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Fat Grafting and Adipose-Derived Regenerative Cells in Burn Wound Healing and Scarring

A Systematic Review of the Literature

Condé-Green, Alexandra, M.D.; Marano, Andrew A., B.A.; Lee, Edward S., M.D.; Reisler, Tom, M.D.; Price, Leigh Ann, M.D.; Milner, Stephen M., M.B.B.S., B.D.S., D.Sc.; Granick, Mark S., M.D.

Plastic and Reconstructive Surgery: January 2016 - Volume 137 - Issue 1 - p 302–312
doi: 10.1097/PRS.0000000000001918
Reconstructive: Trunk: Original Articles
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Background: There is an abundance of literature supporting the efficacy of fat grafting in aesthetic and reconstructive cases. There has been a recent emphasis on the regenerative capacity of adipose-derived stem cells and their utility in the improvement of wound healing and scarring provided by their cytokine and growth factor profiles. Despite the wealth of evidence supporting their efficacy, little attention has been paid to their utility in burn treatment. The authors’ purpose was to provide an analysis of the literature regarding the use of fat grafting and regenerative cells in the treatment of burn wounds to guide surgeons and scientists on their clinical use.

Methods: A systematic review of the literature was performed by a thorough search of 12 terms using the PubMed, Medline, and Cochrane databases. Two hundred forty-one articles were subject to evaluation by predetermined inclusion and exclusion criteria.

Results: Six murine and 12 human studies were selected, including case-control studies, case series, and case reports. They describe histologic and clinical effects of fat grafting and regenerative cell therapy, including improvements in burn scar size and texture, enhanced angiogenesis, decreased inflammation, alleviation of pain, and return of function.

Conclusions: There is a dearth of randomized controlled trials and quantitative analysis supporting the efficacy of fat grafting and adipose regenerative cells in burns. However, the subjective improvements in scars are encouraging. The authors hope that this review will be a foundation for future studies and will highlight the breadth of knowledge yet to be explored by this therapy.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Baltimore, Md.; and Newark, N.J.

From the Division of Burn Surgery, Department of Plastic and Reconstructive Surgery, Johns Hopkins University, School of Medicine; and the Division of Plastic Surgery, Department of General Surgery, Rutgers New Jersey Medical School.

Received for publication April 7, 2015; accepted August 27, 2015.

Presented at the Eighth International Workshop on Wound Technology, in Paris, France, January 18 through 20, 2015; and the Fifth International Fat Grafting Forum, in New Orleans, Louisiana, March 12 through 14. 2015.

Disclosure:The authors declare no conflicts of interests with respect to the authorship and/or publication of this article. The authors received no financial support for the research and/or authorship of this article.

Alexandra Condé-Green, M.D., Division of Plastic Surgery, Department of General Surgery, Rutgers New Jersey Medical School, Newark, N.J. 07103, acondegreen@yahoo.com

©2016American Society of Plastic Surgeons