Autologous fat transfer to treat fibrosis and scar-related conditions: A systematic review and meta-analysis

Todor K. Krastev; Sander J. Schop; Juliette Hommes; Andrzej Piatkowski; Rene R. W. J. van Der Hulst

doi:10.1016/j.bjps.2020.08.023

Autologous fat transfer to treat fibrosis and scar-related conditions: A systematic review and meta-analysis

Todor K. Krastev^*, Sander J. Schop, Juliette Hommes, Andrzej Piatkowski, Rene R. W. J. van Der Hulst

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

22 Citations (Web of Science)

Abstract

Background: Autologous fat transfer (AFT), also known as lipofilling, has been demonstrated to be more than just a filler. Through both mechanical dissection and local tissue remodelling mediated by stem cells, it is thought to improve scar quality, function and even pain. This paper aims to investigate the evidence regarding its safety and effectiveness for treating fibrosis and scar-related conditions.

Methods: A literature search was performed in PubMed, Embase and the Cochrane Library to identify relevant studies. Extensive data extraction and standardization allowed conducting a meta-analysis.

Results: Forty-five studies (3033 patients) provided sufficient data for meta-analysis. The AFT treatment resulted in significant increase in satisfaction scores of both patient and surgeon (p = 0.001). Furthermore, a significant overall scar improvement was also found in the evaluation using the Patient and Observer Scar Assessment Scale, with the most notable effect in the scar stiffness (p

Conclusions: AFT is a promising treatment for fibrosis and scar-related conditions. Future research should focus on determining the long-term effects of AFT on fibrosis, pain and function. In addition, it would be crucial to quantify the mechanical and regenerative properties of fat as well as the effect of added supplements or stem cells. (C) 2020 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd.

Original language	English
Pages (from-to)	2033-2048
Number of pages	16
Journal	Journal of Plastic Reconstructive and Aesthetic Surgery
Volume	73
Issue number	11
DOIs	https://doi.org/10.1016/j.bjps.2020.08.023
Publication status	Published - Nov 2020

Keywords

ADIPOSE-TISSUE
APPEARANCE
Autologous fat transfer
Burns
Fibrosis
GRAFT
IMPLANT
IMPROVEMENT
INJECTION
Lipofilling
MANAGEMENT
PAIN
RECONSTRUCTION
Radiotherapy
Scars
TRANSPLANTATION
SURGERY
BREAST-CANCER
NECK
RADIOTHERAPY

Access to Document

10.1016/j.bjps.2020.08.023Licence: CC BY

Cite this

@article{324bd0aabf314df4bec528dd0ffe215a,

title = "Autologous fat transfer to treat fibrosis and scar-related conditions: A systematic review and meta-analysis",

abstract = "Background: Autologous fat transfer (AFT), also known as lipofilling, has been demonstrated to be more than just a filler. Through both mechanical dissection and local tissue remodelling mediated by stem cells, it is thought to improve scar quality, function and even pain. This paper aims to investigate the evidence regarding its safety and effectiveness for treating fibrosis and scar-related conditions.Methods: A literature search was performed in PubMed, Embase and the Cochrane Library to identify relevant studies. Extensive data extraction and standardization allowed conducting a meta-analysis.Results: Forty-five studies (3033 patients) provided sufficient data for meta-analysis. The AFT treatment resulted in significant increase in satisfaction scores of both patient and surgeon (p = 0.001). Furthermore, a significant overall scar improvement was also found in the evaluation using the Patient and Observer Scar Assessment Scale, with the most notable effect in the scar stiffness (pConclusions: AFT is a promising treatment for fibrosis and scar-related conditions. Future research should focus on determining the long-term effects of AFT on fibrosis, pain and function. In addition, it would be crucial to quantify the mechanical and regenerative properties of fat as well as the effect of added supplements or stem cells. (C) 2020 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd.",

keywords = "ADIPOSE-TISSUE, APPEARANCE, Autologous fat transfer, Burns, Fibrosis, GRAFT, IMPLANT, IMPROVEMENT, INJECTION, Lipofilling, MANAGEMENT, PAIN, RECONSTRUCTION, Radiotherapy, Scars, TRANSPLANTATION, SURGERY, BREAST-CANCER, NECK, RADIOTHERAPY",

author = "Krastev, {Todor K.} and Schop, {Sander J.} and Juliette Hommes and Andrzej Piatkowski and {van Der Hulst}, {Rene R. W. J.}",

