Elsayed, S., HELAL, H., Ghanem, M., Amin Abdelgawad, E., Labib, J. (2024). Clinical and Histological Efficacy of Nanofat Grafting in the Healing Process of Chronic Ulcers. The Egyptian Journal of Plastic and Reconstructive Surgery, 48(4), 327-334. doi: 10.21608/ejprs.2024.385113
Sherif Mohamed Saif Eldeinin Elsayed; HESHAM HELAL; Mohamed Abdelmohsen Ghanem; Ebrahim Mohamed Amin Abdelgawad; Jolly Mounir William Labib. "Clinical and Histological Efficacy of Nanofat Grafting in the Healing Process of Chronic Ulcers". The Egyptian Journal of Plastic and Reconstructive Surgery, 48, 4, 2024, 327-334. doi: 10.21608/ejprs.2024.385113
Elsayed, S., HELAL, H., Ghanem, M., Amin Abdelgawad, E., Labib, J. (2024). 'Clinical and Histological Efficacy of Nanofat Grafting in the Healing Process of Chronic Ulcers', The Egyptian Journal of Plastic and Reconstructive Surgery, 48(4), pp. 327-334. doi: 10.21608/ejprs.2024.385113
Elsayed, S., HELAL, H., Ghanem, M., Amin Abdelgawad, E., Labib, J. Clinical and Histological Efficacy of Nanofat Grafting in the Healing Process of Chronic Ulcers. The Egyptian Journal of Plastic and Reconstructive Surgery, 2024; 48(4): 327-334. doi: 10.21608/ejprs.2024.385113
Clinical and Histological Efficacy of Nanofat Grafting in the Healing Process of Chronic Ulcers
1The Departments of Plastic, Burn & Maxillofacial Surgery, Faculty of Medicine, Ain Shams University
2The Departments of Histology & Cell Biology, Faculty of Medicine, Ain Shams University
Abstract
Background: Chronic ulcers have many bad impacts and are becoming an economic burden. Nanofat is rich origin of fatty-derived stem cells and different precursor cells. This work aimed to assess efficacy of nanofat injection in chronic ulcers and evaluating its effect on the healing process. Objective: Evaluation of the efficacy of non-fat graft injection in the healing process of chronic ulcers. Methods: This prospective randomized controlled study was carried out on 20 patients of both sexes aged between 18 - 60 years old with no co-morbidities. We included patients with chronic upper or lower extremity post-traumatic ulcers of 5cm maximum diameter with no healing on conventional dressing for at least 3 months. Patients were randomly divided into two equal groups: Group A (study group) was scheduled for nanofat injection and Group B (control group) with conventional dressing with no plan for surgical intervention. Results: Vascularity, pigmentation, pliability and height were significantly improved in group A than group B. Time frame for complete healing was significantly delayed in group < br />B than that of group A (median time for complete healing was 16.5 weeks and 3 weeks respectively). Patient satisfaction was significantly increased in group A than in group B. Skin biopsies showed that the epidermal thickness, dermal area % of collagen bundles and elastic fibres and the number of epidermal and dermal proliferating cell nuclei were significantly increased while the inflammatory cell count was markedly decreased in group A compared to ulcers of group B. Conclusions: Nanofat grafting may be a promising treatment option for patients with traumatic ulcers, as it can improve wound healing outcomes and patient satisfaction
Gupta S., Sagar S., Maheshwari G., Kisaka T. and Tripathi S.: Chronic wounds: Magnitude, socioeconomic burden and consequences. Wounds Asia, 4 (1): 8-14, 2021. 2- 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- 26, 2013. Vol. 48, No. 4 / Efficacy of Nanofat Grafting i 334 n Healing of Chronic Ulcers 3- Tamburino S., Lombardo G.A., Tarico M.S. and Perrotta R.E.: The Role of Nanofat Grafting in Vulvar Lichen Sclerosus: A Preliminary Report. Arch. Plast Surg., 43: 93–95, 2016. 4- O’Neill R.C., Abu-Ghname A., Davis M.J., Chamata E., Rammos C.K. and Winocour S.J.: The Role of Fat Grafting in Buttock Augmentation. Semin Plast Surg., 34: 38- 46, 2020. 5- Hamza A., Lohsiriwat V. and Rietjens, M.: Lipofilling in breast cancer surgery. Gland Surg., 2: 7-14, 2013. 6- Menkes S., Luca M., Soldati G. and Polla L.: Subcutaneous Injections of Nanofat Adipose derived Stem Cell Grafting in Facial Rejuvenation. Plast Reconstr. Surg. Glob Open, 8: e2550, 2020. 7- Suvarna K.S., Layton C. and Bancroft J.D.: Bancroft’s theory and practice of histological techniques, Elsevier Health Sciences, 2018. 8- Maynard R., Downes N. and Finney B.: Histological Techniques: An Introduction for Beginners in Toxicology. Royal Society of Chemistry, 237-238, 2014. 9- Sanderson T., Wild G., Cull A.M., Marston J. and Zardin G.: Immuno-histochemical and immunofluorescent techniques. In: Suvarna K., Layton C., Bancroft J., eds. Bancroft’s Theory and Practice of Histological Techniques. 8th ed. Elsevier Health Sciences, 294-337, 2018. 10- Elsherbeny K., Elshahat A. and Gad A.M.: 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: 79-88, 2023. 11- Conese M., Annacontini L., Carbone A., Beccia E., Cecchino L.R., Parisi D., Di Gioia S., Lembo F., Angiolillo A., Mastrangelo F., Lo Muzio L. and Portincasa A.: The Role of Adipose-Derived Stem Cells, Dermal Regenerative Templates, and Platelet-Rich Plasma in Tissue Engineering- Based Treatments of Chronic Skin Wounds. Stem Cells Int., 9; 2020: 7056261, 2020. 12- Mohammed S.A., Abd El Salam N.F., Kalleny N.K., Bahaa N. and Labib J.M.: Effect of adipose-derived stem cells on induced photoaging in the skin of adult Guinea pig: Histological and immunohistochemical study. Egyptian Journal of Histology, 40 (2): 184-200, 2017. 13) 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. 14- Nolan G.S., Smith O.J., Heavey S., Jell G. and Mosahebi A.: Histological analysis of fat grafting with platelet-rich plasma for diabetic foot ulcers-A randomized controlled trial. Int. Wound J., 19: 389-98, 2022. 15- Deng C., Yao Y., Liu Z., Li H., Yang Z., Wang D. and Wei Z.: Chronic wound treatment with high-density nanofat grafting combined with negative pressure wound therapy. Int. J. Clin. Exp. Med., 1; 12 (2): 1402-11, 2019. 16- Prabhu V., Rao B.S., Rao A.C., Prasad K. and Mahato K.K.: Photobiomodulation invigorating collagen deposition, proliferating cell nuclear antigen and Ki67 expression during dermal wound repair in mice. Lasers in Medical Science, 1: 1-10, 2022. 17- Qu K.S., Ru Y., Yang D., Kuai L., Luo Y., Zhang P.A., Xing M. and Que H.F.: Fu-Huang ointment ameliorates impaired wound healing associated with diabetes through PI3K-AKT signaling pathway activation. Computers in Biology and Medicine, 1; 155: 106660, 2023. 18- Wei H., Gu S.X., Liang Y.D., Liang Z.J., Chen H., Zhu M.G., et al.: Nanofat-derived stem cells with platelet-rich fibrin improve facial contour remodeling and skin rejuvenation after autologous structural fat transplantation. Oncotarget, 8: 68542-56, 2017.