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Skar Tedavisinde Güncel Bir Yaklaşım: Nanofat Greft

Year 2018, Volume: 4 Issue: 2, 175 - 181, 01.01.2018

Abstract

Amaç: Vücuttaki skarlar, hastalar için estetik bir problem oluşturmanın yanısıra, özgüveni sarsarak sosyal hayatta iletişimi bozan ciddi durumlara da sebep olabilmektedir. Çalışmamızda yakın zamanda Tonnard tarafından tarif edilen 'nanofat greftin', yağ enjeksiyonu ile kombine kullanılmasının skar tedavisindeki etkisini araştırdık.Gereç ve Yöntemler: Çalışmamıza 20-42 yaş arasında yüzünde veya vücudunda skar nedeni ile Kasım 2016-Ocak 2018 arasında başvuran 7 hasta dahil edildi. 5 hastada skar yüzde, bir hastada göğüs ön yüz ve 1 hastada karında yerleşmişti. Bütün skar hastalarında deplase olan alanlara subkutan mikrofat enjeksiyonu uygulandı. Takiben bütün skar yüzeyini kaplayacak şekilde intradermal olarak nanofat enjeksiyonu yapıldı. Hastalar tedaviden 6 ay sonra deri kalitesinde artma ve skarda düzelme açısından doktor ve hasta tarafından değerlendirilmiştir.Bulgular: Tedaviden 6 ay sonra cilt kalitesinde artma, yüzey düzensizliği ve renk eşitsizliğinde azalma, genel görünümde düzelme açısından hasta ve doktor tarafından değerlendirildi. Bu çalışmaya göre tedavi sonunda hastaların ortalama tedavi yüzdeleri hasta değerlendirmesine göre %54,6- %78,5, doktor değerlendirmesine göre % 43,8- 67,8 arasındadır.Sonuç: Nanofat greft, zengin kök hücre içeriği, kolay hazırlanma ve kullanma kolaylığı avantajları göz önüne alındığında skar tedavisinde diğer yöntemlere ek olarak veya yalnız başına tercih edilebilecek bir yöntemdir. Ancak skar üzerine etkisini daha iyi analiz edebilmek için kontrollü randomize çalışmalara ihtiyaç duyulmaktadır

