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Autologous Fat Grafting for the Oral and Digital Complications of Systemic Sclerosis: Results of a Prospective Study

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Abstract

Background

Systemic sclerosis is a connective tissue disease. Skin involvement of the mouth and hand may compromise function and quality of life. Autologous fat grafting has been described as a specific treatment of these clinical features. We report the results of our prospective study designed to treat and prevent skin complications in systemic sclerosis.

Materials and Methods

We treated 25 patients with mouth and/or hand involvement (microstomia, xerostomia, skin sclerosis, Raynaud’s phenomenon and long-lasting digital ulcers) with autologous fat grafting, according to the Coleman’s technique, around the mouth and/or at the base of each finger. The surgical procedures were repeated in each patient every 6 months for a total of two or three times. Clinical data were collected before the first surgery and again 6 months after each surgical procedure. Pain, skin thickness, saliva production and disability were assessed with validated tests.

Results

Overall we performed 63 autologous fat grafting sessions (either on the mouth, on the hands or on both anatomical areas). Results at 6 moths after the last session included improvement of xerostomia evaluated with a sialogram, reduction of the skin tension around the mouth and, in the hands, reduction of the Raynaud phenomenon as well as skin thickness. Pain was reduced while the perception of disability improved. Digital ulcers healed completely in 8/9 patients.

Conclusions

Our results confirm the efficacy and safety of autologous fat grafting for the treatment of skin complications and digital ulcers due to systemic sclerosis. In addition, the patients’ subjective well-being improved.

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Authors and Affiliations

  1. Plastic Surgery, Policlinico di Sant’Orsola, DIMES, University of Bologna, Bologna, Italy

    Marco Pignatti

  2. Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy

    Amelia Spinella, Emanuele Cocchiara, Giorgia Citriniti, Federica Lumetti, Carlo Salvarani & Dilia Giuggioli

  3. Plastic Surgery, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy

    Giulia Boscaini, Irene Laura Lusetti & Giorgio De Santis

  4. Unit of Dentistry and Oral-Maxillofacial Surgery, University of Modena and Reggio Emilia, Modena, Italy

    Giacomo Setti

  5. Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria, Policlinico di Modena, Modena, Italy

    Massimo Dominici

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  1. Marco Pignatti
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  2. Amelia Spinella
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Correspondence to Marco Pignatti.

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None of the authors has any commercial interest in the subject of study and does not have received any financial or material support.

Ethical Approved

The study was approved by the local ethical committee of the University of Modena and Reggio Emilia (number 275/16) and performed according to the criteria of the Helsinki declaration.

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All patients gave their written consent.

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Pignatti, M., Spinella, A., Cocchiara, E. et al. Autologous Fat Grafting for the Oral and Digital Complications of Systemic Sclerosis: Results of a Prospective Study. Aesth Plast Surg 44, 1820–1832 (2020). https://doi.org/10.1007/s00266-020-01848-2

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