A Comparative Study between Autologous Nanofat Graft and Fractional CO2 Laser in the Management of Post Burn Scars | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Article 3, Volume 46, Issue 3, July 2022, Page 211-221 PDF (14.78 MB) | ||||
| Document Type: Research article | ||||
| DOI: 10.21608/ejprs.2022.254697 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Yosra Abdelfattah Yasseen   ; Eman Nagy Mohamed; Sherine Mohamed Aboul Fotouh; Amr Magdy Sayed Mahmoud
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| The Department of Plastic Reconstructive and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University | ||||
| Abstract | ||||
| Background: Post burn scarring is a common complication that can lead to functional disability and cosmetic disfigurement. Superficial burn wounds usually heal without complications, unlike deep ones that have an increased risk for abnormal scar formation. Aim of Study: Is to compare between autologous nanofat grafting and fractional CO2 laser in the management of post burn scars regarding aesthetic improvement. Patients and Methods: This is a prospective study carried out at Plastic Surgery Department, Ain Shams University Hospital from February 2020 to February 2022. The study included 20 cases of post burn scars, they were divided randomly into two equal groups; the first group was managed by 2 sessions of autologous nanofat grafting while the other group was managed by 6 sessions of fractional CO2 laser. Results: There was statistically significant improvement after nanofat grafting and fractional CO2 laser. According to VSS; more statistically significant improvement of pliability was found among nanofat grafting group than fractional CO2 laser. While POSAS observer scale showed more improvement for pigmentation and pliability scores. Moreover, POSAS patient scale found more improvement among nanofat grafting group regarding itching, color, stiffness and total scores. Conclusion: Autologous nanofat injection and fractional CO2 laser use resulted in a significant aesthetic improvement of post burn scars. However, autologous nanofat injection had more significant improvement than laser regarding pliability, pigmentation, itching, color and stiffness. | ||||
| Keywords | ||||
| Post burn scars; Autologous nanofat; Fractional CO2 laser; Plastic surgery | ||||
| References | ||||
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1- McKee D.M.: Acute management of burn injuries to the hand and upper extremity. J. Hand Surg. Am., Sep. 35 (9): 1542-4, 2010. 2- Pfenninger J.L. and Fowler G.C.: Pfenninger and Fowler's procedures for primary care. Mosby Elsevier, 1733 p, 2011. 3- Liotta D.R., Costantino P.D. and Hiltzik D.H.: Revising large scars. Facial Plast Surg [Internet]. Oct [cited 2019 Nov 7], 28 (5): 492-6, 2012. Available from: http://www. ncbi.nlm.nih.gov/pubmed/23027215. 4- Loder S., Peterson J.R., Agarwal S., Eboda O., Brownley C., DeLaRosa S., et al.: Wound healing after thermal injury is improved by fat and adipose-derived stem cell isografts. J. Burn Care Res. [Internet]. [cited 2019 Nov 7]; 36 (1): 70-6. Available from: http://www.ncbi. nlm.nih.gov/pubmed/25185931. 