Skip to main content
Erschienen in: Aesthetic Plastic Surgery 3/2008

01.05.2008 | Original Article

Fat Injection for Cases of Severe Burn Outcomes: A New Perspective of Scar Remodeling and Reduction

verfasst von: M. Klinger, M. Marazzi, D. Vigo, M. Torre

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 3/2008

Einloggen, um Zugang zu erhalten

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 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.
Literatur
1.
Zurück zum Zitat Alster CS, Williams CM (1995) Treatment of keloid sternotomy scars by the 585-nm flashlamp-pumped pulsed-dye laser. Lancet 345:1198–1200PubMedCrossRef Alster CS, Williams CM (1995) Treatment of keloid sternotomy scars by the 585-nm flashlamp-pumped pulsed-dye laser. Lancet 345:1198–1200PubMedCrossRef
2.
Zurück zum Zitat Billings E Jr, May JW Jr (1989) Historical review and present status of free fat graft autotransplantation in plastic and reconstructive surgery. Plast Reconstr Surg 83:368–381PubMedCrossRef Billings E Jr, May JW Jr (1989) Historical review and present status of free fat graft autotransplantation in plastic and reconstructive surgery. Plast Reconstr Surg 83:368–381PubMedCrossRef
3.
Zurück zum Zitat Boyadjiev C, Popchristova E, Mazgalova J (1995) Histomorphologic changes in keloids treated with Kenacort. J Trauma 38:299–302PubMedCrossRef Boyadjiev C, Popchristova E, Mazgalova J (1995) Histomorphologic changes in keloids treated with Kenacort. J Trauma 38:299–302PubMedCrossRef
4.
Zurück zum Zitat Carney SA, Cason CG, Gowar JP, Stevenson JH, McNee J, Groves AR, Thomas SS, Hart NB, Auclair P (1995) Cica-Care gel sheeting in the management of hypertrophic scarring. Burns 20:163–167CrossRef Carney SA, Cason CG, Gowar JP, Stevenson JH, McNee J, Groves AR, Thomas SS, Hart NB, Auclair P (1995) Cica-Care gel sheeting in the management of hypertrophic scarring. Burns 20:163–167CrossRef
5.
Zurück zum Zitat Carr-Collins JA (1992) Pressure techniques for the prevention of hypertrophic scar. Clin Plast Surg 19:733–743PubMed Carr-Collins JA (1992) Pressure techniques for the prevention of hypertrophic scar. Clin Plast Surg 19:733–743PubMed
6.
Zurück zum Zitat Coleman SR (1997) Facial recontouring with lipostructure. Clin Plast Surg 24:347–367PubMed Coleman SR (1997) Facial recontouring with lipostructure. Clin Plast Surg 24:347–367PubMed
7.
Zurück zum Zitat Coleman SR (1995) Long-term survival of fat transplants: Controlled demonstrations. Aesth Plast Surg 19:421–425CrossRef Coleman SR (1995) Long-term survival of fat transplants: Controlled demonstrations. Aesth Plast Surg 19:421–425CrossRef
8.
Zurück zum Zitat De Ugarte DA, Ashjian PH, Elbarbary A, Hedrick MH (2003) Future of fat as raw material for tissue regeneration. Ann Plast Surg 50:215–219PubMedCrossRef De Ugarte DA, Ashjian PH, Elbarbary A, Hedrick MH (2003) Future of fat as raw material for tissue regeneration. Ann Plast Surg 50:215–219PubMedCrossRef
9.
Zurück zum Zitat Ellenbogen R (2000) Fat transfer: Current use in practice. Clin Plast Surg 27:545–556PubMed Ellenbogen R (2000) Fat transfer: Current use in practice. Clin Plast Surg 27:545–556PubMed
10.
Zurück zum Zitat Ersek RA (1991) Tranplantation of purified autologous fat: A 3-year follow-up is disappointing. Plast Reconstr Surg 87:219–227PubMedCrossRef Ersek RA (1991) Tranplantation of purified autologous fat: A 3-year follow-up is disappointing. Plast Reconstr Surg 87:219–227PubMedCrossRef
