Open AccessAutologous Fat Transfer as a Treatment for Peripheral Neuropathic Pain without Apparent Cause
Author(s) -
Jop Beugels,
Juliëtte Hommes,
Andrea J.R. Balthasar,
René R W J van der Hulst,
Andrzej Piatkowski
Publication year - 2018
Publication title -
plastic and reconstructive surgery. global open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.759
H-Index - 28
ISSN - 2169-7574
DOI - 10.1097/gox.0000000000001905
Subject(s) - medicine , neuropathic pain , visual analogue scale , refractory (planetary science) , anesthesia , patient satisfaction , surgery , prospective cohort study , scars , quality of life (healthcare) , physics , nursing , astrobiology
Summary: Neuropathic pain has a far-reaching effect on the daily lives of patients. Recently, autologous fat transfer (AFT) has demonstrated promising results in patients with painful scars or after neuroma excision. However, there is a subgroup of patients who do not show any apparent cause for the pain. We hypothesized that in these patients, AFT alone in the area around the affected nerve might lead to beneficial results. Patients with clearly demarcated neuropathic pain and who had exhausted all other treatment options were referred by a pain specialist. Fourteen patients who met the inclusion criteria received AFT in the area of the affected nerve. Pain scored on the visual analog scale, patient satisfaction, and quality of sleep were recorded before and after surgery. To investigate long-term effects, a second follow-up was planned at least 1 year later. Patient satisfaction was 93% after the first follow-up and 86% after more than 1 year. The mean VAS score was 7.4 before surgery and significantly decreased to 3.8 after autologous fat grafting ( P < 0.0001) and 4.3 ( P = 0.0017) at long-term follow-up. The quality of sleep improved in 50% of the patients, whereas the remainder indicated no difference. No complications were registered. The results show that AFT alone, even over a longer period of time and in patients refractory to multiple treatment modalities, can be useful to treat peripheral neuropathic pain without apparent cause. For definitive evidence, a larger prospective study is warranted.