Comparison of Fat Graft in Post-Burn Scars versus Platelet-Rich Plasma Regarding Scar Quality and Healing

Platelet-Rich Plasma and Fat Graft in Post-Burn Scar Treatment

Authors

  • Muhammad Nasrullah Postgraduate Medical Institute, Ameer Ud Din Medical College, Lahore General Hospital, Lahore, Pakistan
  • Muhammad Amin Postgraduate Medical Institute, Ameer Ud Din Medical College, Lahore General Hospital, Lahore, Pakistan
  • Samia Fatima Department of Plastic Surgery, Jinnah Burn and Reconstructive Surgery Center, Allama Iqbal Medical College, Lahore, Pakistan
  • Sana Imdad Postgraduate Medical Institute, Ameer Ud Din Medical College, Lahore General Hospital, Lahore, Pakistan
  • Hirra Rehman Allavi Postgraduate Medical Institute, Ameer Ud Din Medical College, Lahore General Hospital, Lahore, Pakistan
  • Muhammad Imran Department of Plastic Surgery, Government of Khawaja Muhammad Safdar Medical College, Sialkot, Pakistan
  • Aiza Latif Aftab Postgraduate Medical Institute, Ameer Ud Din Medical College, Lahore General Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i04.1407

Keywords:

Post-Burn Scars, Fat Graft, Healing Process, Scar Quality

Abstract

Post-burn scars occur when burns damage the skin leading inevitable injury. Various techniques are applied for treatments and reduction so f these scares. Objective: To compare the effect of Platelet Rich Plasma (PRP) and fat graft in post-burn scars on the outcome of the healing process and quality of chronic wounds. Methods: One hundred cases were equally divided in group I (platelet-rich plasma) and group II (fat graft), age between 20-60 years were enrolled. The patients were those who were having post traumatic or and post burn chronic wounds which were within the duration of ≥3 months. A 5cc blood was withdrawn from each patient. Fat graft and platelet rich plasma were prepared, applied and compared for up to 12 weeks for their wound size, healing rate and scar quality. Results: There was no difference win age or gender within groups with a mean age of 43.46 and 44.36 years in group I and Group I. The comparative analysis within the original wound size and decrease in it within the 4 weeks’ time followed by 12 weeks’ time presented significant variance with both procedures bringing sufficient minimizing in the size, however a slight better result was presented in group II in comparison with Group I. Average healing rate was higher in group II than group I. Conclusions: Both procedures are efficient in terms of scar quality and healing of post burn scar. However, within the two groups the fat graft is more efficient and reliable with high healing time and rate.

References

Fredman R, Katz AJ, Hultman CS. Fat grafting for burn, traumatic, and surgical scars. Clinics in Plastic Surgery. 2017 Oct; 44(4): 781-91. doi: 10.1016/j.cps.2017.05.009. DOI: https://doi.org/10.1016/j.cps.2017.05.009

Piccolo NS, Piccolo MS, Piccolo MT. Fat grafting for treatment of burns, burn scars, and other difficult wounds. Clinics in Plastic Surgery. 2015 Apr; 42(2): 263-83. doi: 10.1016/j.cps.2014.12.009. DOI: https://doi.org/10.1016/j.cps.2014.12.009

Giusti I, D'Ascenzo S, Macchiarelli G, Dolo V. In vitro evidence supporting applications of platelet derivatives in regenerative medicine. Blood Transfusion. 2020 Mar; 18(2): 117. doi: 10.2450/2019.0164-19.

Keyhan SO, Hemmat S, Badri AA, Abdeshahzadeh A, Khiabani K. Use of platelet-rich fibrin and platelet-rich plasma in combination with fat graft: which is more effective during facial lipostructure?. Journal of Oral and Maxillofacial Surgery. 2013 Mar; 71(3): 610-21. doi: 10.1016/j.joms.2012.06.176. DOI: https://doi.org/10.1016/j.joms.2012.06.176

De Pascale MR, Sommese L, Casamassimi A, Napoli C. Platelet derivatives in regenerative medicine: an update. Transfusion Medicine Reviews. 2015 Jan; 29(1): 52-61. doi: 10.1016/j.tmrv.2014.11.001. DOI: https://doi.org/10.1016/j.tmrv.2014.11.001

