Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft
ElSherbeny, K., Elshahat, A., Gad, A. (2023). Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft. EKB Journal Management System, 47(2), 79-88. doi: 10.21608/ejprs.2023.291375
Khaled ElSherbeny; Ahmed Elshahat; Ahmed M Gad. "Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft". EKB Journal Management System, 47, 2, 2023, 79-88. doi: 10.21608/ejprs.2023.291375
ElSherbeny, K., Elshahat, A., Gad, A. (2023). 'Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft', EKB Journal Management System, 47(2), pp. 79-88. doi: 10.21608/ejprs.2023.291375
ElSherbeny, K., Elshahat, A., Gad, A. Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft. EKB Journal Management System, 2023; 47(2): 79-88. doi: 10.21608/ejprs.2023.291375

Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft

The Egyptian Journal of Plastic and Reconstructive Surgery
Article 2, Volume 47, Issue 2, April 2023, Page 79-88  XML PDF (20.65 MB)
Document Type: Research article
DOI: 10.21608/ejprs.2023.291375
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Authors
Khaled ElSherbeny* ; Ahmed Elshahatorcid ; Ahmed M Gad
The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University
Abstract
Background: Split-thickness grafts (STSGs) harvesting
is a common technique to reconstruct absent skin and to reestablish
the skin barrier in burn and skin defects. Donor site
morbidity is not uncommon. Various materials and dressings
had been used to improve healing of donor site. Fat grafting
or its components had been used in promotion of healing in
chronic and irradiated wounds indicating the possibility of
improving healing.
Objective: To evaluate the effect of adding nano fat grafts
to donor sites of STSGs.
Patients and Methods: Twenty (20) adult patients were
included in this comparative self-controlled clinical trial from
March 2020 to April 2021. These patients had raw areas of
skin needing STSG. STSG thickness was 0.12.5 inch leaving
an area measuring 7x15cm (105cm2) at the donor site. The
donor site area in the lower limb was used as a test area where
it was divided into two equal areas, one area was covered by
nano fat graft and Vaseline gauze (group A), the other acting
as a control group was covered by Vaseline gauze only (group < br />B). Group A was compared to group B as regard healing time
from 10th day onward and quality of healing after one month
using Vancouver scale (VSS). Tissue biopsy was taken at day
21 from both groups. Any Donor site complications were
noted.
Results: Comparing The rate of donor site healing in
group A with group B, group A showed faster healing with a
mean of (13.30±2.61) versus (16.05±2.43) days from the date
of harvesting of STSG. Histologically the mean thickness of
neo epithelium in group A was more than that of group B with
a mean value of 255.04±15.27mm and 161.15±28.75mm consecutively.
Group A showed better vascularity and pliability
while no difference was detected as regard pigmentation and
height. Infection occurred in donor site of one patient.
Conclusions: Using topical nano fat graft and Vaseline
gauze on the donor site of STSG improves healing time as
well as vascularity and pliability in comparison to Vaseline
gauze alone.
Keywords
Donor site; Split thickness skin graft; Nano fat graft; Vancouver scar scale
References
1- Demirtas Y., Yagmur C., Soylemez F., Ozturk N. and
Demir A.: Management of split-thickness skin graft donor
site: A prospective clinical trial for comparison of five
different dressing materials. Burns, 36: 999-1005, 2010.
2- Lohsiriwat V. and Chuangsuwanich A.: Comparison of
the ionic silver-containing hydrofiber and paraffin gauze
dressing on split-thickness skin graft donor sites. Ann.
Plast. Surg., 62: 421-422, 2009.
3- Cigna E., Tarallo M., Bistoni G., Anniboletti T., Trignano
E., Tortorelli G., et al.: Evaluation of polyurethane dressing
with ibuprofen in the management of split-thickness skin
graft donor sites. In Vivo, 23: 983-986, 2009.
4- Spear M. and Bailey A.: Treatment of skin graft donor
sites with a unique transparent absorbent acrylic dressing.
Plast. Surg. Nurs., 29: 194-200, quiz 201-202, 2009.
5- Hormbrey E., Pandya A. and Giele H.: Adhesive re ension
dressings are more comfortable than alginate dressings
on split-skin-graft donor sites. Br. J. Plast. Surg., 56: 498-
503, 2003.
6- Kilinc H., Sensoz O., Ozdemir R., Unlu R.E. and Baran
C.: Which dressing for split-thickness skin graft donor
sites? Ann. Plast. Surg., 46: 409-414, 2001.
7- Blome-Eberwein S., Johnson R.M., Miller S.F., Caruso
D.M., Jordan M.H., Milner S., et al.: Hydrofiber dressing
with silver for the management of split-thickness donor
sites: A randomized evaluation of two protocols of care.
Burns, 36: 665-672, 2010.
8- Markl P., Prantl L., Schreml S., Babilas P., Landthaler M.
and Schwarze H.: Management of split-thickness donor
