Shoshani Oren, Berger Joseph, Fodor Lucian, Ramon Yitzchak, Shupak Avi, Kehat Izhak, Gilhar Amos, Ullmann Yehuda
Department of Plastic and Reconstructive Surgery, Rambam Medical Center, Haifa, Israel.
J Drugs Dermatol. 2005 May-Jun;4(3):311-6.
Adipose tissue injection as a free graft for the correction of soft tissue defects is a widespread procedure in plastic surgery. The main problem in achieving long-term soft tissue augmentation is partial absorption of the injected fat, and hence the need for over-correction and re-injections. Lidocaine, used for local anesthesia, has been suspected as an inhibitor of growth of adipocytes in culture and slowing down glucose transport and lipolysis in adipocytes. In addition, reduced blood supply by local application of epinephrine was accused of having a negative effect on the graft. The purpose of this study was to examine the effect of local anesthesia, administered to the fat donor site, on the take of the injected fat. Human adipose tissue, obtained by suction-assisted lipectomy, was injected subcutaneously into the scalp of nude mice. Local anesthesia of the fat donor site consisted of a solution with 600 mg of lidocaine (0.06%) and epinephrine 1:1000000. In a control group, normal saline with no local anesthesia or epinephrine was administered to the donor site. One cc of fat was injected after centrifugation into each animal scalp. There were 10 animals in each group. The animals were sacrificed 15 weeks after the procedure. Graft weight and volume were measured, and histologic evaluation was performed. No significant differences were demonstrated between the groups in regard with the grafts' weight and volume and the histologic parameters investigated. In conclusion, local anesthesia solution, consisting of lidocaine and epinephrine, does not alter the take of fat grafts, and has no influence on the adipocytes viability.
脂肪组织注射作为一种游离移植用于修复软组织缺损，是整形手术中一种广泛应用的方法。实现长期软组织增大的主要问题是注射脂肪的部分吸收，因此需要过度矫正和再次注射。用于局部麻醉的利多卡因被怀疑是培养中脂肪细胞生长的抑制剂，并会减缓脂肪细胞中的葡萄糖转运和脂肪分解。此外，局部应用肾上腺素导致的血液供应减少被认为对移植物有负面影响。本研究的目的是检查在脂肪供区给予局部麻醉对注射脂肪存活的影响。通过吸脂辅助抽脂术获取的人脂肪组织，皮下注射到裸鼠头皮。脂肪供区的局部麻醉由含有600毫克利多卡因（0.06%）和1:1000000肾上腺素的溶液组成。在对照组中，供区给予不含局部麻醉剂或肾上腺素的生理盐水。将1毫升经离心后的脂肪注射到每只动物的头皮中。每组有10只动物。术后15周处死动物。测量移植物的重量和体积，并进行组织学评估。在移植物的重量、体积以及所研究的组织学参数方面，两组之间未显示出显著差异。总之，由利多卡因和肾上腺素组成的局部麻醉溶液不会改变脂肪移植物的存活，并且对脂肪细胞的活力没有影响。
