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Klinger F, Bozzo G, Vinci V, Klinger M, Battistini A. Comment on "Reverse Expansion Following Nipple Sparing Mastectomy: A Natural, Safe and Effective Autologous Technique for Breast Reconstruction". Aesthetic Plast Surg 2023; 47:49-50. [PMID: 35543725 DOI: 10.1007/s00266-022-02898-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 12/13/2022]
Abstract
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 .
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Affiliation(s)
- Francesco Klinger
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Reconstructive and Aesthetic Plastic Surgery School, Humanitas Clinical and Research Hospital,, University of Milan, Via Manzoni 56, 20090, Rozzano Mi, Italy
| | - Giulia Bozzo
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Reconstructive and Aesthetic Plastic Surgery School, Humanitas Clinical and Research Hospital,, University of Milan, Via Manzoni 56, 20090, Rozzano Mi, Italy
| | - Valeriano Vinci
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele- Milan, Italy
| | - Marco Klinger
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Reconstructive and Aesthetic Plastic Surgery School, Humanitas Clinical and Research Hospital,, University of Milan, Via Manzoni 56, 20090, Rozzano Mi, Italy
| | - Andrea Battistini
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Reconstructive and Aesthetic Plastic Surgery School, Humanitas Clinical and Research Hospital,, University of Milan, Via Manzoni 56, 20090, Rozzano Mi, Italy.
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Lorenzano V, Vaccari S, Vinci V, Klinger FM. Letter to the Editor on Density-Based High-Quality Fat: Characterization and Correlation with Different Body Fat Ratio. Aesthetic Plast Surg 2023; 47:109-110. [PMID: 35920863 DOI: 10.1007/s00266-022-03040-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Valerio Lorenzano
- Department of Plastic and Reconstructive Surgery, European Institute of Oncology, IRCCS, Milan, Italy.
| | - Stefano Vaccari
- Humanitas Clinical and Research Center - IRCCS - Plastic Surgery Unit, Rozzano, Italy
| | - Valeriano Vinci
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- Humanitas Clinical and Research Center-IRCCS, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Francesco Maria Klinger
- Department of Health Sciences, Ospedale San Paolo, University of Milan, Via Antonio di Rudinì, 8, 20142, Milan, Italy
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Autologous Fat Grafting as Treatment of Postmastectomy Pain Syndrome: A Randomized Controlled Trial. Plast Reconstr Surg 2023; 151:520e-521e. [PMID: 36730330 DOI: 10.1097/prs.0000000000009940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Postirradiation Capsular Contracture in Implant-Based Breast Reconstruction: Management and Outcome. Plast Reconstr Surg 2021; 148:843e-844e. [PMID: 34605795 DOI: 10.1097/prs.0000000000008444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Huang R, Jiao H, Fan J, Liu L, Tian J, Gan C, Yang Z, Zhang T, Zeng Y, Su Z. Invited Response on: Nanofat Injection for the Treatment of Depressed Facial Scars. Aesthetic Plast Surg 2021; 45:2548-2549. [PMID: 33885939 DOI: 10.1007/s00266-021-02283-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 10/21/2022]
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Safety and Effectiveness of Autologous Fat Grafting after Breast Radiotherapy: A Systematic Review and Meta-Analysis. Plast Reconstr Surg 2021; 148:658e-659e. [PMID: 34468480 DOI: 10.1097/prs.0000000000008339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Comment on "Nanofat Injection for the Treatment of Depressed Facial Scars". Aesthetic Plast Surg 2021; 45:2546-2547. [PMID: 33890121 DOI: 10.1007/s00266-021-02264-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
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Comment on: "Breast Reconstruction Does Not Increase the Incidence of Postmastectomy Pain Syndrome". Ann Plast Surg 2021; 89:338-339. [PMID: 34510084 DOI: 10.1097/sap.0000000000002999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Francesco K, Benedetta A, Valeria B, Andrea B, Stefano V, Giulia B, Valeriano V. Comment to "Early Intervention with Autologous Fat Grafting to Reduce Hypertrophic Scar Formation: A Preliminary Study". Aesthetic Plast Surg 2021; 46:223-224. [PMID: 34378074 DOI: 10.1007/s00266-021-02510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Klinger Francesco
- Plastic Surgery Unit, Reconstructive and Aesthetic Plastic Surgery School, MultiMedica Holding S.p.A., University of Milan, Milan, Sesto San Giovanni, Italy
| | - Agnelli Benedetta
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy.
