Autologous fat grafting does not improve burn scar appearance: A prospective, randomized, double-blinded, placebo-controlled, pilot study

- Fat grafting is used to “treat” scars in hopes of improving scar appearance.
- We tested the effects of fat grafts compared to control areas injected with saline.
- Blinded observers did not see improvement comparing fat grafted and control sides.
- The blinded patients did not see improvement when comparing fat grafted and control sides.

ObjectiveIt has been proposed that fat grafts can improve the appearance of mature burn scars. The pluripotent progenitor cells contained within autologous adipose tissue grafts are believed to induce skin repair and improve scar appearance. We conducted a prospective, randomized, double-blinded, placebo-controlled study to evaluate the effects of fat grafts on the appearance of mature burn scars.MethodsPediatric burn survivors with mature scars were recruited for this study. A homogeneous scar measuring 10 × 5 cm was randomized into two halves: one was injected with autologous fat graft and the other with normal saline. Scar injection was performed using standard Coleman technique. Appearance of the two scar halves was assessed, six to twelve months later by the operating surgeon, by blinded observers and by the blinded patients.ResultsEight patients completed the study pilot with 6-12 month follow-up. Assessment by the patients did not clearly favor fat grafts or saline injections; the operating surgeon did not identify any differences on any of the patients; the blinded observers measured all scars using Vancouver Scar Scale and noticed no differences in pigmentation, vascularity and height; differences in pliability showed similar changes in both the fat grafted and control arms. After the pilot was completed, decision was made to stop enrolling patients for this study since no benefit to fat grafting was observed.ConclusionsSingle treatment with autologous fat grafts did not improve mature pediatric burn scars when compared to normal saline injections.