Abstract
BackgroundThe use of fat grafting as a reconstructive surgical option is becoming much more common. Adipose-derived stem cells found in fat grafts are believed to facilitate wound healing via differentiation into fibroblasts and keratinocytes and the release of pro-healing growth factors. Several small studies have shown a positive effect of fat grafting in healing of wounds of a variety of aetiologies. When fat is combined with autologous platelet-rich plasma (PRP), there may be enhanced healing effects. This may be due to the pro-angiogenic and anti-inflammatory effects of PRP. We aim to synthesise the current evidence on combination fat grafting and PRP for wound healing to establish the efficacy of this technique.Methods/designWe will conduct a comprehensive literature search in the MEDLINE, EMBASE, CENTRAL, Science Citation Index, and Google Scholar databases (up to July 2017) to identify studies on fat grafting and PRP for wound healing. All primary studies and systematic reviews of these studies will be included, except case reports and case series with fewer than three patients, to evaluate the outcome of fat grafting and PRP on wound healing either on its own or when compared to other studies. Primary outcome measures are expected to be the proportion of total wounds healed at 12 weeks and the average wound healing time (time for 100% re-epithelialisation). Expected secondary outcome measures are the proportion of wounds achieving 50% wound healing, the type of wound benefitting most from fat grafting, economic evaluation, health-related quality of life, and adverse events. Subgroup analysis will be performed for the proportions of wounds healed based on wound aetiology.DiscussionThis review will provide robust evidence of the efficacy of fat grafting and PRP for wound healing. This is an emerging technique, and this review is expected to guide clinical practice and ongoing research aimed at improving wound care.Systematic review registrationPROSPERO CRD42016049881
Highlights
The use of fat grafting as a reconstructive surgical option is becoming much more common
Adipose-derived stem cells or MSCs found in fat are believed to facilitate healing through differentiation into cells which affect wound healing e.g. fibroblasts and keratinocytes [3]
In the event of no randomised controlled trial (RCT) being available to be included in the study, this review will be reported according to the MetaAnalysis of Observational Studies in Epidemiology (MOOSE) guidelines [33]
Summary
The use of fat grafting as a reconstructive surgical option is becoming much more common. Adipose-derived stem cells found in fat grafts are believed to facilitate wound healing via differentiation into fibroblasts and keratinocytes and the release of pro-healing growth factors. When fat is combined with autologous platelet-rich plasma (PRP), there may be enhanced healing effects. Adipose-derived stem cells or MSCs found in fat are believed to facilitate healing through differentiation into cells which affect wound healing e.g. fibroblasts and keratinocytes [3]. They release pro-healing growth factors and anti-inflammatory cytokines [4] as well as healing-related peptides such as. The evidence remains limited with no randomised controlled trials reported
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