Qualitative and Quantitative Analysis of Autologous Fat Grafting: A Randomized Controlled Trial
James C. Brown, MD1, Hulan Shang, MS1, Ning Yang, PhD1, Justine Pierson, MS1, Catherine Ratliffe, PhD2, Adam Katz, MD1.
1University of Florida, Gainesville, FL, USA, 2University of Virginia, Charlottesville, VA, USA.
PURPOSE: Despite a lack of high-level evidence to support improved skin/scar quality, interest in autologous fat grafting for such continues to grow. However, current treatment paradigms lack objective, high level evidence of long-term efficacy. This multi-center, double-blinded, randomized, placebo-controlled trial aimed to evaluate the effect of autologous fat grafting in patients with cutaneous scars. METHODS:
17 patients with cutaneous scars affecting quality of life were enrolled and underwent Coleman-type fat grafting. Grafting was completed with either autologous fat or saline at 1mL/cm2, and outcomes measured at baseline, 6 and 12 months. Grafted scars were evaluated using the following criteria(instrument): subjective scar quality assessment (POSAS), hardness (durometer), elasticity (cutometer), color/pigment (colorimeter) and histological analysis. Statistics were completed using SPSS. RESULTS:
Patients were 42% female, with an mean age of 42.1 ±12.9 years. POSAS score totals, cutometer and durometer analyses were not significantly different between grafted (fat) and control (saline) scar apperance, elasticity or hardness at 0, 6, or 12 months, respectively. A single significant colorimetric difference in the a* coordinate at 6 months (p = 0.037) was demonstrated, but was not durable at 12 months (p = 0.49). Individual POSAS parameter statistics and histology results are pending. CONCLUSION:
Recently, fat grafting has been increasingly touted for its ability to improve skin/scar quality and appearance. However, our study results demonstrate that this may not be supported by objective or subjective evidence obtained under randomized, placebo-treated conditions. Any putative improvements in scar quality from fat grafting are also achieved using saline controls.
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