ElSherbeny, K., Elshahat, A., Gad, A. (2023). Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft. The Egyptian Journal of Plastic and Reconstructive Surgery, 47(2), 79-88. doi: 10.21608/ejprs.2023.291375
Khaled ElSherbeny; Ahmed Elshahat; Ahmed M Gad. "Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft". The Egyptian Journal of Plastic and Reconstructive Surgery, 47, 2, 2023, 79-88. doi: 10.21608/ejprs.2023.291375
ElSherbeny, K., Elshahat, A., Gad, A. (2023). 'Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft', The Egyptian Journal of Plastic and Reconstructive Surgery, 47(2), pp. 79-88. doi: 10.21608/ejprs.2023.291375
ElSherbeny, K., Elshahat, A., Gad, A. Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft. The Egyptian Journal of Plastic and Reconstructive Surgery, 2023; 47(2): 79-88. doi: 10.21608/ejprs.2023.291375
Effect of Nano Fat Graft on the Healing of Donor Site of Split Thickness Skin Graft
The Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain Shams University
Abstract
Background: Split-thickness grafts (STSGs) harvesting is a common technique to reconstruct absent skin and to reestablish the skin barrier in burn and skin defects. Donor site morbidity is not uncommon. Various materials and dressings had been used to improve healing of donor site. Fat grafting or its components had been used in promotion of healing in chronic and irradiated wounds indicating the possibility of improving healing. Objective: To evaluate the effect of adding nano fat grafts to donor sites of STSGs. Patients and Methods: Twenty (20) adult patients were included in this comparative self-controlled clinical trial from March 2020 to April 2021. These patients had raw areas of skin needing STSG. STSG thickness was 0.12.5 inch leaving an area measuring 7x15cm (105cm2) at the donor site. The donor site area in the lower limb was used as a test area where it was divided into two equal areas, one area was covered by nano fat graft and Vaseline gauze (group A), the other acting as a control group was covered by Vaseline gauze only (group < br />B). Group A was compared to group B as regard healing time from 10th day onward and quality of healing after one month using Vancouver scale (VSS). Tissue biopsy was taken at day 21 from both groups. Any Donor site complications were noted. Results: Comparing The rate of donor site healing in group A with group B, group A showed faster healing with a mean of (13.30±2.61) versus (16.05±2.43) days from the date of harvesting of STSG. Histologically the mean thickness of neo epithelium in group A was more than that of group B with a mean value of 255.04±15.27mm and 161.15±28.75mm consecutively. Group A showed better vascularity and pliability while no difference was detected as regard pigmentation and height. Infection occurred in donor site of one patient. Conclusions: Using topical nano fat graft and Vaseline gauze on the donor site of STSG improves healing time as well as vascularity and pliability in comparison to Vaseline gauze alone.
1- Demirtas Y., Yagmur C., Soylemez F., Ozturk N. and Demir A.: Management of split-thickness skin graft donor site: A prospective clinical trial for comparison of five different dressing materials. Burns, 36: 999-1005, 2010. 2- Lohsiriwat V. and Chuangsuwanich A.: Comparison of the ionic silver-containing hydrofiber and paraffin gauze dressing on split-thickness skin graft donor sites. Ann. Plast. Surg., 62: 421-422, 2009. 3- Cigna E., Tarallo M., Bistoni G., Anniboletti T., Trignano E., Tortorelli G., et al.: Evaluation of polyurethane dressing with ibuprofen in the management of split-thickness skin graft donor sites. In Vivo, 23: 983-986, 2009. 4- Spear M. and Bailey A.: Treatment of skin graft donor sites with a unique transparent absorbent acrylic dressing. Plast. Surg. Nurs., 29: 194-200, quiz 201-202, 2009. 5- Hormbrey E., Pandya A. and Giele H.: Adhesive re ension dressings are more comfortable than alginate dressings on split-skin-graft donor sites. Br. J. Plast. Surg., 56: 498- 503, 2003. 6- Kilinc H., Sensoz O., Ozdemir R., Unlu R.E. and Baran C.: Which dressing for split-thickness skin graft donor sites? Ann. Plast. Surg., 46: 409-414, 2001. 7- Blome-Eberwein S., Johnson R.M., Miller S.F., Caruso D.M., Jordan M.H., Milner S., et al.: Hydrofiber dressing with silver for the management of split-thickness donor sites: A randomized evaluation of two protocols of care. Burns, 36: 665-672, 2010. 8- Markl P., Prantl L., Schreml S., Babilas P., Landthaler M. and Schwarze H.: Management of split-thickness donor sites with synthetic wound dressings: Results of a comparative clinical study. Ann. Plast. Surg., 65: 490-496, 2010. 