Fat and epidermal cell suspension grafting: a new advanced one-step skin regeneration surgical technique

Abstract

BackgroundDystrophic skin scarring commonly occurs following skin cancer resections. In particular, the cosmetic outcome of skin graft reconstructions, following epidermoidal carcinoma removal, is generally poor due to wide marginal tumour excision, loss of subcutaneous tissues, and subsequent pigmented atrophic scarring of the graft coverage. Skin grafting sequelae need a three dimensional correction to restore either the epidermal layer or the dermal/subdermal volume and vascularization.MethodsThe surgeons combined CO2 laser ablation, subdermal lipofilling according to the Coleman’s technique and epidermal cell suspension autografting to correct wide depressed and dyschromic facial scar. The Authors applied this new technique on three nasal skin cancer resected patients: two of them actually need a longer follow-up, the third patient, a 48 yr old caucasian male, presented a skin grafting scar due to sclerodermiform basal cell carcinoma removal. This case is reported discussing pre-intra and post-operative records up to a complete twelve months follow-up.ResultsRecords at six and twelve months follow-up after surgery demonstrate a fully integrated skin graft and a good restoration of the treated area, presenting the same texture and pigmentation of the adjacent untreated skin. Optimal, stable three-dimensional skin cosmetic restoration was obtained in a single stage surgical procedure.ConclusionAutologous non-cultured epidermal cell suspension transplantation on an epidermal laser ablated skin area, in combination with lipofilling subdermal reconstruction, appears to be an effective, simple and time-saving method to correct skin graft sequelae, in skin cancer patients. This new technique allows to restore a three-dimensional morphological structure of the treated area and to recover a natural appearance of the skin at the same time. The Authors believe that this technique can be safely used to treat any kind of dystrophic scarring.

The use of noncultured regenerative epithelial suspension for improving skin color and scars: A report of 8 cases and review of the literature

“…Studies included were 13 case reports, 3 randomized researches, and 1 comparative study, respectively. Of the 17 cases, 4 were performed for treating wound healing in burn, 6 for vitiligo treatment, 2 for chronic wound, 2 for skin cancer reconstruction, 1 for skin scar and 1 for congenital melanocytic nevi . A summary of the 17 cases is presented in Table .…”

Extracellular fraction of adipose tissue as an innovative regenerative approach for vitiligo treatment

“…One of the challenges is to determine how targeting the disease‐specific microenvironment could improve the clinical outcome of cell graft since a hostile microenvironment could also be improper for cell engraftment. We recently successfully used fat minigraft in combination with autologous non‐cultured epidermal cell suspension transplantation to correct skin scarring occurring after skin cancer resection . In this case, the patient's plasma was employed as a natural carrier for the epidermal cells.…”

“…We recently successfully used fat minigraft in combination with autologous non-cultured epidermal cell suspension transplantation to correct skin scarring occurring after skin cancer resection. [71] In this case, the patient's plasma was employed as a natural carrier for the epidermal cells. Based on the results presented in this study, this procedure may be improved in the future by the replacement of plasma with AT-Ex.…”

TEMA 6-2016: Técnicas de reconstrucción nasal tras resección de un carcinoma basocelular

“…(1)(2)(3)(4)(5)(6) Es una neoplasia de piel no melanocítica que surge de las células basales de la epidermis o de folículos pilosos, y que al ser localmente invasiva y de crecimiento lento puede resultar en gran desfiguración cosmética. (1,2,5,7,8) El CBC se observa más frecuentemente en zonas fotoexpuestas por la acumulación crónica de radiación ultravioleta. Ocurre principalmente en la cara, siendo más común en la nariz, específicamente en la punta nasal y las alas; y en pacientes de piel clara.…”