title: Alleviation of neuropathic scar pain using autologous fat grafting.
abstract: Traumatic wounds inflict small- and large-fiber sensory nerve damage, causing neuropathic pain in scar tissue, thus impairing patients' quality of life and leading to the development of psychological disorders. Autologous fat grafting has been clinically shown to improve scar quality, but few studies have explored the effects of this technique on pain. The purpose of this study was to assess the effect of fat grafting on treating neuropathic scar pain. From February 2008 to January 2013, 13 patients who were identified using the Douleur Neuropathique 4 Questions (scores>4/10) were enrolled in this study. The Visual Analog Scale (VAS) and Neuropathic Pain Symptom Inventory (NPSI) were used to evaluate pain preoperatively and 1 week, 4 weeks, and 24 weeks postoperatively. The mechanism of trauma, scar location and size, duration of allodynia, fat graft volume, pharmacologic therapy duration, and total follow-up time were recorded. Thirteen patients experiencing neuropathic pain were enrolled in this study. The mean±SD age was 33.08±16.35 years. The mean duration of pain was 4.29±2.85 months. The mean VAS score before treatment was 7.54±1.05. The mean VAS scores decreased by 4.38±1.66 after 1 week of treatment (P=0.009), 5.38±2.06 after 4 weeks of treatment, and 5.62±2.18 after 24 weeks of treatment. The mean NPSI scores were 49.38±13.25 before treatment, 25±14.4 after 1 week of treatment (P=0.004), 21±17.78 after 4 weeks of treatment, and 14.62±16.88 after 24 weeks of treatment. The 13 patients followed a mean of 24 weeks; 10 (77%) of the patients had improvement of 5 or greater on the VAS score. The mean follow-up period was 19.3±12.26 months (range, 6-38 months). No surgical complications were noted in this series. In our study, both VAS and NPSI scores decreased significantly, revealing that the autologous fat grafting can alleviate neuropathic scar pain 1 week after operation and in the long term.
authors.affiliation: From the *Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, †Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ‡Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, §Center for Stem Cell Research, Kaohsiung Medical University, Kaohsiung, Taiwan, and ∥Department of Anesthesia, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Shu-Hung
authors.initials: SH
authors.lastname: Huang
authors.forename: Sheng-Hua
authors.initials: SH
authors.lastname: Wu
authors.forename: Kao-Ping
authors.initials: KP
authors.lastname: Chang
authors.forename: Cen-Hung
authors.initials: CH
authors.lastname: Lin
authors.forename: Chih-Hau
authors.initials: CH
authors.lastname: Chang
authors.forename: Yi-Chia
authors.initials: YC
authors.lastname: Wu
authors.forename: Su-Shin
authors.initials: SS
authors.lastname: Lee
authors.forename: Sin-Daw
authors.initials: SD
authors.lastname: Lin
authors.forename: Chung-Sheng
authors.initials: CS
authors.lastname: Lai
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D000368:Aged; D064592:Autografts; D002921:Cicatrix / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D009437:Neuralgia / Q000209:etiology / Q000601:surgery*; D059408:Pain Management / Q000379:methods*; D055815:Young Adult