Morphological features of skin scars on the background of treatment with autologous adipocytes

Authors

DOI:

https://doi.org/10.26641/2307-0404.2020.3.214822

Keywords:

fatty tissue, autolipografting, skin scars, morphological, immunohistochemical research

Abstract

So far the pathogenesis of changes and reconstruction of recipient tissues after transplantation of autologous adipocytes have not been studied sufficiently. The purpose of the research was to carry out the estimation of efficiency and morphological grounding of the surgery of transplanting autologous adipocytes for treating skin scars. The study included 35 patients (12 males and 23 females at the age of 18-55 years) with skin scars after deep burns. The majority of patients were with atrophic scars – 25 (71.4%); with hypertrophic – 8 (22.9%); with normotrophic – 2 (5.7%). To verify the processes in scar tissues the histological biopsy examination of the scar tissue was carried out; the samples were taken from patients with post-burn skin scars before and after the operation of transplanting autologous adipocytes. Sections were studied and pho­tographed under the microscope Zeiss "Primo Star", photocamera DCM 500. To verify the mechanism of action of autoadipocytes on the reparative processes in the scar tissues, biopsy of 11 patients with atrophic scars was studied, with immunohistochemical methods  of determining CD-34 + - cells with the help of monoclonal mouse antibodies to CD-34 (clone QBEnd/10) and determination of Ki-67– antigen in the nucleus of cells in all phases of the cellular cycle, except for G0 which was studied with the help of monoclonal rabbit antibodies (clone SP6), Thermo Scientific, USA. The carried out research has shown that after transplantation of autologous adipocytes in patients with post-burn scars, the process of tissue reconstruction starts in the recipient area. On the 12th and 21st day after the operation in areas of hyalinosis there was “discementing” and “separation” of collagen fibers, which may testify in favor of the probable lysis of the smallest dense hyaline deposits by the enzymes of the transplanted autologous adipocytes, in particular by lipoproteinlipasa. Thus there was a release of the skin fiber structures from lipoproteins of the blood plasma, the drainage function of the stroma and circulation of the tissue fluid were restored, intercellular communication was mitigated. In the tissue gaps which were freed from massive molecular deposits and polymers, capillaries were formed. Thus the total number of CD34 + - elements in biopsy before the operation on average was 39.3±7.3 (p<0.01), on the 14th day after the operation this indicator increased up to 53.5±11.0 (p<0.01), and on the 21st day it reached 83,4+22,8 (p<0.01), that is it has increased twice in comparison with the values before the operation.Accordingtotheresultsofthe immunohistochemicalresearch oftheproliferativeactivityof Ki-67 cellsinallcasesthepositivereactionwasobservedexclusivelyin cells of the basal multi-layered keratinized squamous epithelium, cells of glandular and peloid appendages of skin. Inthe areaswheretherewereCD34 + - elementsamong the bundles of collagen fibers, reaction with Ki-67 was negative. Onlyinscarbiopsyonthe 21stdayaftertheoperation, inhypodermthereweresingularepithelioidcellsneargapswithextracellularfatwhichhad Ki-67+ reaction.The increase in the number of endothelium and other CD34+ elements testifies in favor of transformation of the transplanted autologous fat cells in endothelium and other CD34+ cells.

Author Biographies

І. V. Baranov

CenterofThermal Injury and Plastic Surgery
S. Nihoian aven., 53, Dnipro, 49000, Ukraine

N. M. Nor

CenterofThermal Injury and Plastic Surgery
S. Nihoian aven., 53, Dnipro, 49000, Ukraine,
SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» Department of General Surgery 
S. Nihoian aven., 53, Dnipro, 49000, Ukraine 

S. V. Slesarenko

CenterofThermal Injury and Plastic Surgery
S. Nihoian aven., 53, Dnipro, 49000, Ukraine

P. О. Badiul

CenterofThermal Injury and Plastic Surgery
S. Nihoian aven., 53, Dnipro, 49000, Ukraine,SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» Department of General Surgery
S. Nihoian aven., 53, Dnipro, 49000, Ukraine 

К. V. Tsyhankov

SI «DnipropetrovskClinical HospitalNo. 4» DCC»
Department of Phatological Anatomy
Blyzhnia str., 31, Dnipro, 49000, Ukraine

References

Antamonov MY. [Mathematical processing and analysis of medical and biological data]. Kyiv; 2017. Russian.

