Long-term Results After Autologous Fat Transfer for Treatment of Chronic Lower Extremity Wounds

Author(s):  
Johannes Eschborn ◽  
Philipp Kruppa ◽  
Iakovos Georgiou ◽  
Manfred Infanger ◽  
Mojtaba Ghods

Autologous fat transfer may offer a simple and effective treatment option for chronic wound patients, delivering adipose-derived stem cells, with potent regenerative attributes. Nevertheless, the clinical benefit has not yet been sufficiently demonstrated. A total of 39 wound patients were treated with autologous fat transfer (AFT) and matched with a control group, according to the identified confounding variables “gender” and “method of defect closure.” All data were acquired retrospectively. Primary outcome was “wound closure” and “reduction of wound size.” After a follow-up of 48 weeks, there was no significant difference in primary outcome (wound closure P = .54) between both groups. The relative wound reduction after fat transfer was 69.9% ± 42.7% compared to 53.4% ± 106.8% in the control group ( P = .91). Subgroup analysis of all patients, healed by secondary intention, revealed an increased wound size reduction ( P  = .03) and wound closure rate ( P = .20) in the case group after 12 weeks. No adverse events were recorded. Fat grafting can reduce the wound size if left to secondary healing and may be considered individually for reconstructive purposes. A repeated application of autologous fat might be beneficial due to a temporary effect.

2018 ◽  
Vol 25 (6) ◽  
pp. 594-601
Author(s):  
Jan-Willem Groen ◽  
Andrzej A. Piatkowski ◽  
John H. Sawor ◽  
Janneke A. Wilschut ◽  
Roger K. Khouri ◽  
...  

Objective. The aim of this study is to compare the cosmetic evaluation of autologous fat transfer (AFT) for various indications between surgeons and different laymen groups. Background Data. Despite the upsurge in AFT scientific/clinical interest, objectifying satisfaction has only recently progressed beyond simple Likert-type/Visual Analog Scales. Furthermore, differences in satisfaction between laymen and surgeons has not been thoroughly studied. Method. A photo comparison study between European plastic surgeons and different laymen groups was conducted to investigate agreement on cosmetic evaluation of AFT. Three sets of preoperative/postoperative photographs illustrating patients treated with External Vacuum Expansion (EVE) + AFT for various indications in breast surgery were scored according to the Harris Scale, and the interrater agreement was analyzed using Cohen’s κ. Results. The overall agreement between the surgeons and the groups of former augmentation, control group, and deep inferior epigastric artery perforator patients was fair, moderate, and substantial, respectively. Interrater agreements among different laymen groups and surgeons from different countries among themselves was substantial to almost perfect. Finally, we found that laymen are generally more optimistic about postoperative results than surgeons. Conclusion. In our study, former augmentation patients showed the lowest agreement with surgeons, in the cosmetic appreciation of EVE + AFT and this group might benefit from a more thorough preoperative consultation regarding expectations when choosing AFT. However, overall laymen tend to be more optimistic about postoperative results and surgeon education in general does not seem influenced by surgeon nationality. The significant differences between surgeons and laymen in the cosmetic evaluation of EVE + AFT justifies further studies that focus on the qualitative aspects of these differences to further balance patients’ and surgeons’ expectations.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Pierre G. Vico ◽  
Axel Delange ◽  
Axel De Vooght

Parotidectomy is a surgical procedure associated to functional (Frey’s syndrome) as well as aesthetic (facial asymmetry) complications that can be very disturbing for the patient. Several procedures have been described to primarily avoid or secondarily reconstruct the facial defect and treat the neurological iatrogenic syndrome. Autologous fat transfer was primarily used in 10 cases to avoid such complications. It is an easy technique widely used in cosmetic and reconstructive surgery. This technique gives very satisfying long-term results on the cosmetic as well as on the physiological point of view.


2006 ◽  
Vol 118 (Supplement) ◽  
pp. 98 ◽  
Author(s):  
Brian P. Dickinson ◽  
Matthew R. Kaufman ◽  
James P. Bradley ◽  
Kristy L. Wasson ◽  
Joubin S. Gabbay ◽  
...  

2014 ◽  
Vol 3 (1) ◽  
pp. 62-69
Author(s):  
Kshemendra Senarath-Yapa ◽  
Rebecca Garza ◽  
Adrian McArdle ◽  
Graham Walmsley ◽  
Michael Hu ◽  
...  

2021 ◽  
Vol 9 ◽  
pp. 205031212110202
Author(s):  
Rgda Mohamed Osman ◽  
Mounkaila Noma ◽  
Abdallah Elssir Ahmed ◽  
Hanadi Abdelbagi ◽  
Rihab Ali Omer ◽  
...  

