title: Autologous fat graft in scar treatment.
abstract: BACKGROUND
  Regenerative medicine is an emerging and rapidly evolving field of research and therapy, thanks to new discoveries on stem cells. Adipose tissue is a connective tissue which contains a reserve of mesenchymal stem cells. Clinical improvements in trophic characteristics of teguments after autologous fat graft are well described in literature. In this paper, we present our observation after 6 years of autologous fat graft experience in scar remodeling.
  
  
  METHODS
  All patients recruited had retractile and painful scars compromising the normal daily activity/mobility of the joint involved. We performed surgical procedure with Coleman technique. In 20 patients, we performed a clinical assessment using Patient and Observer Scar Assessment Scale (POSAS) and Durometer measurements.
  
  
  RESULTS
  In all treated scars, a qualitative improvement was shown both from an aesthetic and functional point of view. Most importantly, reduction or complete resolution of pain and increases in scar elasticity were objectively assessable in all cases. In patients studied using Durometer and POSAS score, areas treated with autologous fat graft showed statistically significant reduction in hardness measurements in comparison with areas infiltrated with saline solution. POSAS scores showed a statistically significant reduction of a great deal of POSAS parameters as a result of an improvement of both clinical evaluation and patient perception.
  
  
  CONCLUSIONS
  Injection of processed autologous fat seems to be a promising and effective therapeutic approach for scars with different origin such as burns and other trauma scars, and post-surgery and radiotherapy outcomes. In general, we can affirm that treated areas regain characteristics similar to normal skin, which are clinically objectivable, leading not only to aesthetic but also functional results.
authors.affiliation: From the *Università degli Studi di Milano-U.O. Chirurgia Plastica 2, Dipartimento di Medicina Translazionale, IRCCS Istituto Clinico Humanitas, Rozzano, Milan, and †Università degli Studi di Milano-U.O. Chirurgia Plastica, Multimedica Holding s.p.a., Sesto San Giovanni, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Klinger
authors.forename: Fabio
authors.initials: F
authors.lastname: Caviggioli
authors.forename: Francesco Maria
authors.initials: FM
authors.lastname: Klinger
authors.forename: Silvia
authors.initials: S
authors.lastname: Giannasi
authors.forename: Valeria
authors.initials: V
authors.lastname: Bandi
authors.forename: Barbara
authors.initials: B
authors.lastname: Banzatti
authors.forename: Davide
authors.initials: D
authors.lastname: Forcellini
authors.forename: Luca
authors.initials: L
authors.lastname: Maione
authors.forename: Barbara
authors.initials: B
authors.lastname: Catania
authors.forename: Valeriano
authors.initials: V
authors.lastname: Vinci
mesh_terms: D000061:Accidents, Home; D000063:Accidents, Traffic; D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D064592:Autografts / Q000637:transplantation*; D002056:Burns / Q000601:surgery; D002921:Cicatrix / Q000473:pathology / Q000601:surgery*; D003286:Contracture / Q000601:surgery; D004548:Elasticity; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007271:Injections, Intradermal / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult