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Objectives: The objective of this study was to analyze all available research on the application of autologous fat grafting (AFG) and adipose-derived stem cells (ADSC) to present evidence-based recommendations, particularly in the clinical treatment of acute burns and burn-related scars. Materials and Methods: We conducted a systematic search of PubMed, COCHRANE, and EMBASE, as well as a manual search of previous reviews' reference lists up. The risk of bias (RoB) was assessed using RoB 2.0 and ROBINS-I, where appropriate. Results: Six eligible studies were selected (2 randomized clinical trials [RCT], 1 retrospective cohort, and 3 experimental studies) with subjects ranging from 3 to 100. Only one study evaluated the use of AFG for acute burns. Improvements in wound healing, vascularization, scar characteristics, and tissue architecture were generally observed in some studies, supported by molecular markers, while one study reported nonsignificant results. Subjective patient satisfaction was reported to have improved. Functional outcomes improvement in the treated regions was minimal. However, study heterogeneity arose mainly from treatment protocols. Cautious results interpretation due to potential bias, especially in selection and confounding domains, and limited clinical trials are important to note. More studies are needed to evaluate. Conclusion: AFG and ADSC hold potential as valuable treatment options for burn-related scars, supported by a body of evidence, but further well-designed RCT are needed. The efficacy of acute burn settings is yet to be further evaluated since evidence is limited.
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Introduction and importance: The incidence of squamous cell carcinoma (SCC) in the population aged under 30 years reaches only 1% of total cases. We report the first case from Papua, Indonesia, with a double primary SCC in a patient aged just 25 years, with albinism as a risk factor. This case report can hopefully enrich existing knowledge of such tumors. Case presentation: A 25-year-old Papuan female patient came to the oncology clinic of Jayapura Regional General Hospital with a tumor on the left lower lip and a skin tumor on the right temporal side of the face. The patient noticed that the tumor on the lower lip appeared a few weeks earlier than that on the right temporal skin. Both tumors had grown gradually for 5 years. Both tumors were painless, but for the last 3 months, the tumor had bled easily. The patient was born with oculocutaneous albinism (OCA) without other syndromic or systemic disorders. Clinical discussion and conclusion: In this patient, we suspected double primary SCCs considering the location of the tumor, which theoretically spreads distantly; the size of the lesion at less than 2 cm; the depth of the lesion at less than 4 mm; and the well-differentiated cytology. Another consideration was that patients with OCA have a 1000-fold risk of developing skin cancer and an increased risk of recurrence. Therefore, continual evaluation and screening are necessary.
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INTRODUCTION AND IMPORTANCE: Deformities resulting from nasal continuous positive airway pressure delivered using prongs can cause functional and aesthetic issues for patients. Resultant severe tissue damage to the nasal structures often requires surgical intervention and techniques continue to evolve. CASE PRESENTATION: This case report describes a 6-year-old male presenting with a full-thickness columella defect; contracture causing deformities involving the nasal tip, ala nasi, and left nasal cavity wall; missing left lateral-medial cruris cartilage; and partially missing right medial cruris cartilage. The abnormalities initially appeared when the patient was 7 days old after receiving treatment by nasal continuous positive airway pressure for 7 days. A one-stage procedure was performed as follows: left ala nasi reconstruction with skin excision followed by an ear cartilage graft; a nasal cartilage shield graft to form the nasal tip; reconstruction of the columella with a cartilage graft combined with bilateral soft tissue flaps taken from the nasal floor and mucosa vestibulum; and a full-thickness skin graft to cover the secondary defect resulting from the flaps. At 1-month post-surgery, satisfactory results were reported. CLINICAL DISCUSSION AND CONCLUSION: Our approach combining two flaps taken from the nasal floor and the inner layer of the ala nasi, a cartilage graft from the ear, and a full-thickness skin graft delivered a one-stage surgical technique that yielded satisfactory results without deformities of the donor site. However, the surgical technique should be individualized to patients. This case report adds to the literature and offers surgeons an alternative approach for managing nasal deformities.
