Clinical Impact of Highly Condensed Stromal Vascular Fraction Injection in Surgical Management of Depressed and Contracted Scars
- 132 Downloads
Recent research on stromal vascular fraction (SVF) has demonstrated the presence of numerous growth factors that aid in tissue regeneration and suggest the potential for scar treatment. This study was conducted to clinically show that adding stem cells can improve the surgical outcomes of scar formation.
Between March 2014 and February 2016, 17 patients underwent injections of fat and highly condensed SVF simultaneously with scar reduction surgeries and 15 patients received scar revision with or without simultaneous application of highly condensed SVF (4.90 × 107 stem cells/ml) at our institution. Clinical photographs were taken before and after surgery, and the scars were graded using the following standard scales: the Observer Scar Assessment Scale (OSAS), Stony Brook Scar Evaluation Scale (SBSES), Vancouver Scar Scale (VSS), and Visual Analog Scale (VAS).
All patients showed improvement, registering significant increases in scar tissue scores (P < 0.05 in all four scoring systems). Patients in the SVF group showed more improved outcomes than patients in the non-SVF group for all scar tissue scores except the SBSES (OSAS, P = 0.029; SBSES, P = 0.281; VSS, P = 0.001; VAS, P = 0.021). Subcategories of these scales reflected more favorable outcomes in terms of height and pliability; however, there was no significant change in vascularity.
SVF injections enhance tissue regeneration by contributing stem cells and growth factors to improve outcomes in scar revisions or tissue grafts. Harvesting the SVF through liposuction also provides a cosmetic benefit. Significant SVF-related gains in the scoring of scars indicate the merit of SVF as an aspect of conventional scar management.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
KeywordsCicatrix Stem cells Mesenchymal stem cell transplantation Treatment outcome Adipose tissue
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
- 1.Coleman SR (2006) Structural fat grafting: more than a permanent filler. Plast Reconstr Surg 118:108S–120S. https://doi.org/10.1097/01.prs.0000234610.81672.e7 CrossRefGoogle Scholar
- 7.Singer AJ, Arora B, Dagum A et al (2007) Development and validation of a novel scar evaluation scale. Plast Reconstr Surg 120:1892–1897. https://doi.org/10.1097/01.prs.0000287275.15511.10 CrossRefGoogle Scholar
- 9.Duncan JAL, Bond JS, Mason T et al (2006) Visual analogue scale scoring and ranking: a suitable and sensitive method for assessing scar quality? Plast Reconstr Surg 118:909–918. https://doi.org/10.1097/01.prs.0000232378.88776.b0 CrossRefGoogle Scholar
- 23.Gentile P, De Angelis B, Pasin M et al (2014) Adipose-derived stromal vascular fraction cells and platelet-rich plasma. J Craniofac Surg 25:267–272. https://doi.org/10.1097/01.scs.0000436746.21031.ba CrossRefGoogle Scholar
- 31.Wilson AM (2006) Use of botulinum toxin type A to prevent widening of facial scars. Plast Reconstr Surg 117:1758. https://doi.org/10.1097/01.prs.0000209944.45949.d1 CrossRefGoogle Scholar