| | - Bandi Valeria
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Battistini Andrea
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Vaccari Stefano
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Bozzo Giulia
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
| | - Vinci Valeriano
- Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Milan, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Pieve Emanuele, Italy
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Autologous Craniofacial Fat Grafting in the Irradiated Field. J Craniofac Surg 2021; 32:1742-1745. [PMID: 34319678 DOI: 10.1097/scs.0000000000007549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Autologous fat grafting has been used as a reconstructive modality following the treatment of head and neck malignancy. However, it has been criticized for poor graft retention and unpredictable results, which may be further compromised by prior radiation therapy. This systematic review will consolidate the literature on autologous fat grafting in the previously irradiated craniofacial region and report its effects on aesthetic and functional outcomes, volume resorption, and postoperative complications. A computerized search of Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Web of Science was performed. Screening and data extraction were performed in duplicate. Data were extracted from the included articles, and outcomes were analyzed categorically. Sixty patients from six studies were included. Mean age was 46.06 years (range 13-73) and 37.5% were female. All studies used the Coleman technique fat grafting or a modified version. A total of 94.9% of patients had significant improvement in aesthetic outcomes and 86.1% in the study specific functional outcomes. Mean graft volume resorption was 41% (range 20%-62%) and there were three (5%) postoperative complications. Autologous fat grafting is increasingly being used to optimize aesthetic outcome following head and neck reconstruction, even in the presence of prior radiation treatment. Although the literature to date is encouraging, the heterogeneity in patient population, intervention, outcome measures, and time horizon limit our ability to draw conclusions about the success of craniofacial fat grafting in the irradiated field. Future research should include a large comparative study as well as a protocol for standardizing outcome measures in this population.
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Lisa A, Losurdo A, Testori A, Tinterri C, Santoro A, Klinger M. Comment on: "Oncologic Safety of Autologous Fat Grafting in Breast Reconstruction". Clin Breast Cancer 2021; 21:e693. [PMID: 34052106 DOI: 10.1016/j.clbc.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 04/02/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Andrea Lisa
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Rozzano, Milan, Italy.
| | - Agnese Losurdo
- UO of Medical Oncology, Department of Oncology Hematology, Humanitas Clinical and Research Center, Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan, Italy
| | - Alberto Testori
- Breast Surgery Department, Humanitas Clinical and Research Center, Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan, Italy
| | - Corrado Tinterri
- Breast Surgery Department, Humanitas Clinical and Research Center, Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan, Italy
| | - Armando Santoro
- UO of Medical Oncology, Department of Oncology Hematology, Humanitas Clinical and Research Center, Istituto di Ricovero e Cura a Carattere Scientifico, Rozzano, Milan, Italy; Humanitas University Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy
| | - Marco Klinger
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Rozzano, Milan, Italy
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Galtelli L, Battistini A, Bandi V, Vinci V, Klinger F. Comment on: ``The safety and efficacy of autologous fat grafting during second stage breast reconstruction". J Plast Reconstr Aesthet Surg 2021; 74:2392-2442. [PMID: 33926831 DOI: 10.1016/j.bjps.2021.03.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Leonardo Galtelli
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, Rozzano, 20090 Milan, Italy.
| | - Andrea Battistini
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, Rozzano, 20090 Milan, Italy
| | - Valeria Bandi
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, Rozzano, 20090 Milan, Italy
| | - Valeriano Vinci
- Humanitas University Department of Biomedical Sciences, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy; Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Francesco Klinger
- Plastic Surgery Unit, MultiMedica Holding S.p.A., Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Sesto San Giovanni, Milan, Italy
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Rimondo A, Battistini A, Vinci V, Bandi V, Klinger M, Klinger F. Letter comments on "Autologous fat grafting seems to alleviate postherpetic neuralgia - A feasibility study investigating patient-reported levels of pain". J Plast Reconstr Aesthet Surg 2021; 74:2392-2442. [PMID: 33849801 DOI: 10.1016/j.bjps.2021.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/11/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Andrea Rimondo
- Humanitas Clinical and Research Center - IRCCS, Plastic Surgery Unit, via Manzoni 56, Rozzano, 20089 Milan, Italy; University of Milan, Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, Humanitas Clinical and Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy.