Objectives: Rheumatoid arthritis is a chronic inflammatory autoimmune disease. This study aimed to determine the association of interleukin-17A-197G/A polymorphism with rheumatoid arthritis in Sudanese patients. Methods: A case–control study was conducted between March and December 2018. Clinical and demographic data of the study participants were collected and analyzed. Polymerase chain reaction restriction fragment length polymorphism molecular technique was done to investigate interleukin-17A-197G/A polymorphisms. All statistical tests were considered statistically significant when p < 0.05. Results: The study population included 266 participants aged between 1 and 85 years, with an average of 40 years, classified into 85 (31.2%) cases (mean age 48.5 ± 11.3 years), and 181 (68.8%) controls (mean age 35.3 ± 15.9 years). The interleukin-17A homozygote AA genotype was more frequent among the control group compared to the case group; 95 (52.5%) and 7 (8.2%), respectively. The homozygote GG and the heterozygote AG genotypes were proportionally not different among the cases and control groups; 13 (54.2%) and 11 (45.8%), and 65 (46.4%) and 75 (53.6%), respectively. According to the distribution of interleukin-17A genotypes, a statistically significant difference was observed among cases with the interleukin-17A AA and AG genotypes, p values 0.001 and 0.004, respectively. For the association interleukin-17A genotypes and family history a negatively significant association was reported (95% confidence interval, –0.219, p value = 0.001). There was also a negatively significant association of interleukin-17A genotypes and anti-cyclic citrullinated peptide (95% confidence interval, −0.141, p value = 0.002). Conclusion: This study is the first study in Sudan established the association between interleukin-17A-197G/A (rs2275913) polymorphisms and susceptibly to rheumatoid arthritis. These findings appeal for further research in Sudan to investigate the exact role of IL-17A in immunopathology and disease severity among Sudanese rheumatoid arthritis


2021 ◽  
Vol 13 (01) ◽  
pp. e57-e65
Author(s):  
Boonkit Purt ◽  
Timothy Ducey ◽  
Sean Sykes ◽  
Joseph F. Pasternak ◽  
Denise S. Ryan ◽  
...  

Abstract Purpose The aim of this study was to evaluate whether the simulated tissue models may be used in place of animal-based model for corneal laceration repair for surgical skills acquisition. Design Prospective randomized controlled trial. Participants Seventy-nine military and civilian 2nd- and 3rd-year ophthalmology residents and 16 staff ophthalmologists participating in the Tri-Service Ocular Trauma Skills Laboratory at the Uniformed Services University (Bethesda, MD). Methods Resident ophthalmologists underwent preliminary evaluation of their ability to close a 5-mm linear, full-thickness corneal laceration involving the visual axis. They then were randomized to undergo 90 to 120 minutes of either simulator-based (SIM) or swine cadaveric-tissue-based (CADAVER) corneal laceration repair. The same evaluation was performed post training. On a more limited basis, the study was repeated for attending ophthalmologists to act as a pilot for future analysis and test efficacy for “refresher” training. Main Outcome Measures Successful wound closure with secondary outcomes of suture length, tension, depth, and orientation, as graded by attending ophthalmologists. Results No significant difference in CADAVER versus SIM groups in the primary outcome of watertight wound closure of the corneal laceration. CADAVER group performed better than SIM group for certain metrics (suture depth, p = 0.009; length, p = 0.003; and tension, p = 0.043) that are associated with poor wound closure and increased amount of induced corneal astigmatism. For attending ophthalmologists, six of the eight in each group (SIM and CADAVER) retained or improved their skills. Conclusions For resident ophthalmologists, SIM training is sufficient for achieving the primary outcome of watertight wound closure. However, CADAVER training is superior for wound metrics for the ideal closure. For attending ophthalmologists, SIM training may be useful for retention of skills.


2015 ◽  
Vol 55 (5) ◽  
pp. 243
Author(s):  
Hilda Hilda ◽  
Bidasari Lubis ◽  
Hakimi Hakimi ◽  
Olga Rasiyanti Siregar

Background Cancer treatment in children influences the quality of life of patients and their families. The Pediatric Quality of Life (PedsQL) inventory is a questionnaire to assess quality of life of the healthy and ill children. Objective To compare quality of life in children with cancer and their normal siblings, and to compare quality of life in those with hematologic malignancies to those with solid tumors. Methods A cross-sectional study was conducted among 5-to-18- year-olds at the Hematology-Oncology Division at Haji Adam Malik Hospital, Medan, North Sumatera, from May to July 2012. The case group (subjects with cancer) filled the PedsQL 3.0 and 4.0 questionnaires, while the control group (normal siblings) filled only the PedsQL 4.0 questionnaire. Independent T-test was used to compare the quality of life between children with cancer and their normal siblings. Results There were 46 children in each group. The PedsQL 4.0 results in children with cancer and their normal siblings, and PedsQL 3.0 between hematology malignant and solid cancer were as follows: physical function 36.9 vs. 80.7, respectively (95%CI of differences -52.639 to -34.990; P= 0.0001), emotional function 40.4 vs. 69.3, respectively (95%CI of differences -35.912 to -21.914; P=0.0001), social function 71.5 vs. 93.9, respectively (95%CI of differences - 29.238 to -15.587; P=0.0001), school function 20.7 vs. 74.2, respectively (95%CI of differences - 62.124 to -44.832; P=0.0001), and total score 42.1 vs. 79.3, respectively (95%CI of differences - 43.066 to -31.344; P=0.0001). School function was the most affected parameter in children with cancer compared to their normal siblings. Conclusion There is a significant difference in quality of life between children with cancer and their normal siblings, for all four parameters examined by the PedsQL inventory. However, there are no significant differences in quality of life between children with hematologic malignancy and those with solid cancer.


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