Facial and Hand Scars Appearance after Autologous Nanofat Grafting in Patients with Post Burn Scars
Introduction: Management of unsightly post burn scars has changed tremendously in current era of cosmetic awareness. 5 12% of all worldwide injuries are burn injuries and approximately 11 million patients need hospital care. Multiple treatment methods for scar improvement including fat grafting are under investigation. Nano fat Grafting is newer modality of fat grafting for improving scar quality. Aims Objectives: The aim of this study was to assess the outcome of facial and hand scars appearance after autologous Nanofat grafting in patients with post burn scars. Place and duration of study: The study was performed in Plastic Surgery Department of Shaikh Zayed hospital, Lahore Pakistan from October 2018 to September 2019. Material Methods: 30 patients with post burn scars of face and hands were included; age range was 18 to 43 years. Skin type 2 to 4 (Fitzpatrick skin type) Patients with skin graft, hypertrophic scars, contractures, or keloids were excluded. Scars were assessed by the patients and observer on a scale "POSAS" (Patient and Observer Scar Assessment Scale) the observer was a plastic surgeon. Scar was assessed before surgery using the POSAS scar scale. Fat was taken from the abdomen using 3mm cannulas with side holes of 1 2mm under tumescent conditions and transferred to 10 cc syringes with luer lock. Nano fat obtained after emulsification by passing 30 times from one syringe to another through luer lock. The follow up was on 7th day, at 3 months and at 6 months. Results: The mean POSAS score of observer decreased significantly from admission 35.8+ 4.0, at 3 months 31.3+ 3.8 and 6 months to 27.5+ 3.0, p value 0.05. The mean POSAS score of patients also significantly decreased, p value 0.05 over the same time period from admission at 42.4+ 5.2, to 3 month 37.3+ 4.0 and 6 month to 32.2+ 3.2. Conclusion: Nano fat grafting results in improvement in scar appearance and is an effective approach towards the management post burn scar of face and hands.