title: The Use of Autologous Fat Grafting for Treatment of Scar Tissue and Scar-Related Conditions: A Systematic Review.
abstract: BACKGROUND
  Scar tissue can cause cosmetic impairments, functional limitations, pain, and itch. It may also cause emotional, social, and behavioral problems, especially when it is located in exposed areas. To date, no gold standard exists for the treatment of scar tissue. Autologous fat grafting has been introduced as a promising treatment option for scar tissue-related symptoms. However, the scientific evidence for its effectiveness remains unclear. This systematic review aims to evaluate the available evidence regarding the effectiveness of autologous fat grafting for the treatment of scar tissue and scar-related conditions.
  
  
  METHODS
  A systematic literature review was performed using MEDLINE, Cochrane Library, EMBASE, and Web of Science. No language restrictions were imposed.
  
  
  RESULTS
  Twenty-six clinical articles were included, reporting on 905 patients in total. Meta-analysis was not performed because of the heterogeneous methodology demonstrated among the articles. Main outcome measures were scar appearance and skin characteristics, restoration of volume and/or (three-dimensional) contour, itch, and pain. All publications report a beneficial effect of autologous fat grafting on scar tissue. There is statistical significant improvement of the scar appearance, skin characteristics, and pain. Itch and restoration of volume and three-dimensional contour also improved.
  
  
  CONCLUSIONS
  Autologous fat grafting is used to improve a variety of symptoms related to scar tissue. This systematic review suggests that autologous fat grafting provides beneficial effects with limited side effects. However, the level of evidence and methodological quality are quite low. Future randomized controlled trials with a methodologically strong design are necessary to confirm the effects of autologous fat grafting on scar tissue and scar-related conditions.
authors.affiliation: Amsterdam, The Netherlands From the Department of Plastic, Reconstructive, and Hand Surgery and the EMGO+ Institute for Health and Care Research, VU University Medical Center.
authors.forename: Vera L
authors.initials: VL
authors.lastname: Negenborn
authors.forename: Jan-Willem
authors.initials: JW
authors.lastname: Groen
authors.forename: Jan Maerten
authors.initials: JM
authors.lastname: Smit
authors.forename: Frank B
authors.initials: FB
authors.lastname: Niessen
authors.forename: Margriet G
authors.initials: MG
authors.lastname: Mullender
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D002921:Cicatrix / Q000175:diagnosis / Q000601:surgery*; D017439:Cicatrix, Hypertrophic / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D018570:Risk Assessment; D014182:Transplantation, Autologous; D014945:Wound Healing / Q000502:physiology*