationwiththesufasubcisionandfatgraftingtechniqueaprospectiveclinicalstudy