Intra-Scar Fat Cell Implantation to Alleviate Itchy, Burning and Painful Scars
Ted Huang, MD, Ludwik Branski, MD.
Shriners Burns Hospital-Galveston, Galveston, TX, USA.
Hyperesthesia, paresthesia and pruritus are common symptoms experienced by individuals in scars during the period of active wound healing. The management can be problematic especially for patients with burns. Although regimens utilizing antihistaminic, tranquilizers and direct pressure application or intra-lesional injection of steroids have been advocated, the attainable effectiveness is variable and unpredictable. Basing upon the finding of numbness noted in patients in an area treated with free fat cell implantation, a similar sensory alteration may be elicited in a symptomatic scared skin by implanting fatty tissues, especially for those a conventional regimen had failed to alleviate itchy, burning and painful sensation.
Clinical Materials and Method: Between 2006 and 2012, 117 burn patients with the age ranged between 3 years and 15 years underwent the fat cell implantation procedure to control aberrant sensation experienced in a scarred area. The medical treatment prescribed had failed to alleviate the problems in all patients. Fat tissues aspirated manually from the buttock and/or the lower abdomen, were implanted in the offending scar tissues in the hand, thighs, and the upper trunk. There were 6 patients who had itchy scars in the chest and the back, 5 in the thighs and the remaining in the upper extremities. The amount of fat cells implanted varied between 12 to 60 cc. The treated areas were managed with light pressure dressing following the procedure. The children were followed at regular time intervals.
Findings: Aberrant sensation experienced in an offending scar disappeared immediately following the implantation and remained symptom free for the period of observation. They were followed for 1 to 6 years, with an average of 1.74 years. With an exception of a patient encountered hypo-hemoglobinemia; i.e., the hemoglobin value decreased to 4.5 Gm% from 9 Gm%, following the procedure, no complications were noted. Re-implantation of fat cells was needed in 3 because of persistent scar pruritus.
Conclusion and Summary: Although the exact scientific reasons remained undefined, sensory disturbance noted in the scarred area uncontrollable with a conventional regimen, could be effectively alleviated by implanting autologous fat cells in the offending scar tissues. The procedure is technically simple and the morbidities are low.
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