11.
Zurück zum Zitat Gibran NS, Heimbach DM (2000) Current status of burn wound pathophysiology. Clin Plast Surg 27:11–22PubMed Gibran NS, Heimbach DM (2000) Current status of burn wound pathophysiology. Clin Plast Surg 27:11–22PubMed
12.
Zurück zum Zitat Harrop AR, Ghahary A, Scott PG, Forsyth N, Uji-Friedland A, Tredget EE (1995) Regulation of collagen synthesis and mRNA expression in normal and hypertrophic scar fibroblasts in vitro by interferon-gamma. J Surg Res 58:471–477PubMedCrossRef Harrop AR, Ghahary A, Scott PG, Forsyth N, Uji-Friedland A, Tredget EE (1995) Regulation of collagen synthesis and mRNA expression in normal and hypertrophic scar fibroblasts in vitro by interferon-gamma. J Surg Res 58:471–477PubMedCrossRef
13.
Zurück zum Zitat Horl HW, Feller AM, Biemer E 1991 Technique for liposuction fat reimplantation and long-term volume evaluation by magnetic resonance imaging. Ann Plast Surg 26:248–258PubMed Horl HW, Feller AM, Biemer E 1991 Technique for liposuction fat reimplantation and long-term volume evaluation by magnetic resonance imaging. Ann Plast Surg 26:248–258PubMed
14.
Zurück zum Zitat Kesselring UK (1983) Regional fat aspiration for body contouring. Plast Reconstr Surg 72:610–619PubMedCrossRef Kesselring UK (1983) Regional fat aspiration for body contouring. Plast Reconstr Surg 72:610–619PubMedCrossRef
15.
Zurück zum Zitat Illouz YG (1983) Body contouring by lipolysis: A 5-year experience with over 3,000 cases. Plast Reconstr Surg 72:591–597PubMedCrossRef Illouz YG (1983) Body contouring by lipolysis: A 5-year experience with over 3,000 cases. Plast Reconstr Surg 72:591–597PubMedCrossRef
16.
Zurück zum Zitat Illouz YG (1988) Present results of fat injection. Aesth Plast Surg 12:175–181CrossRef Illouz YG (1988) Present results of fat injection. Aesth Plast Surg 12:175–181CrossRef
17.
Zurück zum Zitat Lawrence WT (1991) In search of the optimal treatment of keloids: Report of a series and review of the literature. Ann Plast Surg 27:164–178PubMedCrossRef Lawrence WT (1991) In search of the optimal treatment of keloids: Report of a series and review of the literature. Ann Plast Surg 27:164–178PubMedCrossRef
18.
Zurück zum Zitat Mojallal A, Foyatier JL (2004) Historical review of the use of adipose tissue transfer in plastic and reconstructive surgery. Ann Chir Plast Esthét 49:419–425PubMedCrossRef Mojallal A, Foyatier JL (2004) Historical review of the use of adipose tissue transfer in plastic and reconstructive surgery. Ann Chir Plast Esthét 49:419–425PubMedCrossRef
19.
Zurück zum Zitat Neuber GA (1893) Fettransplantation. Langenbecks Arch Klin Chir Ver Dtsch Z Chir 22:66 Neuber GA (1893) Fettransplantation. Langenbecks Arch Klin Chir Ver Dtsch Z Chir 22:66
20.
Zurück zum Zitat Norris JE (1995) Superficial x-ray therapy in keloid management: A retrospective study of 24 cases and literature review. Plast Reconstr Surg 95:1051–1055PubMedCrossRef Norris JE (1995) Superficial x-ray therapy in keloid management: A retrospective study of 24 cases and literature review. Plast Reconstr Surg 95:1051–1055PubMedCrossRef
21.