Pixley JN, Cook MK, Singh R, Larrondo J, McMichael AJ. A comprehensive review of platelet-rich plasma for the treatment of dermatologic disorders. Journal of Dermatological Treatment. 2023 Dec; 34(1): 2142035. doi: 10.1080/09546634.2022.2142035. DOI: https://doi.org/10.1080/09546634.2022.2142035

Sommeling CE, Heyneman A, Hoeksema H, Verbelen J, Stillaert FB, Monstrey S et al. The use of platelet-rich plasma in plastic surgery: a systematic review. Journal of Plastic, Reconstructive and Aesthetic Surgery. 2013 Mar; 66(3): 301-11. doi: 10.1016/j.bjps.2012.11.009. DOI: https://doi.org/10.1016/j.bjps.2012.11.009

Pu LL. Towards more rationalized approach to autologous fat grafting. Journal of Plastic, Reconstructive and Aesthetic Surgery. 2012 Apr; 65(4): 413-9. doi: 10.1016/j.bjps.2011.09.033. DOI: https://doi.org/10.1016/j.bjps.2011.09.033

Noone RB, Goldwyn RM, McGrath M, Spear S, Evans GR. 50th anniversary plastic surgery research council panel on the future of academic plastic surgery. Plastic and Reconstructive Surgery. 2007 Nov; 120(6): 1709-21. doi: 10.1097/01.prs.0000282308.47851.54. DOI: https://doi.org/10.1097/01.prs.0000282308.47851.54

Panayi AC, Orkaby AR, Sakthivel D, Endo Y, Varon D, Roh D et al. Impact of frailty on outcomes in surgical patients: a systematic review and meta-analysis. The American Journal of Surgery. 2019 Aug; 218(2): 393-400. Doi: 10.1016/j.amjsurg.2018.11.020. DOI: https://doi.org/10.1016/j.amjsurg.2018.11.020

Gir P, Brown SA, Oni G, Kashefi N, Mojallal A, Rohrich RJ et al. Fat grafting: evidence-based review on autologous fat harvesting, processing, reinjection, and storage. Plastic and Reconstructive Surgery. 2012 Jul; 130(1): 249-58. doi: 10.1097/PRS.0b013e318254b4d3. DOI: https://doi.org/10.1097/PRS.0b013e318254b4d3

Griffin MF, Almadori A, Butler PE. Use of lipotransfer in scleroderma. Aesthetic Surgery Journal. 2017 Jul; 37(3): S33-7. doi: 10.1093/asj/sjx067. DOI: https://doi.org/10.1093/asj/sjx067

Kato H, Mineda K, Eto H, Doi K, Kuno S, Kinoshita K, Kanayama K, Yoshimura K. Degeneration, regeneration, and cicatrization after fat grafting: dynamic total tissue remodeling during the first 3 months. Plastic and reconstructive surgery. 2014 Mar; 133(3): 303e-13e. doi: 10.1097/PRS.0000000000000066. DOI: https://doi.org/10.1097/PRS.0000000000000066

Baran CN, Çelebioglu S, Sensöz Ö, Ulusoy G, Civelek B, Ortak T et al. The behavior of fat grafts in recipient areas with enhanced vascularity. Plastic and reconstructive surgery. 2002 Apr; 109(5): 1646-50. doi: 10.1097/00006534-200204150-00023. DOI: https://doi.org/10.1097/00006534-200204150-00023

Wu M, Li Y, Wang Z, Feng J, Wang J, Xiao X et al. Botulinum toxin A improves supramuscular fat graft retention by enhancing angiogenesis and adipogenesis. Dermatologic Surgery. 2020 May; 46(5): 646-52. doi: 10.1097/DSS.0000000000002106. DOI: https://doi.org/10.1097/DSS.0000000000002106

Lee SK, Kim DW, Dhong ES, Park SH, Yoon ES. Facial soft tissue augmentation using autologous fat mixed with stromal vascular fraction. Archives of Plastic Surgery. 2012 Sep; 39(05): 534-9. doi: 10.5999/aps.2012.39.5.534. DOI: https://doi.org/10.5999/aps.2012.39.5.534