| | - Andrea Battistini
- Humanitas Clinical and Research Center - IRCCS, Plastic Surgery Unit, via Manzoni 56, Rozzano, 20089 Milan, Italy; University of Milan, Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, Humanitas Clinical and Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Valeriano Vinci
- Humanitas University Department of Biomedical Sciences, Via Rita Levi Montalcini 4, Pieve Emanuele, 2009 Milan, Italy; Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Valeria Bandi
- Humanitas Clinical and Research Center - IRCCS, Plastic Surgery Unit, via Manzoni 56, Rozzano, 20089 Milan, Italy; University of Milan, Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, Humanitas Clinical and Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Marco Klinger
- Humanitas Clinical and Research Center - IRCCS, Plastic Surgery Unit, via Manzoni 56, Rozzano, 20089 Milan, Italy; University of Milan, Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, Humanitas Clinical and Research Hospital, via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Francesco Klinger
- Plastic Surgery Unit, MultiMedica Holding S.p.A., Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Milanese 300, 20099 Sesto San Giovanni, Milan - Italy
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Fat Grafting in Radiation-Induced Soft-Tissue Injury: A Narrative Review of the Clinical Evidence and Implications for Future Studies. Plast Reconstr Surg 2021; 147:819-838. [PMID: 33776031 DOI: 10.1097/prs.0000000000007705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
SUMMARY Radiation-induced changes in skin and soft tissue result in significant cosmetic and functional impairment with subsequent decrease in quality of life. Fat grafting has emerged as a therapy for radiation-induced soft-tissue injury, and this narrative review aims to evaluate the current clinical evidence regarding its efficacy. A review was conducted to examine the current clinical evidence of fat grafting as a therapy for radiation-induced injury to the skin and soft tissue and to outline the clinical outcomes that can be used to more consistently quantify chronic radiation-induced injury in future clinical studies. The current clinical evidence regarding the efficacy of fat grafting to treat radiation-induced injury of the skin and soft tissue suggests that fat grafting increases skin softness and pliability, induces volume restoration, improves hair growth in areas of alopecia, reduces pain, and improves cosmetic and functional outcomes. However, literature in this field is far from robust and mired by the retrospective nature of the studies, lack of adequate controls, and inherent limitations of small case series and cohorts. A series of actions have been identified to strengthen future clinical data, including the need for physical examination using a validated scale, appropriate imaging, skin biomechanics and microcirculation testing, and histologic analysis. In conclusion, radiation-induced soft-tissue injury is a significant health burden that can lead to severe functional and aesthetic sequelae. Although still in a preliminary research phase, there is promising clinical evidence demonstrating the benefits of fat grafting to treat chronic changes after radiation therapy. Future clinical studies will require larger cohorts, adequate controls, and consistent use of objective measurements.
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Lisa AVE, Murolo M, Maione L, Vinci V, Battistini A, Morenghi E, De Santis G, Klinger M. Autologous fat grafting efficacy in treating PostMastectomy pain syndrome: A prospective multicenter trial of two Senonetwork Italia breast centers. Breast J 2020; 26:1652-1658. [PMID: 32524696 DOI: 10.1111/tbj.13923] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 12/24/2022]
Abstract
Postmastectomy pain syndrome (PMPS) represents a common complication following breast surgery defined as a chronic neuropathic pain located in the front of the chest, in the axilla and in the upper arm that for more than 3 months after surgery. Several medications prove to be ineffective while autologous fat grafting revealed to be an innovative solution in the treatment of neuropathic pain syndromes based on retrospective studies. For this reason, we performed a prospective multicenter trial to reduce the memory bias and further increase the evidence of the results. From February 2018 to March 2019, 37 female patients aged between 18 and 80 years, underwent mastectomy or quadrantectomy with pathologic scarring and chronic persistent neuropathic pain, compatible with PMPS, are been included in the study and treated with autologous fat grafting. During the enrollment phase, patients were asked to estimate pain using the Visual Analogue Scale (VAS) and POSAS questionnaire in order to evaluate scar outcomes. The VAS scale, starting from 6.9 (1.3), decreased in the first month by 3.10 (1.59), continuing to fall by 0.83 (1.60) to 3 months and by 0.39 (2.09) at 6 months. Statistical analysis showed a significant reduction after 1 month (P < .0001) and 3 months (P < .005). All POSAS grades documented a statistically significant reduction (P < .0001) of the scores by both observers and patients. We observed that no significant association was found between age, BMI, menopausal status of patients, days from oncologic surgery to autologous fat grafting and reduction of VAS values over time while both smoking and axillary dissection were observed as the main factor significantly associated with a reduced clinical efficacy (respectively, P = .0227 and P = .0066). Our prospective multicenter trial confirms the efficacy of fat grafting in the treatment of PMPS based on the principle of regenerative medicine with a satisfactory response in terms of pain reduction and improvement of the quality of the treated tissues. Clinical questionnaires show that the cicatricial areas improve in terms of color, thickness, skin pliability, and surface irregularities. Regenerative effect is based also on the adoption of needles. The combined effect of fat grafting and needles determines a clinical full response.