Zurück zum Zitat Rigotti G, Marchi A, Galie M, Baroni G, Benati D, Krampera M, Pasini A, Sbarbati A (2007) Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: A healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg 119:1409–1422PubMedCrossRef Rigotti G, Marchi A, Galie M, Baroni G, Benati D, Krampera M, Pasini A, Sbarbati A (2007) Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: A healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg 119:1409–1422PubMedCrossRef
22.
Zurück zum Zitat Tholpady SS, Llull R, Ogle RC, Rubin JP, Futrell JW, Katz AJ (2006) Adipose tissue: Stem cells and beyond. Clin Plast Surg 33:55–62PubMedCrossRef Tholpady SS, Llull R, Ogle RC, Rubin JP, Futrell JW, Katz AJ (2006) Adipose tissue: Stem cells and beyond. Clin Plast Surg 33:55–62PubMedCrossRef
23.
Zurück zum Zitat Von Heimburg D, Pallua N (2001) Two-year histological outcome of facial lipofilling. Ann Plast Surg 46:644–646CrossRef Von Heimburg D, Pallua N (2001) Two-year histological outcome of facial lipofilling. Ann Plast Surg 46:644–646CrossRef
24.
Zurück zum Zitat Von Heimburg D, Hemmrich K, Haydarlioglu S, Staiger H, Pallua N (2004) Comparison of viable cell yield from excised versus aspirated adipose tissue. Cells Tissues Organs 178:87–92CrossRef Von Heimburg D, Hemmrich K, Haydarlioglu S, Staiger H, Pallua N (2004) Comparison of viable cell yield from excised versus aspirated adipose tissue. Cells Tissues Organs 178:87–92CrossRef
25.
Zurück zum Zitat Yowler CJ, Fratianne RB (2000) Current status of burn resuscitation. Clin Plast Surg 27:1–10PubMed Yowler CJ, Fratianne RB (2000) Current status of burn resuscitation. Clin Plast Surg 27:1–10PubMed
26.
Zurück zum Zitat Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, Benhaim P, Lorenz HP, Hedrick MH (2001) Multilineage cells from human adipose tissue: Implications for cell-based therapies. Tissue Eng 7:211–228PubMedCrossRef Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, Benhaim P, Lorenz HP, Hedrick MH (2001) Multilineage cells from human adipose tissue: Implications for cell-based therapies. Tissue Eng 7:211–228PubMedCrossRef
27.
Zurück zum Zitat Zuk PA, Zhu M, Ashjian P, De Ugarte DA, Huang JI, Mizuno H, Alfonso ZC, Fraser JK, Benhaim P, Hedrick MH (2002) Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell 13:4279–4295PubMedCrossRef Zuk PA, Zhu M, Ashjian P, De Ugarte DA, Huang JI, Mizuno H, Alfonso ZC, Fraser JK, Benhaim P, Hedrick MH (2002) Human adipose tissue is a source of multipotent stem cells. Mol Biol Cell 13:4279–4295PubMedCrossRef
28.
Zurück zum Zitat Brzoska M, Geiger H, Gauer S, Baer P (2005) Epithelial differentiation of human adipose tissue-derived adult stem cells. Biochem Biophys Res Comm 330:142–150PubMedCrossRef Brzoska M, Geiger H, Gauer S, Baer P (2005) Epithelial differentiation of human adipose tissue-derived adult stem cells. Biochem Biophys Res Comm 330:142–150PubMedCrossRef
Metadaten
Titel
Fat Injection for Cases of Severe Burn Outcomes: A New Perspective of Scar Remodeling and Reduction
verfasst von
M. Klinger
M. Marazzi
D. Vigo
M. Torre
Publikationsdatum
01.05.2008
Verlag
Springer-Verlag
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 3/2008
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-008-9122-1

Weitere Artikel der Ausgabe 3/2008

Aesthetic Plastic Surgery 3/2008 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.