9- Holmes I.V. J.H., Molnar J.A., Shupp J.W., Hickerson W.L., King B.T., Foster K.N., et al.: Demonstration of the safety and effectiveness of the RECELL1 System combined with splitthickness meshed autografts for the reduction of donor skin to treat mixed-depth burn injuries. Burns, 45: 77282, 2019. 10- Giele H., Tong A. and Huddleston S.: Adhesive retention dressings are more comfortable than alginate dressings on split skin graft donor sites - a randomised controlled trial. Ann. R Coll. Surg. Engl., 83: 431-434, 2001. 11- Severin Läuchli, Jürg Hafner, Sonja Ostheeren, Dieter Maye, R. Marjam J. Barysch and Lars E. French: Management of Split-Thickness Skin Graft Donor Sites: A Randomized Controlled Trial of Calcium Alginate versus Polyurethane Film Dressing Lauchli, et al., dermatology, 227 (4): 361-366, 2013. 12- Albert Stachura, Wiktor Paskal, Weronika Pawlik, Maciej J. Mazurek and Janusz Jaworowski: The Use of Adipose- Derived Stem Cells (ADSCs) and Stromal Vascular Fraction (SVF) in Skin Scar Treatment-A Systematic Review of Clinical Studies. J. Clin. Med., 10: 3637, 2021. 13- Brzoska M., Geiger H., Gauer S. and Baer P.: Epithelial differentiation of human adipose tissue-derived adult stem cells. Biochem Biophys Res. Commun, 330: 142-150, 2007. 14- Suvarna S.K., Layton C. and Bancroft J.D.: Bancroft's theory and practice of histological techniques, 8th edition, Churchill Livingstone, UK, ElSevier, pp. 131, 2019. 15- Marco Humrich, Lisa Goepel, Mandy Gutknecht and David Lohrberg: Health-related quality of life and patient burden in patients with split-thickness skin graft donor site wounds. Int. Wound J., 15: 266-273, 2018. 16- Serebrakian A.T., Pickrell B.B., Varon D.E., Mohamadi A., Grinstaff M.W., Rodriguez E.K., et al.: Meta-analysis and systematic review of skin graft donor-site dressings with future guidelines. Plast. Reconstr. Surg. Glob. Open, 6: e1928, 2018. 17- Brolmann F., Eskes A. and Gosling J.: Randomised clinical trial of donor site wound dressings after split skin grafting. Br. J. Surg., 100: 619-627, 2013. 18- Lauchli S., Hafner J., Ostheeren S., Mayer D. and Barysch M.: Management of split-thickness skin graft donor sites: A randomized controlled trial of calcium alginate versus polyurethane dressing. Dermatology, 227: 361-366, 2013. 19- Schubert H.M., Brandstetter M., Ensat F., Kohlosy H. and Schwabegger A.H.: Split thickness skin graft for coverage of soft tissue defects. Oper. Orthop. Traumatol., 24 (4- 5): 432-438, 2012. 20- Tonnard P., Verpaele A., Peeters G., Hamdi M., Cornelissen M. and Declercq H.: Nanofat grafting: Basic research and clinical applications. Plast. Reconstr. Surg., 132: 1017- 1026, 2013. 21- Gentile P., Scioli M.G., Bielli A., Orlandi A. and Cervelli V.: Comparing different nanofat procedures on scars: Role of the stromal vascular fraction and its clinical implications. Regen. Med., 12: 939-952, 2017. 22- Friji M.T.: Nanofat grafting: Basic research and clinical applications. Plast. Reconstr. Surg., 134: 333e-4, 2014. 88 Vol. 47, No. 2 / Effect of Nano Fat Graft on the Healing of Donor Site 23- Copcu H.E. and Oztan S.: New mechanical fat separation technique: Adjustable regenerative adipose-tissue transfer (ARAT) and mechanical stromal cell transfer (MEST). Aesthet. Surg. J. Open Forum., 2: ojaa035, 2020. 24- Chung K., Ahmer K., and Gohori B.: Systematic review of skin graft donor-site dressings - commentary. Plast. Reconstr. Surg., 124 (1): 307-308, 74, 2009. 25- Bertozzi N., Simonacci F., Grieco M.P., Grignaffini E. and Raposio E.: The biological and clinical basis for the use of adipose-derived stem cells in the field of wound healing. Ann. Med. Surg., 20: 41-8. 2, 2017. 26-Malachy Asuku a, Tzy-Chyi Yu a,*, Qi Yan b, Elaine Böing a, Helen Hahn a, Sara Hovland a, Matthias B. Donelan c,d,e: Split-thickness skin graft donor-site morbidity: A systematic literature review. Burns, 47: 1525- 1546, 2021. 27- Nedelec B., Shankowsky A. and Tredgett E.E.: Rating the resolving hypertrophic scar: Comparison of the Vancouver Scar Scale and scar volume. J. Burn Care Rehabil., 21: 205-12, 2000. 28- Madhan Jeyaraman, Sathish Muthu, Shilpa Sharma, Charan Ganta, Rajni Ranjan and Saurabh Kumar: World J. Stem Cells, November 26; 13 (11): 1733-1746, 2021. 29- Holmes IV J.H., Molnar J.A., Shupp J.W., Hickerson W.L., King B.T., Foster K.N., et al.: Demonstration of the safety and effectiveness of the RECELL1 System combined with split-thickness meshed autografts for the reduction of donor skin to treat mixed-depth burn injuries. Burns, 45: 772-82, 2019. 30- Davies L.C., Heldring N., Kadri N. and Le Blanc K.: “Mesenchymal Stromal Cell Secretion of Programmed Death-1 Ligands Regulates T Cell-Mediated Immunosuppression,” Stem Cells, Vol. 35, No. 3, pp. 766-776, 2016
View on SCiNiTO
Top