Baranov ІV. [Lipofiling as a method of treating scars skins].Plastic, reconstructive and aesthetic surgery. 2019;1-2:23-30. Ukrainian.

Bardova EA. [Some aspects of scarring treat­ment]. Dermatology and Venereology. 2015;1(67):55-62. Ukrainian.

Besedin AM, Tsygankov KV, Gritsenko PA. [Morphological characteristics of wounds in patients with diabetes mellitus during Vacuum therapy]. Kharkov Surgical School. 2016;1(76):47-54. Ukrainian.

Kovalenko AA, Kozinets GP, Kovalenko OM, et al. [The influence of surgical treatment of dermal burns on na­tural resistance and development of scars]. Plastic, recon­structive and aesthetic surgery. 2018;1-2:48-61. Ukrainian.

Smolanka ІІ, Моtuziuk ІN, Sydorchuk ОІ, et al. [Place of lipofilling in complex treatment of patients with breast cancer: history aspects and own experience]. Clinical oncology. 2015;3(19):40-44. Ukrainian.

Myadelets OD, Sobolevskaya IS, Myadelets VO. [Histophysiology of fat-containing skin structures]: a ma­nual. Vitebsk: VGMU; 2015. p. 291. Russian.

Slesarenko SV, Baranov IV, Nor NN, Tsyhan­kov КV. [Reorganization of the tissue structure of skin scars when lipofilling is used]. Plastic, reconstructive and aesthetic surgery. 2019;3-4:22-31. Ukrainian.

Brewin MP, Homer SJ. The lived experience and quality of life with burn scarring-the results from a large-scale online survey. Burns. 2018;44:1801-10. doi: https://doi.org/10.1016/j.burns.2018.04.007

Harris WM, Plastini M, Kappy N, et al. Endothe­lial differentiated adipose-derived stem cells improvement of survival and neovascularization in fat transplantation. Aesthetic surgery journal. [Internet]. 2018;39(2):220-32. doi: https://doi.org/10.1093/asj/sjy130

Gal S, Ramirez JI, Maguina P. Autologous fat grafting does not improve burn scar appearance: a prospective, randomized, double-blinded, placebo-con­trolled, pilot study. Burns. [Internet]. 2017;43(3):486-9. doi: https://doi.org/10.1016/j.burns.2016.09.019

Badiul P, Sliesarenko S, Baranov I, et al. Lipofil­ling influence on the tissue structure of the skin scars. European Journal Burn Care. 2020;1:150.

Khouri Roger K Jr, Khouri Roger K. Current Cli­nical Applications of Fat Grafting. Plastic Reconstructive Surgery. 2017;3:466-86. doi: https://doi.org/10.1097/PRS.0000000000003648

Seo BF, Jung SN. The immunomodulatory ef­fects of mesenchymal stem cells in prevention or treatment of excessive scars. Stem cells international. [Internet]. 2015;2016:8. doi: https://doi.org/10.1155/2016/6937976

Garza RM, Rennert RC, Paik KJ, et al. Studies in fat grafting: Part IV. Adipose-derived stromal cell gene expression in cell-assisted lipotransfer. Plastic Reconstructive Surgery. 2015;135:1045-55. doi: https://doi.org/10.1097/PRS.0000000000001104

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Published

2020-10-05

How to Cite

1.
Baranov ІV, Nor NM, Slesarenko SV, Badiul PО, Tsyhankov КV. Morphological features of skin scars on the background of treatment with autologous adipocytes. Med. perspekt. [Internet]. 2020Oct.5 [cited 2024Nov.22];25(3):96-104. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/214822

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CLINICAL MEDICINE