Effect of autologous fat transplantation and anastomotic vascular anterolateral fascial fat flap transplantation for PHFA facial soft tissue defect / 中国医师杂志

ABSTRACT

Objective To evaluate the efficacy and value of autologous fat transplantation and anesthesia of the anterolateral femoral fascial flap (ALT) in the clinical treatment of progressive hemifacial atrophy (PFHA).Methods From April 2014 to June 2017,42 patients with progressive hemi-facial wretched malformations who were treated in our hospital were randomly divided into observation group (using autologous fat transplantation).And 21 cases with anastomotic anterolateral femoral fascial fat flap transplantation were enrolled in the control group.Then the therapeutic effect was compared between the two groups.Results The rate of facial asymmetry in the observation group and the control group were (10.96 ±1.35) ％ and (11.98 ± 1.37) ％ in the 6 months after operation,significantly lower than that before operation [(20.13 ± 1.59)％ and (24.65 ± 1.81)％],and the difference was statistically significant (P ＜0.05);While there was no significant difference between the two groups (P ＞ 0.05).The volume of facial defect [(14.16 ±2.98)ml and (8.95 ±4.31)ml] in the observation group and the control group 6 months after operation was significantly lower than that before the operation [(43.17 ± 12.15)ml and (46.83 ±16.21)ml],with statistically significantthe difference (P ＜ 0.05);While the difference between the two groups was not statistically significant (P ＞ 0.05).The operation time and hospital days in the observation group were significantly lower than in the control group,and the number of operation times was more than that of the control group (P ＜ 0.05).The volume retention rate of the actual transplanted tissue in the observation group was lower than that of the control group [(28.12 ± 6.11) ％ vs (77.21 ± 5.33) ％],with statistically significant difference (P ＜ 0.05).There was no significant difference in the maximum and average 3-D deviation,as well as the the postoperative complications between the two groups at 6 months after operation (P ＞ 0.05).In the observation group,the satisfaction rate of the patients was significantly better than that of the control group (P ＜ 0.05),but there was no significant difference between the satisfaction degree of doctors and the third party (P ＞ 0.05).Conclusions Autologous fat granule transplantation in the clinical treatment of severe PFHA patients can effectively restore the patient's facial symmetry.At the same time,it has the characteristics of simple operation,easy operation,rich material,quick recovery of surgical trauma and no rejection.It is worth widely spreading in clinical practice.