Letter Comments On “Autologous fat grafting seems to alleviate postherpetic neuralgia – a feasibility study investigating patient-reported levels of pain”

Abstract Background The use of autologous fat grafting (AFG) is becoming increasingly common as an adjunct to breast reconstruction. However, there is a paucity of data comparing the varying processing devices. Objectives The goal of this study is to compare the outcomes of two commercially available AFG processing devices. Methods The authors conducted a retrospective review of patients who underwent AFG using dual filter (Puregraft®) or single filter (Revolve TM) processing systems between 2016 and 2019. Propensity score matching was utilized to adjust for confounding. A total of 38 breasts from the Puregraft® group were matched with 38 breasts from the Revolve TM system. Results Matching was successful in achieving a similar distribution of baseline characteristics between the two groups. The mean number of AFG sessions was comparable between the two groups (p=0.37) with a similar median total volume (Puregraft®, 159 ml vs. Revolve TM, 130 ml, p=0.23). Complication rates were similar between the two devices (Puregraft®, 26%; Revolve TM,18%; p=0.47). Patients with at least one complication had higher overall AFG volume (median, 200 vs.130 ml, p=0.03) and number of sessions (mean, 2.4 vs.1.8, p=0.009) compared to those without any postoperative complication. Conclusions The decision for which processing system to use for autologous fat grafting should be based on surgeon preference as overall complication rates were comparable between two commonly used commercially available systems. Future studies are underway to decipher whether either system has superior graft retention, cosmetic or patient reported outcomes.

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A Step in the Right Direction: A Prospective Randomized, Controlled Crossover Trial of Autologous Fat Grafting For Rejuvenation of the Heel

Aesthetic Surgery Journal ◽

10.1093/asj/sjab095 ◽

2021 ◽

Author(s):

Isaac B James ◽

Beth R Gusenoff ◽

Sheri Wang ◽

Gabriella DiBernardo ◽

Danielle Minteer ◽

...

Keyword(s):

Soft Tissues ◽

Fat Grafting ◽

Foot Pain ◽

Fat Pad ◽

Autologous Fat Grafting ◽

Autologous Fat ◽

Dermal Thickness ◽

Patient Reported ◽

Group 2 ◽

Group 1

Abstract Background The shock-absorbing soft tissues of the heel are composed of dermis and specialized fat pads. Heel fat pad atrophy (FPA) is common and can be painful and debilitating. In our previous work, autologous fat grafting (AFG) was effective for treating pain from forefoot FPA. Objectives We hypothesized that AFG to the heel would relieve pain and improve function in patients with heel FPA. Methods Patients with heel FPA and associated pain were recruited and randomized into two groups. Group 1 received AFG upon enrollment and was followed for 2yrs. Group 2 received offloading and activity modification for 1yr, then crossed over, underwent AFG, and was followed for 1yr afterward. Outcome measures included ultrasound-measured fat pad and dermal thickness, pedobarograph-measured foot pressures and forces, and patient-reported outcomes as measured by the Manchester Foot Pain and Disability Index (MFPDI). Results Thirteen subjects met inclusion criteria and completed the study. Seven (12 affected feet) were randomized into Group 1, and six (9 affected feet) were randomized into Group 2. Average age was 55yrs and BMI was 30.5kg/m 2. Demographics were not significantly different between groups. Heel fat pad thickness increased after AFG but returned to baseline at 6mo. However, AFG increased dermal thickness significantly and increased fat pad thickness under compressive load compared to controls at 6-12mo. Foot pain, function, and appearance were also significantly improved compared to controls at 6-12mo. Conclusions AFG improved patient-reported foot pain, function, and appearance and may rejuvenate local soft tissues in patients with heel FPA.

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