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Affiliation(s)
- Andrea Vittorio Emanuele Lisa
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Milan, Italy
| | - Matteo Murolo
- Chirurgia Plastica, Università di Modena e Reggio, Policlinico di Modena, Modena, Italy
| | - Luca Maione
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Milan, Italy
| | - Valeriano Vinci
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Milan, Italy
| | - Andrea Battistini
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Milan, Italy
| | - Emanuela Morenghi
- Biostatistics Unit, Humanitas Clinical and Research Center, Rozzano, Italy
| | - Giorgio De Santis
- Chirurgia Plastica, Università di Modena e Reggio, Policlinico di Modena, Modena, Italy
| | - Marco Klinger
- Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Milan, Italy
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Response to: "Clinical Application of Precise Composite Breast Augmentation". Ann Plast Surg 2020; 84:731-732. [PMID: 32433333 DOI: 10.1097/sap.0000000000002383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Comment on "Unfiltered Nanofat Injections Rejuvenate Postburn Scars of Face". Ann Plast Surg 2019; 83:489-490. [PMID: 31524750 DOI: 10.1097/sap.0000000000001959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Maione L, Lisa A, Vinci V, Bandi V, Klinger F, Klinger M. AUtologous fat graft in foot calcaneal postsurgical chronic ulcer. Injury 2019; 50 Suppl 4:S64-S67. [PMID: 31526600 DOI: 10.1016/j.injury.2019.08.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Post-traumatic injury of talus's posterior area and ankle joint with consequent scar formation is often complicated by an unhealing trophic ulcer. Aim of this paper is to evaluate the autologous fat graft effectiveness in treating Achilles tendon area wounds. MATERIAL AND METHODS From October 2011 to March 2014 we treated with fat graft a total of 7 patients with post-surgical painful chronic ulcer of calcaneal area. Mean age was 38.6 years (range 22-64 years). One patient was a professional football player who was presenting a post-injury ulcer not respondant to advanced dressings. RESULTS Wound rehepitelization was observed in all cases treated within one month and fat grafting resolved pain related to the wound. All patient returned to their daily normal activities. In all cases treated we observed an increased softness of perilesional post-surgical scars. Our professional football player came back able to perform an usual training 5 days post-operation obtaining complete rehepitelization within 3 weeks. DISCUSSION Our surgical approach showed a therapeutic effect that relies on biological properties of adipose tissue; those properties are clear in both procedures of chronic ulcer's rehepitelization stimulation and perilesional tissue's enhancement obtaining pain control. The procedure is safe, with low rate of complication.
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Affiliation(s)
- Luca Maione
- Clinica San Carlo, Plastic Surgery Unit, Via Ospedale 21, 20037, Paderno Dugnano, Milan, Italy
| | - Andrea Lisa
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Plastic Surgery Unit, Humanitas Clinical and Research Center, University of Milan, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Valeriano Vinci
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Plastic Surgery Unit, Humanitas Clinical and Research Center, University of Milan, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Valeria Bandi
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Plastic Surgery Unit, Humanitas Clinical and Research Center, University of Milan, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Francesco Klinger
- Reconstructive and Aesthetic Plastic Surgery School, MultiMedica Holding S.P.A., Plastic Surgery Unit, University of Milan, Sesto San Giovanni, Milan, Italy
| | - Marco Klinger
- Reconstructive and Aesthetic Plastic Surgery School, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Plastic Surgery Unit, Humanitas Clinical and Research Center, University of Milan, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
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