Autologous Fat Grafting – A Step Forward in Wound Management

Author(s):  
Komal Saeed ◽  
Farid Ahmad Khan ◽  
Saad Bin Abdul Qudus ◽  
Sundas Javed

Autologous fat grafting (AFG) is an emerging therapeutic option for wounds that are not ready for grafting. The regenerative potential of autologous fat lies in the adipose derived stem cells (ADSCs) contained within the stromal vascular fraction (SVF), which are capable of differentiating into multiple cell lineages. However to date, there has been no comprehensive evaluation of its efficacy in acute complicated wounds. This study aims to critically evaluate the efficacy and safety of AFG in cutaneous wound healing. Materials and Methods: This prospective, quasi experimental study was conducted in the Department Of Plastic Surgery, SIMS, Lahore, between June 2020 and June 2021. Thirty patients with pale granulation, not ready for grafting with no vital structure exposed were included in the study after detailed history, examination and were photographed pre and postoperatively. The procedure was performed under local anaesthesia. 40 to 80 ml fat was harvested from lower abdomen and after emulsification, placed over the wound wrapped in sufra tulle dressing. The dressing was changed on third postoperative day and outcome was assessed on clinical grounds. Results: Thirty patients (M:F Ratio 1.75:1) with mean age 30 years (Range 13-45 years) were included in this study with post traumatic (n = 23) and post infective (n = 7). Of 27 patients who completed their follow up, all had healthy granulation tissue which was later on grafted. Mean number of fat dressing sessions were 2 (Range 1-3). Conclusion: Autologous fat grafting has shown promising results for cutaneous wounds without any unacceptably high complication rates reported so far. Randomised controlled trials should be done on a larger scale to prove its efficacy in the management of complicated wounds.

Author(s):  
Malke Asaad ◽  
Skyler M Howell ◽  
Jun Liu ◽  
Gregory P Reece ◽  
Edward I Chang ◽  
...  

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.


2020 ◽  
Vol 146 (6) ◽  
pp. 1275-1284
Author(s):  
Kai Zhang ◽  
Fuwei Liu ◽  
Yanyuan Zhang ◽  
Xin Huang ◽  
Mingyue Tang ◽  
...  

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