An exploration of the relationship of fatty tissue, burn injury and scarring

  • Ryan S Chiang University of California
  • Kassandra King University of California
  • Derek Banyard University of California
  • Shadi Lalezari University of California
  • Ilaria Tocco Tussardi University of California
  • Jason D Toranto University of California
  • Alan David Widgerow University of the Witwatersrand
  • Gregory RD Evans University of California
Keywords: fat tissue, bun injury, scarring, relationship

Abstract

Adipose-derived stem cells (ADSCs) have been proposed as a treatment modality in burn wound management. While the therapeutic use of ADSCs increases, their mechanisms of action pertaining to wound healing are still poorly understood. Although fat tissue from lipoaspirate may induce wound healing under certain circumstances, in other situations it is possible that ADSCs may cause or exacerbate hypertrophic scarring (HTS). This potentially deleterious effect is considered to be due to excessive angiogenesis and tissue granulation propagated by the presence of the ADSCs. The overstimulation of vascular endothelial growth factor that may occur in burns of a certain depth and state of maturation is likely to cause this hypergranulation. ADSCs, or the stromal vascular fraction (SVF) cells, have been found to be effective in initiating softening and/or transformation in scar consistency and compliance in already established hypertrophic scars and scar contractures. In contrast, in certain phases of acute burn wound injuries, particularly when fat cones are exposed in deeper injuries, the addition of ADSCs may contribute to HTS. Until the mechanisms of action of lipoaspirate components (SVF or ADSCs) are better understood, physicians should proceed with caution before applying lipoaspirate contents to the surface of burn wounds.

Author Biographies

Ryan S Chiang, University of California
Center for Tissue Engineering and Plastic Surgery Department University of California Irvine
Kassandra King, University of California
Center for Tissue Engineering and Plastic Surgery Department University of California Irvine
Derek Banyard, University of California
MD, MBA Chief Scientist Center for Tissue Engineering and Plastic Surgery Department University of California Irvine
Shadi Lalezari, University of California
BS Center for Tissue Engineering and Plastic Surgery Department University of California Irvine
Ilaria Tocco Tussardi, University of California
MD Plastic Surgery Resident Center for Tissue Engineering and Plastic Surgery Department University of California Irvine
Jason D Toranto, University of California
MD Assistant Professor Center for Tissue Engineering and Plastic Surgery Department University of California Irvine
Alan David Widgerow, University of the Witwatersrand
MBBCh; FCS (Plast); MMed (Wits); FACS Honorary Professor Department of Plastic Surgery University of the Witwatersrand Johannesburg South Africa and Irvine CA, USA
Gregory RD Evans, University of California
MD, FACS Chairman Plastic Surgery Department University of California Irvine
Section
General Review