Fat injection for cases of severe burn outcomes: a new perspective of scar remodeling and reduction.
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.
Klinger
M
M
Università degli Studi di Milano, Istituto di Chirurgia Plastica, Unità Operativa di Chirurgia Plastica, IRCCS Istituto Clinico Humanitas, Via Manzoni 56, 20089 Rozzano, Italy. marco.klinger@humanitas.it
Marazzi
M
M
Vigo
D
D
Torre
M
M
D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D002056:Burns / Q000473:pathology / Q000628:therapy*; D002675:Child, Preschool; D002921:Cicatrix / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007267:Injections; D015187:Lipectomy; D008297:Male; D012720:Severity of Illness Index; D033581:Stem Cell Transplantation / Q000379:methods