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Yesantharao et al. Plast Aesthet Res 2022;9:60 Plastic and
DOI: 10.20517/2347-9264.2022.67
Aesthetic Research

Systematic Review Open Access

Nanofibrillar collagen scaffolds for lymphedema
treatment: current applications and future directions

Pooja S. Yesantharao , Dung H. Nguyen

Division of Plastic & Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94304, USA.
Correspondence to: Dr. Dung H. Nguyen, Division of Plastic & Reconstructive Surgery, Stanford University School of Medicine,
900 Blake Wilbur, MC 5348, Palo Alto, Stanford, CA 94304, USA. E-mail: nguyendh@stanford.edu

How to cite this article: Yesantharao PS, Nguyen DH. Nanofibrillar collagen scaffolds for lymphedema treatment: current
applications and future directions. Plast Aesthet Res 2022;9:60. https://dx.doi.org/10.20517/2347-9264.2022.67
Received: 22 Jun 2022 First Decision: 29 Aug 2022 Revised: 4 Oct 2022 Accepted: 28 Oct 2022 Published: 3 Nov 2022

Academic Editor: Matthew Iorio Copy Editor: Peng-Juan Wen Production Editor: Peng-Juan Wen

Abstract
Aim: Biosynthetic scaffolds represent cutting-edge therapeutic efforts for secondary lymphedema. In particular,
nanofibrillar collagen scaffolds have shown efficacy in both preclinical and clinical contexts, and there has been
growing interest in these scaffolds in recent years. This study systematically reviewed the current literature on
nanofibrillar collagen scaffolds for lymphedema treatment to synthesize findings and highlight areas for further
research.

Methods: This was a systematic scoping review of the literature on nanofibrillar collagen scaffolds for lymphedema
treatment.

Results: Upon review of the literature, 32 relevant articles were identified, of which seven articles specifically
investigating nanofibrillar collagen scaffolds were selected for inclusion. Of these articles, three investigated
scaffold placement in small or large animal models, while four were clinical investigations ranging from case
reports to retrospective cohort studies. Across all studies, scaffold implantation was associated with significant
improvement in lymphedema symptoms compared to untreated controls, especially when used in combination
with physiologic microsurgical procedures such as vascularized lymph node transfer. However, even when used
alone or in combination with lymph node fragments, subcutaneous placement of these scaffolds improved
lymphedema symptoms. Additionally, in a rodent model of lymphedema, scaffold placement at the time of lymph
node harvest forestalled the development of lymphedema, highlighting the preventative capacity of these scaffolds
as well.

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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