Stem cell enriched dermal substitutes for the treatment of late burn contractures in patients with major burns

doi:10.1016/j.burns.2017.09.026

Burns

Volume 44, Issue 3, May 2018, Pages 724-726

https://doi.org/10.1016/j.burns.2017.09.026 Get rights and content

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Contracture release

Surgical release of contractures was performed under general anaesthetic and the resulting defects assessed intraoperatively (Figs. 2b and 3b).

ADRC harvest

Abdominal fat was harvested from the patients by tumescent liposuction and the automated Celution system (Cytori Therapeutics, San Diego, CA, USA) was used to extract the Stromal Vascular Fraction (SVF) from the lipoaspirate. SVF extraction is a robustly validated technique which produces a heterogeneous population of cells, very rich in adipose stem

Case 1

A healthy 42-year-old female patient with significant breast asymmetry following major scald injuries as a child which required excision and skin grafting at the time. Prior to Integra resurfacing the patient had undergone lipofilling of the breasts, but the result remained suboptimal cosmetically. Fig. 2 shows the preoperative contracture, intraoperative defect and postoperative result. The patient was very satisfied with her outcome and still maintains an excellent result at 7 months

Conclusion

There is no doubt that stem-cell research in the field of Burns Surgery has yet to yield any groundbreaking results. However, by combining two easily accessible medical devices (Integra and Cytori), we were able to treat complex burns contractures and produce very good functional and cosmetic outcomes with high patient satisfaction. We would not recommend this technique routinely, but we believe that it bears consideration when dealing with highly complex burns patients with contractures