Radyoterapiye Bağlı Hasarlı Alanda Erken Dönemde Uygulanan Yağ Greftinin Cilt Kalitesine Etkisi

Abstract

Radiotherapy, as adjuvant therapy, decreases loco-regional disease recurrance in cancer patients and improves their overall survival. Along the treatment it also gives damage to the normal cells so that affects the tissue quality. In recent years autologous fat grafting have been performed with increasing frequency, to improve quality of skin and provide convenience during the breast reconstruction surgery. The purpose of this study is to study the effects of fat grafting on controlly induced injury by irradiation objectively and to show improvements in morphological and histological tissue quality. The other purpose of this study is to understand the the effect of timing of fat grafting after radiotherapy on fibrosis. 16 Wistar Albino rats in 2 groups (n=8) were irradiated an area on the pectoral region about 4X6 cm2 in size including bilateral pectoral muscles and breasts with 20 Gy dose. The early group rats underwent fat grafting procedure under subcutaneus tissue of the irradiated area in the same day after radiotherapy. The late group the fat grafting protocol were performed 21 days after radiotherapy. The harvested fat graft was injected to right part of the pectoral region and equal amount of saline to the left part of the region. 11 weaks after radiotherapy the skin assesment was done macroscopically and samples were processed for histologic analysis. Early and late fat grafting applied sides in both groups were better quality than the skin sides fat grafting not applied. Early and late fat grafting groups were compared to each other, between the groups there was no significant difference that could be seen morphologically. Radiotherapy induced necrosis was statistically significantly lower when compared to the control sides (p=0.012, p=0.025). This difference was not significant between the early and late groups treated with fat grafting (p=0.574). The histopathologically epithelial thickness, number of capillaries, number of inflammatory cells and fibrosis at the dermis revealed no significant difference. 87.5% of subjects in the early group treated with fat grafting of was detected to have low grade fibrosis. Besides this 62.5% of the late group treated with fat graft was found low grade. Fat grafting is a simple method terms derivation and application. Patients who were expected to have tissue damage due to radiotherapy may benefit from early fat grafting. Early fat grafting may accelerate wound healing and help to improve the quality of skin by reducing the fibrosis.