title: Autologous fat graft as treatment of post short stature surgical correction scars.
abstract: BACKGROUND
  Surgical limb lengthening is undertaken to correct pathological short stature. Among the possible complications related to this procedure, painful and retractile scars are a cause for both functional and cosmetic concern. Our team has already shown the efficacy of autologous fat grafting in the treatment of scars with varying aetiology, so we decided to apply this technique to scars related to surgical correction of dwarfism. A prospective study was conducted to evaluate the efficacy of autologous fat grafting in the treatment of post-surgical scars in patients with short-limb dwarfism using durometer measurements and a modified patient and observer scar assessment scale (POSAS), to which was added a parameter to evaluate movement impairment.
  
  
  METHODS
  Between January 2009 and September 2012, 36 children (28 female and 8 male) who presented retractile and painful post-surgical scars came to our unit and were treated with autologous fat grafting. Preoperative and postoperative mean durometer measurements were analysed using the analysis of variance (ANOVA) test and POSAS parameters were studied using the Wilcoxon rank sum test.
  
  
  RESULTS
  There was a statistically significant reduction in all durometer measurements (p-value <0.05) and in all but one of the POSAS parameters (p-value <0.05) following treatment with autologous fat grafting.
  
  
  CONCLUSIONS
  Surgical procedures to camouflage scars on lower limbs are not often used as a first approach and non-surgical treatments often lead to unsatisfactory results. In contrast, our autologous fat grafting technique in the treatment of post-surgical scars has been shown to be a valuable option in patients with short-limb dwarfism.
  
  
  CONCLUSIONS
  There was a reduction of skin hardness and a clinical improvement of all POSAS parameters in all patients treated. Moreover, the newly introduced POSAS parameter appears to be reliable and we recommend that it is included to give a more complete evaluation of patient perception.
authors.affiliation: University of Milan, Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano (Mi) - Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Maione
authors.affiliation: U.O. Complessa di Ortopedia e Traumatologia pediatrica-Azienda Ospedaliera Istituto Ortopedico Gaetano Pini, Milano, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Memeo
authors.affiliation: U.O. Complessa di Ortopedia e Traumatologia pediatrica-Azienda Ospedaliera Istituto Ortopedico Gaetano Pini, Milano, Italy.
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Pedretti
authors.affiliation: U.O. Complessa di Ortopedia e Traumatologia pediatrica-Azienda Ospedaliera Istituto Ortopedico Gaetano Pini, Milano, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Verdoni
authors.affiliation: University of Milan, Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano (Mi) - Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lisa
authors.affiliation: University of Milan, Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano (Mi) - Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Bandi
authors.affiliation: University of Milan, Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano (Mi) - Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Giannasi
authors.affiliation: University of Milan, Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano (Mi) - Italy.
authors.forename: Valeriano
authors.initials: V
authors.lastname: Vinci
authors.affiliation: S.C.T.S.-Istituto Ortopedico Galeazzi, Milano, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mambretti
authors.affiliation: University of Milan, Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano (Mi) - Italy.. Electronic address: marco.klinger@humanitas.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Klinger
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D064592:Autografts; D001852:Bone Lengthening / Q000009:adverse effects* / Q000379:methods; D002921:Cicatrix / Q000473:pathology / Q000601:surgery*; D003286:Contracture / Q000473:pathology / Q000601:surgery*; D004392:Dwarfism / Q000601:surgery*; D004548:Elasticity; D004954:Esthetics; D005260:Female; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007271:Injections, Intradermal; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome
keywords: Autologous fat grafting; Durometer; Lipostructure; Patient and observer scar assessment scale (POSAS); Short stature surgical correction