Zuidema, R. (2019) Efficacy and presence of autologous fat transplantation in the treatment of patients with adherent scars, a pilot study. thesis, Medicine.
Full text available on request.Abstract
Introduction A substantial number of burn survivors develop an adherent scar because the subcutis had to be excised. Therefore, its important functions are missing. These patients suffer from pain, itching or limited range of motion (ROM). Autologous fat transplantation (AFT) is an upcoming and promising technique for the reconstruction of the subcutis. However, the effect on ROM and functionality have not been investigated yet. Also, it is still not proven whether the transplanted adipose tissue is present after AFT, because not all adipose tissue might survive the grafting process. This study aims to add ROM, functionality and presence of adipose tissue assessment to the existing literature. Methods A prospective uncontrolled trial was carried out. Eight adherent scars, from five patients undergoing AFT, were included. Pliability (Cutometer), color (Dermatospectometer), scar quality (POSAS), ROM (goniometry), functionality (QuickDASH/LEFS) and presence of adipose tissue (ultrasonography) were assessed preoperatively and at 3-months follow-up. Results Pliability increased in all of the three assessed scars. The patient-rated scar quality significantly improved with a median of the difference (MOD) of 0.7 (p = 0.092). ROM increased with 10 degrees in one scar with a severe preoperative limitation in ROM, whereas in all other scars ROM showed almost no difference. The upper extremity functionality significantly improved with a MOD of 8.5 (p = 0.068). Furthermore, an increase in subcutaneous tissue was visible on five out of six ultrasounds. No differences were seen for color, lower extremity functionality and the observer-rated scar quality. Conclusion This study shows that AFT has a significant positive effect on multiple aspects of scar quality and on upper extremity functionality. Furthermore, this study shows that adipose tissue is still present at 3-months follow-up and its presence supports the hypothesis that adipose tissue is instrumental in the treatment of adherent scars.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor and Jongen, Drs. S.J.M. and Department of Plastic and Reconstructive Surgery |
| Supervisor name: | Nieuwenhuis, Dr. M.K. and Burn Center and Martini Hospital Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:47 |
| Last Modified: | 25 Jun 2020 10:47 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/851 |
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