References

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  • Kroepfl L, Emer JJ. Combination therapy for acne scarring: personal experience and clinical suggestions. J Drugs Dermatol 2016; 15:1413-19.
  • Spiekman M, van Dongen JA, Willemsen JC, Hoppe DL, van der Lei B, Harmsen MC. The power of fat and its adipose-derived stromal cells: Emerging concepts for fibrotic scar treatment. J Tissue Eng Regen Med 2017; 11: 3220–35.
  • Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, Benhaim P, Lorenz HP, Hedrick MH. Multilineage cells from human adipose tissue: Implications for cell- based therapies. Tissue Eng 2001; 7(2): 211–28.
  • Bruno A, Delli Santi G, Fasciani L, Cempanari M, Palombo M, Palombo P. Burn scar lipofilling: Immunohistochemical and clinical outcomes. J Craniofac Surg 2013; 24: 1806–14.
  • Byrne M, O’Donnell M, Fitzgerald L, Shelley OP. Early experience with fat grafting as an adjunct for secondary burn reconstruction in the hand: Technique, hand function assessment and aesthetic outcomes. Burns 2016; 42: 356–65.
  • Coleman SR. Hand rejuvenation with structural fat grafting. Plast Reconstr Surg 2002; 110: 1731–47.
  • Coleman SR. Structural fat grafting: More than a permanent filler. Plast Reconstr Surg 2006; 118: 108–20.
  • Klinger M, Marazzi M, Vigo D, Torre M. Fat injection for cases of severe burn outcomes: a new perspective of scar remodeling and reduction. Aesthetic Plast Surg 2008; 32: 465–69.
  • Rigotti G, Marchi A, Galie M, Baroni G, Benati D, Krampera M, Pasini A, Sbarbati A. Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg 2007; 119: 1409–22.
  • Tonnard P, Verpaele A, Peeters G, Hamdi M, Cornelissen M, Declercq H. Nanofat grafting: Basic research and clinical applications. Plast Reconstr Surg 2013;132:1017- 26.
  • Neuber G. Fettransplantation. Chir Kongr Verhandl Deutsche Gesellschaft für Chir 1893; 22: 66.
  • Illouz YG. Body contouring by lipolysis: A 5-year experience with over 3000 cases. Plast Reconstr Surg 1983; 72 :591–7.
  • Nguyen PS, Desouches C, Gay AM, Hautier A, Magalon G. Development of micro-injection as an innovative autologous fat graft technique: The use of adipose tissue as dermal filler. J Plast Reconstr Aesthet Surg 2012;65:1692– 9.
  • Eto H, Suga H, Matsumoto D, Inoue K, Aoi N, Kato H, Araki J, Yoshimura K. Characterization of structure and cellular components of aspirated and excised adipose tissue. Plast Reconstr Surg 2009; 124:1087–97.
  • Lin G, Garcia M, Ning H, Banie L, Guo YL, Lue TF, Lin CS. Defining stem and progenitor cells within adipose tissue. Stem Cells Dev 2008; 17: 1053–63.
  • Akita S, Yoshimoto H, Ohtsuru A, Hirano A, Yamashita S. Autologous adipose-derived regenerative cells are effective for chronic intractable radiation injuries. Radiat Prot Dosimetry 2012; 151: 656–60.
  • Tiryaki T, Findikli N, Tiryaki D. Staged stem cellenriched tissue (SET) injections for soft tissue augmentation in hostile recipient areas: A preliminary report. Aesthetic Plast Surg 2011; 35: 965–71.
  • Mahdavian Delavary B, van der Veer WM, van Egmond M, Niessen FB, Beelen RH. Macrophages in skin injury and repair. Immunobiology 2011; 216:753–62.
  • Uyulmaz S, Sanchez Macedo N, Rezaeian F, Giovanoli P, Lindenblatt N. Nanofat grafting for scar treatment and skin quality improvement. Aesthet Surg J 2018; 38:421- 28.
  • Gu Z, Li Y, Li H. Use of condensed nanofat combined with fat grafts to treat atrophic scars. JAMA Facial Plast Surg 2018; 20: 128-35.

A Current Approach to Scar Treatment: Nanofat Graft

Year 2018, Volume: 4 Issue: 2, 175 - 181, 01.01.2018

Abstract

Objective: Face and body scars can cause serious aesthetic and psychological problems that disturb the patients' self-confidence and their communication in social life. We investigated the effect of 'nanofat graft' which recently described by Tonnard, on scar treatment in combination with fat injection in this study.Material and Methods: Seven patients were included between the ages of 20-42 years who referred because of scar on their face or body between November 2016 and January 2018. The scar was located in the face in five patiens, in the front of the chest in one patient, and in the lower abdomen in one patient. Subcutaneous fat injections were performed to atrophic scar areas in all patients. Subsequently, nanofat injection was performed intradermally to cover the entire scar surface. Patients were evaluated by the patient and the physician for improvement of the sacrring and skin quality after 6 months of treatment.Results: Skin quality, surface irregularity, color inequality and overall appearance were evaluated by the patient and the physican. At the end of the treatment, the mean improvement percentages of the scars were 54.6% -78.5% according to the patient evaluation and 43.8-67.8% according to the physican evaluation.Conclusion: Nanofat graft which has certain advantages, such as rich stem cell content and ease of preparation and use, can be preferred alone or in combination with other methods of scar treatment. However, controlled randomized trials are needed to better analyze the effect of nanofat on the scar

