Effect of Autologous Fat Transfer in Acute Burn Wound Management: A Randomized Controlled Study

Abstract Objective The use of fat grafting is being widely used for different indications one of which is wound healing. In this study we compare the use of autologous fat grafting (AFG) as a novel indication in acute burn wounds healing and post-burn scarring to the conventional methods of burn wound management both clinically and histologically. Several small observational studies demonstrated the effect of the AFG in healing of chronic wounds, different vascular ulcers or effect on scars yet there is no randomized controlled trial to compare its roll with the conventional methods. Methods The study was a prospective, open-label single centre, randomized control clinical trial included 100 patients with superficial and deep dermal burns from March 2019 to March 2020 randomized to AFG protocol consisted of a single injection of autologous fat grafting then dressed with nano fat (Group A) or conventional methods of serial dressings with 1% silver sulphadiazine or other topical agents (Group B). Inclusion criteria included newly admitted burn patients with affected total body surface area (TBSA) (10%-25%) while exclusion criteria included burns patients with affected TBSA of 25%, or loss of subcutaneous fat, fascia, muscles and bones, inhalational burn, and burns in genitalia, perineum and peri-anal areas and co-morbidity(ies) that might affect wound healing or eligibility for anaesthesia and surgery. Also, results were confirmed by histological analysis for samples from both groups by light microscopic examination, and the nano-fat was subjected to flow cytometric analysis of the cluster of differentiation (CD) markers of mesenchymal stem cells markers CD 90, CD44, CD45, CD 73, and CD 34. (ClinicalTrials.gov Identifier: NCT03791710) Results There was a significant reduction in total hospital stay days (p= Conclusion In a comparison between AFG protocol to the conventional methods in the treatment of acute burn wounds, AFG protocol was associated with significant clinical improvement in the form of lower hospital stay time, lower incidence of scaring or contracture and lower need for skin grafting which was confirmed by serial photographic and histological assessment.