| BackgroundHypertrophic scar causes unpleasant cosmetic and functional problems for patients,yet its treatment remains challenging.Mechanical micronization of adipose tissue can remove adipocytes and condense functional cells.Stromal vascular fraction gel(SVF-gel)is a product obtained by a series of simple mechanical processes,including inter-syringe shifting and centrifugation.This study aimed to assess the therapeutic effect of SVF-gel in the treatment of hypertrophic scar.MethodsAnimal experiment:The hypertrophic scar model was established on rabbit ears.SVF-gel and SVF suspension were produced from the rabbit inguinal fat pad and injected to the scar lesion.Two patients with severe scars caused by skin necrosis related to nasal HA injection that were not corrected by intralesional steroids and laser treatment,scars were treated by a single or multiple intradermal and subcutaneous injections of SVF-gel.The structural characterization of the scars were detected via histologic and immunohistochemical analyses.Inflammatory and fibrogenic gene expression were evaluated.Clinical cases:2 patients with skin necrosis related nasal hyaluronic acid(HA)injection,received C02 ablative laser treatment yet with noticeable scar left.Fat harvested from patients' abdomen or thigh,processed to ECM/SVF-gel,injected to the scar area subcutaneously and intracutaneously.ResultsAnimal experiment:Following the injection of SVF-gel or SVF suspension,the hypertrophic scar tissue became less visible and softer.The dermal thickness was significantly decreased,compared with PBS treatment.The SVF-gel treatment restored the subcutaneous fat tissue in the scar,while the other two treatments failed.Both SVF-gel and SVF suspension treatment reduced the macrophage amount in the dermal layer,with decreasing expression of interleukin-6 and monocyte chemoattractant protein-1.Myofibroblasts and collagen deposition were reduced in these two groups.Clinical cases:Injection of SVF-gel improved scars in all cases,and all patients were satisfied with the results.Histological examination showed that the collagen content of scar tissue was reduced after SVF-gel injection.Moreover,injection of SVF-gel induced adipogenesis within scars.ConclusionsSVF-gel transplantation has a good therapeutic effect on hypertrophic scar tissue.The injection of SVF-gel into hypertrophic scar tissue reduced the amount of macrophages and myofibroblasts.Moreover,it can restore a complete cutaneous structure with subcutaneous fat tissue. |
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