References

  • Ochi H, Tan L, Tan WP, Goh CL. Treatment of facial acne scarring with fractional carbon dioxide laser in Asians, a retrospective analysis of efficacy and complications. Dermatol Surg 2017; 43:1137-43.
  • Kroepfl L, Emer JJ. Combination therapy for acne scarring: personal experience and clinical suggestions. J Drugs Dermatol 2016; 15:1413-19.
  • Spiekman M, van Dongen JA, Willemsen JC, Hoppe DL, van der Lei B, Harmsen MC. The power of fat and its adipose-derived stromal cells: Emerging concepts for fibrotic scar treatment. J Tissue Eng Regen Med 2017; 11: 3220–35.
  • Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, Benhaim P, Lorenz HP, Hedrick MH. Multilineage cells from human adipose tissue: Implications for cell- based therapies. Tissue Eng 2001; 7(2): 211–28.
  • Bruno A, Delli Santi G, Fasciani L, Cempanari M, Palombo M, Palombo P. Burn scar lipofilling: Immunohistochemical and clinical outcomes. J Craniofac Surg 2013; 24: 1806–14.
  • Byrne M, O’Donnell M, Fitzgerald L, Shelley OP. Early experience with fat grafting as an adjunct for secondary burn reconstruction in the hand: Technique, hand function assessment and aesthetic outcomes. Burns 2016; 42: 356–65.
  • Coleman SR. Hand rejuvenation with structural fat grafting. Plast Reconstr Surg 2002; 110: 1731–47.
  • Coleman SR. Structural fat grafting: More than a permanent filler. Plast Reconstr Surg 2006; 118: 108–20.
  • Klinger M, Marazzi M, Vigo D, Torre M. Fat injection for cases of severe burn outcomes: a new perspective of scar remodeling and reduction. Aesthetic Plast Surg 2008; 32: 465–69.
  • Rigotti G, Marchi A, Galie M, Baroni G, Benati D, Krampera M, Pasini A, Sbarbati A. Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg 2007; 119: 1409–22.
  • Tonnard P, Verpaele A, Peeters G, Hamdi M, Cornelissen M, Declercq H. Nanofat grafting: Basic research and clinical applications. Plast Reconstr Surg 2013;132:1017- 26.
  • Neuber G. Fettransplantation. Chir Kongr Verhandl Deutsche Gesellschaft für Chir 1893; 22: 66.
  • Illouz YG. Body contouring by lipolysis: A 5-year experience with over 3000 cases. Plast Reconstr Surg 1983; 72 :591–7.
  • Nguyen PS, Desouches C, Gay AM, Hautier A, Magalon G. Development of micro-injection as an innovative autologous fat graft technique: The use of adipose tissue as dermal filler. J Plast Reconstr Aesthet Surg 2012;65:1692– 9.
  • Eto H, Suga H, Matsumoto D, Inoue K, Aoi N, Kato H, Araki J, Yoshimura K. Characterization of structure and cellular components of aspirated and excised adipose tissue. Plast Reconstr Surg 2009; 124:1087–97.
  • Lin G, Garcia M, Ning H, Banie L, Guo YL, Lue TF, Lin CS. Defining stem and progenitor cells within adipose tissue. Stem Cells Dev 2008; 17: 1053–63.
  • Akita S, Yoshimoto H, Ohtsuru A, Hirano A, Yamashita S. Autologous adipose-derived regenerative cells are effective for chronic intractable radiation injuries. Radiat Prot Dosimetry 2012; 151: 656–60.
  • Tiryaki T, Findikli N, Tiryaki D. Staged stem cellenriched tissue (SET) injections for soft tissue augmentation in hostile recipient areas: A preliminary report. Aesthetic Plast Surg 2011; 35: 965–71.
  • Mahdavian Delavary B, van der Veer WM, van Egmond M, Niessen FB, Beelen RH. Macrophages in skin injury and repair. Immunobiology 2011; 216:753–62.
  • Uyulmaz S, Sanchez Macedo N, Rezaeian F, Giovanoli P, Lindenblatt N. Nanofat grafting for scar treatment and skin quality improvement. Aesthet Surg J 2018; 38:421- 28.
  • Gu Z, Li Y, Li H. Use of condensed nanofat combined with fat grafts to treat atrophic scars. JAMA Facial Plast Surg 2018; 20: 128-35.
There are 21 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Gamze Bektaş This is me

Publication Date January 1, 2018
Published in Issue Year 2018 Volume: 4 Issue: 2

Cite

APA Bektaş, G. (2018). Skar Tedavisinde Güncel Bir Yaklaşım: Nanofat Greft. Akdeniz Tıp Dergisi, 4(2), 175-181.