5- El-Hoshy K., Abdel-Halim M.R.E., Dorgham D., El-Din Sayed S.S. and El-Kalioby M.: Efficacy of fractional carbon dioxide laser in the treatment of mature burn scars: A clinical, histopathological, and histochemical study. J. Clin. Aesthet. Dermatol., Dec. 1; 10 (12): 36-43, 2017. 6- Bruno A., Delli Santi G., Fasciani L., Cempanari M., Palombo M. and Palombo P.: Burn scar lipofilling: Immunohistochemical and clinical outcomes. J Craniofac Surg [Internet]. [cited 2019 Nov 7], 24 (5): 1806-14, 2013. Available from: http://www.ncbi.nlm.nih.gov/ pubmed/24036785. 7- Klinger M., Caviggioli F., Klinger F.M., Giannasi S., Bandi V., Banzatti B., et al.: Autologous fat graft in scar treatment. J Craniofac Surg [Internet]. Sep [cited 2019 Nov 7], 24 (5): 1610-5, 2013. Available from: http:// www.ncbi.nlm.nih.gov/pubmed/24036737. 8- Sullivan T., Smith J., Kermode J., McIver E. and Courtemanche D.J.: Rating the Burn Scar. J. Burn Care Rehabil [Internet]. May 1 [cited 2022 Mar 7], 11 (3): 256-60, 1990. Available from: https://academic.oup. com/jbcr/ article/11/3/256/4786520 9- Fearmonti R., Bond J., Erdmann D. and Levinson H.: A review of scar scales and scar measuring devices. Eplasty [Internet]. Jun 21 [cited 2021 May 6], 10: e43, 2010. Available from: http://www.ncbi.nlm.nih.gov/ pubmed/20596233. 10- Draaijers L.J., Tempelman F.R.H., Botman Y.A.M., Tuinebreijer W.E., Middelkoop E., Kreis R.W., et al.: The Patient and Observer Scar Assessment Scale: A reliable and feasible tool for scar evaluation. Plast. Reconstr. Surg., Jun. 113 (7): 1960-5, 2004. 11- Azzam O.A., Bassiouny D.A., El-Hawary M.S., El Maadawi Z.M., Sobhi R.M. and El-Mesidy M.S.: Treatment of hypertrophic scars and keloids by fractional carbon dioxide laser: A clinical, histological, and immunohistochemical study. Lasers Med Sci [Internet]. Jan. 1 [cited 2021 Apr. 19], 31 (1): 9-18, 2016. Available from: https://link. springer.com/article/10.1007/s10103-015-1824-4. 12- Lee S. jun, Suh D.H., Lee J.M., Song K.Y. and Ryu H.J.: Dermal Remodeling of Burn Scar by Fractional CO2 Laser. Aesthetic Plast. Surg. [Internet]. Oct 1 [cited 2022 Jan 29], 40 (5): 761-8, 2016. Available from: https:// pubmed.ncbi.nlm.nih.gov/27519176/. 13- Tredget E.E., Levi B. and Donelan M.B.: Biology and principles of scar management and burn reconstruction. Surg. Clin. North Am. [Internet]. [cited 2022 Jan 29], 94 (4): 793-815, 2014. Available from: https://pubmed.ncbi. nlm.nih.gov/25085089/. 14- Rinker B.D. and Vyas K.S.: Do Stem Cells Have an Effect When We Fat Graft? Ann Plast Surg [Internet]. [cited 2022 Jan. 29], 76 (Suppl 4): S359-63, 2016. Available from: https://pubmed.ncbi.nlm.nih.gov/26545225/ 15- Tonnard P., Verpaele A., Peeters G., Hamdi M., Cornelissen M. and Declercq H.: Nanofat grafting: Basic research and clinical applications. Plast. Reconstr. Surg., 132 (4): 1017- 26, 2013. 16- Bollero D., Pozza S., Gangemi E.N., De Marchi A., Ganem J., El Khatib A.M., et al.: Contrast-enhanced ultrasonography evaluation after autologous fat grafting in scar revision. G Chir [Internet]. [cited 2022 Jan 29], 35 (11- 12): 266, 2014. Available from: /pmc/articles/ PMC4321504/ 17- Gu Z., Li Y. and Li H.: Use of Condensed Nanofat Combined With Fat Grafts to Treat Atrophic Scars. JAMA Facial Plast Surg [Internet]. Mar. 1 [cited 2022 Jan. 29], 20 (2): 128-35, 2018. Available from: https://pubmed.ncbi. nlm.nih.gov/28975248/. 