Yu P, Zhai Z, Jin X, Yang X, Qi Z. Clinical application of platelet-rich fibrin in plastic and reconstructive surgery: a systematic review. Aesthetic Plastic Surgery. 2018 Apr; 42(2): 511-9. doi: 10.1007/s00266-018-1087-0. DOI: https://doi.org/10.1007/s00266-018-1087-0

Sinno S, Wilson S, Brownstone N, Levine SM. Current thoughts on fat grafting: using the evidence to determine fact or fiction. Plastic and Reconstructive Surgery. 2016 Mar; 137(3): 818-24. doi: 10.1097/01.prs.0000479966.52477.8b. DOI: https://doi.org/10.1097/01.prs.0000479966.52477.8b

Oranges CM, Striebel J, Tremp M, Madduri S, Kalbermatten DF, Harder Y et al. The preparation of the recipient site in fat grafting: a comprehensive review of the preclinical evidence. Plastic and Reconstructive Surgery. 2019 Apr; 143(4): 1099-107. doi: 10.1097/PRS.0000000000005403. DOI: https://doi.org/10.1097/PRS.0000000000005403

Cucchiani R and Corrales L. The effects of fat harvesting and preparation, air exposure, obesity, and stem cell enrichment on adipocyte viability prior to graft transplantation. Aesthetic Surgery Journal. 2016 Nov; 36(10): 1164-73. doi: 10.1093/asj/sjw106. DOI: https://doi.org/10.1093/asj/sjw106

Kato Y, Iwata T, Morikawa S, Yamato M, Okano T, Uchigata Y et al. Allogeneic transplantation of an adipose-derived stem cell sheet combined with artificial skin accelerates wound healing in a rat wound model of type 2 diabetes and obesity. Diabetes. 2015 Aug; 64(8): 2723-34. doi: 10.2337/db14-1133. DOI: https://doi.org/10.2337/db14-1133

Nie C, Yang D, Xu J, Si Z, Jin X, Zhang J et al. Locally administered adipose-derived stem cells accelerate wound healing through differentiation and vasculogenesis. Cell Transplantation. 2011 Mar; 20(2): 205-16. doi: 10.3727/096368910X520065. DOI: https://doi.org/10.3727/096368910X520065

Rittié L. Cellular mechanisms of skin repair in humans and other mammals. Journal of Cell Communication and Signaling. 2016 Jun; 10: 103-20. doi: 10.1007/s12079-016-0330-1. DOI: https://doi.org/10.1007/s12079-016-0330-1

Martinez‐Zapata MJ, Martí‐Carvajal AJ, Solà I, Expósito JA, Bolíbar I, Rodríguez L et al. Autologous platelet‐rich plasma for treating chronic wounds. Cochrane Database of Systematic Reviews. 2016 May; 2016(5): CD006899. doi: 10.1002/14651858.CD006899.pub3. DOI: https://doi.org/10.1002/14651858.CD006899.pub3

Frautschi RS, Hashem AM, Halasa B, Cakmakoglu C, Zins JE. Current evidence for clinical efficacy of platelet rich plasma in aesthetic surgery: a systematic review. Aesthetic Surgery Journal. 2017 Mar; 37(3): 353-62. doi: 10.1093/asj/sjw178. DOI: https://doi.org/10.1093/asj/sjw178

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Published

2024-04-30
CITATION
DOI: 10.54393/pjhs.v5i04.1407
Published: 2024-04-30

How to Cite

Nasrullah, M., Amin, M., Fatima, S., Imdad, S., Allavi, H. R., Imran, M., & Aftab, A. L. (2024). Comparison of Fat Graft in Post-Burn Scars versus Platelet-Rich Plasma Regarding Scar Quality and Healing: Platelet-Rich Plasma and Fat Graft in Post-Burn Scar Treatment. Pakistan Journal of Health Sciences, 5(04), 200–205. https://doi.org/10.54393/pjhs.v5i04.1407

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