Autologous lipofilling for the burn scar and contracture improvement

Abstract

Lipofilling or fat grafting is increasingly performed in plastic and reconstructive surgery. Lipofilling gives a natural therapeutic result and the grafted fat can remain in the long term as if it is the tissue of the area. The significant disadvantage of lipofilling is the unpredictable volume of the fat that is going to be reabsorbed, which varies between 25 to 80%. There have been several attempts to use different techniques; for example, centrifugation, in order to increase the number of adipose tissue-derived mesenchymal stem cells (ASC) which may improve the therapeutic result via increasing the number of vessels supplying the grafted adipose tissue and decrease the reabsorbed fat. A burn scar creates a lesion that often has poor cosmetic outcome, and causes contraction. This decreases the quality of life of the patient. The conventional surgical treatments for contraction are, namely, Z plasties, skin grafting, and flaps that possibly cause scars again and inevitably prone to contraction once again. Lipofilling is one of the alternative treatments for contracture improvement. Understanding, the cellular and histologic mechanisms that changes the clinical outcomes is important for the therapeutic process which include fat harvesting, fat preparation, and reinjection. This understanding will endorse lipofilling for burn scar and contraction.