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A Comparison of Immediate Autologous Fat Grafting and Expanded Adipose-derived Progenitor Cells on Hypertrophic Scarring in a Swine Model

Rapp SJ; Rumburg A; Runyan C; Schwentker AR, Billmire DA; Pan BS
University of Cincinnati, Cincinnati Children's Medical Center
2013-02-23

Presenter: Scott Rapp

Affidavit:
The resident involvement exceeds 85% of time spent on project.

Director Name: David Billmire

Author Category: Resident Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction

Purpose: Hypertrophic scar formation is unpredictable and poorly understood. Conservative treatment methods have low rates of compliance and high rates of morbidity. This study attempts to develop a reproducible scar model and investigate scar modification through the use of adipose-derived progenitor stromal cells (ASCs).
Methods:20 deep-partial thickness contact burns were created on three 8-week old swine and matured for 6 weeks. Scars were injected with 2 cc saline, expanded autologous ASCs, or 2 cc fresh lipoaspirate and sampled at 2 week intervals up to 8 weeks post injection. Volumetric analysis, mechanical testing through negative pressure transduction, and Vancouver Scar Scale was utilized. Flow cytometry was performed to confirm ASC surface antigens. Expression of collagen proteins, angiogenic and adipogenic growth factors were targeted with qPCR.
Results:3-D Volumetric analysis demonstrates a reduction in average scar thickness at 6 weeks when injected with ASCs (-1.601 cc³) and autologous fat (-1.965 cc³) relative to controls (-0.121 cc³, p < 0.05). Fat or ASCs injection resulted in an initial decrease in overall compliance compared to unburned skin (35.99/ 37.94 vs 49.36 mmHg*mm), but improvement in elasticity at 6 weeks (p <0.05). Rt-PCR expression levels of COL1a1, COL3a1, VEGF, PPAR-ɤ, FABP-4 over time will be presented.
Conclusions: Early results suggest that autologous fat and/or ASCs may improve healing of hypertrophic scarring by altering the cellular and structural components during wound remodeling up to 14 weeks after injury. This may have beneficial applications in early treatment of large or cosmetically sensitive immature burn scars.

Author Contact Information:
Scott Rapp

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