الفهرس 
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Abstract
The objective of this prospective study was to demonstrate if the addition of PRP to fat injection in the management of atrophic scar would be of any difference from fat injection alone. We accomplished this through a clinical work.
The clinical work
To carry out the clinical work, thirty patients were submitted to this study. The total number of females was 61 (46.7%) in contrast to total number of males 14 (53.3%). The age of patients ranged between 15 and 40 years with a mean of 23.13 years. Twenty seven patients (90%) were under 30 years of age.
Results of patients with different age and causes of the scar were discussed. Part of the scar patient group will belong to group A and the other part will be belong to group B of the study.
For group A
Autologous fat transplantation mixed with PRP was used.
For group B
Autologous fat transplantation alone was used.
The method described by Coleman advances the principle that the fat transplants have to survive and be revascularized. Coleman et al. recommend a small quantity of fat injection in fine layers to increase the proportion of fat graft surface area to receptor bed. The total procedure could be done with local or general anesthesia, according to patient/physician preference and the fat volume previewed to be grafted.
The fat harvesting is performed with a blunt cannula connected to 10 ml Luer Lock syringe. The ideal cannula combines efficient collection of fat parcels with minimal damage.
The ideal method for fat purification would separate blood, infiltration fluid, and cell debris from healthy adipocytes with minimal trauma.
Platelet-rich plasma was prepared by drawing blood sample into a vial containing an anticoagulant. The blood will be then centrifuged twice to separate PRP. Calcium chloride was then added to the resultant pellet of platelets and plasma, inducing platelet activation.
The purified fat by centrifugation was mixed through a 3-ways connector with of PRP. The fat/PRP mixture was transferred from 10 ml Luer Lock syringes to 1 ml or 3 ml Luer Lock syringes via a 3-ways connector. It was important to use smaller syringe, because the fat placement must be done precisely.
As suggested by Coleman et al, fat is injected in small parcels and thin strips in several layers. Before injection, it is recommended to create some tunnels, especially in scars, to release fibrotic tissues. The fat graft is then placed by a withdrawing way.
In our study, there was a significant improvement (p= 0.003) regarding the depression of the scar and tissue texture with less fat resorption in group A in comparative to group B.
In this study, 29 patients in group A were satisfied (96.7 %) compared to 21 patients in group B (70%) as there was improvement on skin texture (p<0.001), depression was improved and the need of repeated procedures was decreased.