18- Lee J.W., Park S.H., Lee S.J., Kim S.H., Suh I.S. and Jeong H.S.: Clinical Impact of Highly Condensed Stromal Egypt, J. Plast. Reconstr. Surg., July 2022 221 Vascular Fraction Injection in Surgical Management of Depressed and Contracted Scars. Aesthetic Plast. Surg. [Internet]. Dec. 1 [cited 2022 Jan. 30], 42 (6): 1689-98, 2018. Available from: https://pubmed.ncbi.nlm.nih. gov/30191279/. 19- Jan S.N., Bashir M.M., Khan F.A., Hidayat Z., Ansari H.H., Sohail M., et al.: Unfiltered Nanofat Injections Rejuvenate Postburn Scars of Face. Ann. Plast. Surg. [Internet]. Jan. 1 [cited 2022 Jan. 29], 82 (1): 28-33, 2019. Available from: https://pubmed.ncbi.nlm.nih.gov/ 30285990/. 20- Ishaque M.A., Ali M., Mirza R., Sharif M. and Arshad A.W.: Facial and Hand Scars Appearance after Autologous Nanofat Grafting in Patients with Post Burn Scars. Proceedings [Internet]. Dec. 3 [cited 2022 Jan. 29], 34 (1): 25-9, 2020. Available from: https://proceedings-szmc. org.pk/index.php/szmc/article/view/45. 21- Gal S., Ramirez J.I. and Maguina P.: Autologous fat grafting does not improve burn scar appearance: A prospective, randomized, double-blinded, placebo-controlled, pilot study. Burns [Internet]. May 1 [cited 2022 Jan. 29], 43 (3): 486-9, 2017. Available from: https://pubmed. ncbi.nlm.nih.gov/28041747/. 22- Brown J.C., Shang H., Shang H., Yang N., Pierson J., Ratliff C.R., et al.: Autologous Fat Transfer for Scar Prevention and Remodeling: A Randomized, Blinded, Placebo-controlled Trial. Plast Reconstr surgery Glob open [Internet]. [cited 2022 Jan. 30], 8 (5), 2020. Available from: https://pubmed.ncbi.nlm.nih.gov/33154872/. 23- Ozog D.M., Liu A., Chaffins M.L., Ormsby A.H., Fincher E.F., Chipps L.K., et al.: Evaluation of Clinical Results, Histological Architecture, and Collagen Expression Following Treatment of Mature Burn Scars With a Fractional Carbon Dioxide Laser. JAMA Dermatology, Jan. 149 (1): 50, 2013. 24- Lee S.H., Zheng Z. and Roh M.R.: Early postoperative treatment of surgical scars using a fractional carbon dioxide laser: A split-scar, evaluator-blinded study. Dermatologic Surg [Internet]. Aug. [cited 2022 Jan. 30], 39 (8): 1190-6, 2013. Available from: https://journals. lww.com/dermatologicsurgery/Fulltext/2013/08000/Ear ly_Postoperative_Treatment_of_Surgical_Scars.8.aspx. 25- Majid I. and Imran S.: Efficacy and Safety of Fractional CO2 Laser Resurfacing in Non-hypertrophic Traumatic and Burn Scars. J. Cutan Aesthet Surg. [Internet]. [cited 2022 Jan. 30], 8 (3): 159, 2015. Available from: https:// pubmed.ncbi.nlm.nih.gov/26644740/. 26- Caruana G., Bertozzi N., Boschi E., Grieco M.P., Grignaffini E. and Raposio E.: Role of adipose-derived stem cells in chronic cutaneous wound healing. Ann. Ital Chir [Internet]. Jan. 1 [cited 2020 Dec. 16], 86 (1): 1-4, 2015. Available from: https://europepmc.org/article/ med/25818696. 27- Mailey B., Saba S., Baker J., Tokin C., Hickey S., Wong R., et al.: A comparison of cell-enriched fat transfer to conventional fat grafting after aesthetic procedures using a patient satisfaction survey. Ann. Plast. Surg. [Internet]. Apr [cited 2022 Jan. 31], 70 (4): 410-5, 2013. Available from: https://pubmed.ncbi.nlm.nih.gov/23486128 | ||||
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