note = "Funding Information: This research was funded by the Dutch Society of Plastic Surgeons for the purpose of Autologous Fat Transfer guideline development in the Netherlands. Publisher Copyright: {\textcopyright} 2020 Elsevier Ltd",

year = "2020",

month = nov,

doi = "10.1016/j.bjps.2020.08.023",

language = "English",

volume = "73",

pages = "2033--2048",

journal = "Journal of Plastic Reconstructive and Aesthetic Surgery",

issn = "1748-6815",

publisher = "ELSEVIER SCI LTD",

number = "11",

}

TY - JOUR

T1 - Autologous fat transfer to treat fibrosis and scar-related conditions

T2 - A systematic review and meta-analysis

AU - Krastev, Todor K.

AU - Schop, Sander J.

AU - Hommes, Juliette

AU - Piatkowski, Andrzej

AU - van Der Hulst, Rene R. W. J.

N1 - Funding Information: This research was funded by the Dutch Society of Plastic Surgeons for the purpose of Autologous Fat Transfer guideline development in the Netherlands. Publisher Copyright: © 2020 Elsevier Ltd

PY - 2020/11

Y1 - 2020/11

N2 - Background: Autologous fat transfer (AFT), also known as lipofilling, has been demonstrated to be more than just a filler. Through both mechanical dissection and local tissue remodelling mediated by stem cells, it is thought to improve scar quality, function and even pain. This paper aims to investigate the evidence regarding its safety and effectiveness for treating fibrosis and scar-related conditions.Methods: A literature search was performed in PubMed, Embase and the Cochrane Library to identify relevant studies. Extensive data extraction and standardization allowed conducting a meta-analysis.Results: Forty-five studies (3033 patients) provided sufficient data for meta-analysis. The AFT treatment resulted in significant increase in satisfaction scores of both patient and surgeon (p = 0.001). Furthermore, a significant overall scar improvement was also found in the evaluation using the Patient and Observer Scar Assessment Scale, with the most notable effect in the scar stiffness (pConclusions: AFT is a promising treatment for fibrosis and scar-related conditions. Future research should focus on determining the long-term effects of AFT on fibrosis, pain and function. In addition, it would be crucial to quantify the mechanical and regenerative properties of fat as well as the effect of added supplements or stem cells. (C) 2020 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd.

AB - Background: Autologous fat transfer (AFT), also known as lipofilling, has been demonstrated to be more than just a filler. Through both mechanical dissection and local tissue remodelling mediated by stem cells, it is thought to improve scar quality, function and even pain. This paper aims to investigate the evidence regarding its safety and effectiveness for treating fibrosis and scar-related conditions.Methods: A literature search was performed in PubMed, Embase and the Cochrane Library to identify relevant studies. Extensive data extraction and standardization allowed conducting a meta-analysis.Results: Forty-five studies (3033 patients) provided sufficient data for meta-analysis. The AFT treatment resulted in significant increase in satisfaction scores of both patient and surgeon (p = 0.001). Furthermore, a significant overall scar improvement was also found in the evaluation using the Patient and Observer Scar Assessment Scale, with the most notable effect in the scar stiffness (pConclusions: AFT is a promising treatment for fibrosis and scar-related conditions. Future research should focus on determining the long-term effects of AFT on fibrosis, pain and function. In addition, it would be crucial to quantify the mechanical and regenerative properties of fat as well as the effect of added supplements or stem cells. (C) 2020 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd.

KW - ADIPOSE-TISSUE

KW - APPEARANCE

KW - Autologous fat transfer

KW - Burns

KW - Fibrosis

KW - GRAFT

KW - IMPLANT

KW - IMPROVEMENT

KW - INJECTION

KW - Lipofilling

KW - MANAGEMENT

KW - PAIN

KW - RECONSTRUCTION

KW - Radiotherapy

KW - Scars

KW - TRANSPLANTATION

KW - SURGERY

KW - BREAST-CANCER

KW - NECK

KW - RADIOTHERAPY

U2 - 10.1016/j.bjps.2020.08.023

DO - 10.1016/j.bjps.2020.08.023

M3 - (Systematic) Review article

C2 - 32948494

SN - 1748-6815

VL - 73

SP - 2033

EP - 2048

JO - Journal of Plastic Reconstructive and Aesthetic Surgery

JF - Journal of Plastic Reconstructive and Aesthetic Surgery

IS - 11

ER -