sites with synthetic wound dressings: Results of a comparative
clinical study. Ann. Plast. Surg., 65: 490-496,
2010.
9- Holmes I.V. J.H., Molnar J.A., Shupp J.W., Hickerson
W.L., King B.T., Foster K.N., et al.: Demonstration of
the safety and effectiveness of the RECELL1 System
combined with splitthickness meshed autografts for the
reduction of donor skin to treat mixed-depth burn injuries.
Burns, 45: 77282, 2019.
10- Giele H., Tong A. and Huddleston S.: Adhesive retention
dressings are more comfortable than alginate dressings
on split skin graft donor sites - a randomised controlled
trial. Ann. R Coll. Surg. Engl., 83: 431-434, 2001.
11- Severin Läuchli, Jürg Hafner, Sonja Ostheeren, Dieter
Maye, R. Marjam J. Barysch and Lars E. French: Management
of Split-Thickness Skin Graft Donor Sites: A
Randomized Controlled Trial of Calcium Alginate versus
Polyurethane Film Dressing Lauchli, et al., dermatology,
227 (4): 361-366, 2013.
12- Albert Stachura, Wiktor Paskal, Weronika Pawlik, Maciej
J. Mazurek and Janusz Jaworowski: The Use of Adipose-
Derived Stem Cells (ADSCs) and Stromal Vascular Fraction
(SVF) in Skin Scar Treatment-A Systematic Review
of Clinical Studies. J. Clin. Med., 10: 3637, 2021.
13- Brzoska M., Geiger H., Gauer S. and Baer P.: Epithelial
differentiation of human adipose tissue-derived adult stem
cells. Biochem Biophys Res. Commun, 330: 142-150,
2007.
14- Suvarna S.K., Layton C. and Bancroft J.D.: Bancroft's
theory and practice of histological techniques, 8th edition,
Churchill Livingstone, UK, ElSevier, pp. 131, 2019.
15- Marco Humrich, Lisa Goepel, Mandy Gutknecht and
David Lohrberg: Health-related quality of life and patient
burden in patients with split-thickness skin graft donor
site wounds. Int. Wound J., 15: 266-273, 2018.
16- Serebrakian A.T., Pickrell B.B., Varon D.E., Mohamadi
A., Grinstaff M.W., Rodriguez E.K., et al.: Meta-analysis
and systematic review of skin graft donor-site dressings
with future guidelines. Plast. Reconstr. Surg. Glob. Open,
6: e1928, 2018.
17- Brolmann F., Eskes A. and Gosling J.: Randomised clinical
trial of donor site wound dressings after split skin grafting.
Br. J. Surg., 100: 619-627, 2013.
18- Lauchli S., Hafner J., Ostheeren S., Mayer D. and Barysch
M.: Management of split-thickness skin graft donor sites:
A randomized controlled trial of calcium alginate versus
polyurethane dressing. Dermatology, 227: 361-366, 2013.
19- Schubert H.M., Brandstetter M., Ensat F., Kohlosy H. and
Schwabegger A.H.: Split thickness skin graft for coverage
of soft tissue defects. Oper. Orthop. Traumatol., 24 (4-
5): 432-438, 2012.
20- Tonnard P., Verpaele A., Peeters G., Hamdi M., Cornelissen
M. and Declercq H.: Nanofat grafting: Basic research and
clinical applications. Plast. Reconstr. Surg., 132: 1017-
1026, 2013.
21- Gentile P., Scioli M.G., Bielli A., Orlandi A. and Cervelli
V.: Comparing different nanofat procedures on scars: Role
of the stromal vascular fraction and its clinical implications.
Regen. Med., 12: 939-952, 2017.
22- Friji M.T.: Nanofat grafting: Basic research and clinical
applications. Plast. Reconstr. Surg., 134: 333e-4, 2014.
88 Vol. 47, No. 2 / Effect of Nano Fat Graft on the Healing of Donor Site
23- Copcu H.E. and Oztan S.: New mechanical fat separation
technique: Adjustable regenerative adipose-tissue transfer
(ARAT) and mechanical stromal cell transfer (MEST).
Aesthet. Surg. J. Open Forum., 2: ojaa035, 2020.
24- Chung K., Ahmer K., and Gohori B.: Systematic review
of skin graft donor-site dressings - commentary. Plast.
Reconstr. Surg., 124 (1): 307-308, 74, 2009.
25- Bertozzi N., Simonacci F., Grieco M.P., Grignaffini E.
and Raposio E.: The biological and clinical basis for the
use of adipose-derived stem cells in the field of wound
healing. Ann. Med. Surg., 20: 41-8. 2, 2017.
26-Malachy Asuku a, Tzy-Chyi Yu a,*, Qi Yan b, Elaine
Böing a, Helen Hahn a, Sara Hovland a, Matthias B.
Donelan c,d,e: Split-thickness skin graft donor-site morbidity:
A systematic literature review. Burns, 47: 1525-
1546, 2021.
27- Nedelec B., Shankowsky A. and Tredgett E.E.: Rating
the resolving hypertrophic scar: Comparison of the Vancouver
Scar Scale and scar volume. J. Burn Care Rehabil.,
21: 205-12, 2000.
28- Madhan Jeyaraman, Sathish Muthu, Shilpa Sharma, Charan
Ganta, Rajni Ranjan and Saurabh Kumar: World J. Stem
Cells, November 26; 13 (11): 1733-1746, 2021.
29- Holmes IV J.H., Molnar J.A., Shupp J.W., Hickerson
W.L., King B.T., Foster K.N., et al.: Demonstration of
the safety and effectiveness of the RECELL1 System
combined with split-thickness meshed autografts for the
reduction of donor skin to treat mixed-depth burn injuries.
Burns, 45: 772-82, 2019.
30- Davies L.C., Heldring N., Kadri N. and Le Blanc K.:
“Mesenchymal Stromal Cell Secretion of Programmed
Death-1 Ligands Regulates T Cell-Mediated Immunosuppression,”
Stem Cells, Vol. 35, No. 3, pp. 766-776, 2016

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