Efficacy of Stromal Vascular Fraction for Scar Prevention: A Multicenter, Double-Blinded, Randomized Controlled Trial

Abstract

Background Addressing postoperative scarring remains a significant challenge across all surgical procedures, often leading to long-term aesthetic deficits. Traditional methods for scar management have shown limited efficacy, prompting exploration into innovative approaches such as the application of stromal vascular fraction (SVF).Objectives The efficacy of intraoperative SVF injection in modulating scar formation was assessed by evaluating postoperative scar quality in patients undergoing free tissue transfer.Methods This multicenter, double-blinded, placebo-controlled, randomized study assessed the efficacy of intraoperative SVF injections in mitigating scar formation in patients undergoing free tissue transfer. A total of 45 patients were enrolled from 3 institutions, undergoing either breast reconstruction with abdominal flaps or soft tissue reconstruction with anterolateral thigh flaps. The donor site incision was split in half, with one side receiving SVF injections and the other saline injections, assigned randomly. Scar quality was evaluated using the Vancouver Scar Scale (VSS) and Patient Scar Assessment Questionnaire (PSAQ), along with objective measures of pigmentation using an analyzing device.Results The primary analysis endpoint at 6 months after surgery showed a statistically significant improvement in VSS scores in the SVF group compared to the saline group. However, these differences were not maintained at the 9-month follow-up. PSAQ results indicated improved satisfaction with scar appearance at 6 and 9 months in the SVF group, despite no significant changes in erythema and melanin levels.Conclusions Intraoperative SVF infection can improve postoperative scar appearance in patients undergoing free tissue transfer. This study supports further exploration of SVF as a potential tool for enhancing aesthetic outcomes in scar management.