Journal of plastic surgery and hand surgery
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J Plast Surg Hand Surg · Apr 2012
ReviewImportance of mesenchymal stem cells in autologous fat grafting: a systematic review of existing studies.
Autologous fat grafting (lipofilling) enables repair and augmentation of soft tissues and is increasingly used both in aesthetic and reconstructive surgery. Autologous fat has several advantages, including biocompatibility, versatility, natural appearance, and low donor site morbidity. The main limitation is unpredictable graft resorption, which ranges from 25%-80%, probably as a result of ischaemia and lack of neoangiogenesis. ⋯ This effect of high-level enrichment with ASC is thought to have been caused by paracrine signalling, cellular differentiation, or both. The surgical and tissue handling techniques used in lipofilling are well proved, but the added effect of high-level enrichment with ex vivo expanded ASC still needs to be investigated properly in human lipofilling studies, combined with a thorough follow up and matched control groups. In conclusion, ASC-enriched lipofilling theoretically has the potential for transforming lipofilling from a relatively unpredictable intervention into one in which the resorption rate, quality of tissue, and safety can be predicted, and possibly superior to prosthetic implantation.
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J Plast Surg Hand Surg · Apr 2012
Comparative StudyFormation of hypertrophic scars: evolution and susceptibility.
Formation of hypertrophic scars is a common complication of wound healing, and at present little is known about the incidence and risk factors. Our aim was to analyse the incidence, progression, and regression of postoperative hypertrophic scars over time and to identify risk factors of hypertrophic scars. Patients who had had bilateral reduction mammoplasty or median sternotomy incision were included in the study. ⋯ In conclusion, 60% of patients developed hypertrophic scars postoperatively, typically during the first three months. Most hypertrophic scars that are present after three months are still hypertrophic after 12 months. Young, non-smoking patients are more susceptible to formation of hypertrophic scars.