Department of Plastic Surgery, Plastic Surgery Research Institute, Seoul National University College of Medicine, Seoul National University, Seoul, Korea.
Aesthetic Plast Surg. 2010 Oct;34(5):626-31. doi: 10.1007/s00266-010-9525-7. Epub 2010 May 5.
Fat grafts are commonly used in plastic surgery, but their unpredictable absorption rates are a considerable disadvantage. Furthermore, no agreement has been reached regarding the method that best enables fat graft survival. This study aimed to evaluate the effects of different preparation methods on fat graft viability. Fat tissue was harvested from the remnants of transverse rectus abdominis musculocutaneous (TRAM) flaps by syringe aspiration. Harvested fat tissue was prepared using three different methods: centrifugation, metal sieve concentration, and cotton gauze concentration. To evaluate the viabilities of fat cells, XTT assays were performed. For the study, 18 nude mice were allocated to three groups: the centrifugation, metal sieve, and cotton gauze groups (6 mice per group). Prepared fat (1 ml) was injected into the nuchal area of the mice, and 12 weeks later, grafts were dissected to determine graft survival rates and subjected to histologic analysis. No significant differences were observed in graft survival rates and histologic findings (necrosis and vascularity) between the three groups. However, histologic analysis found the metal sieve group to have significantly lower fat cell viability and more inflammation than the other two groups. The findings suggest that the closed centrifugation technique has no advantage over the open cotton gauze technique in terms of fat graft viability, and that the metal sieve concentration method is deficient as a preparation method because it can cause grafted fat degradation.
脂肪移植在整形手术中被广泛应用，但吸收率难以预测是其主要缺点。此外，对于哪种方法最有利于脂肪移植存活，目前尚未达成共识。本研究旨在评估不同制备方法对脂肪移植活力的影响。采用注射器抽吸法从横行腹直肌肌皮瓣（TRAM）残端获取脂肪组织。采用三种不同方法（离心、金属筛浓缩和纱布浓缩）制备获取的脂肪组织。通过 XTT 检测评估脂肪细胞活力。研究共纳入 18 只裸鼠，分为三组：离心组、金属筛组和纱布组（每组 6 只）。将制备好的脂肪（1ml）注射到小鼠的颈背部，12 周后解剖获取移植物，计算移植物存活率并进行组织学分析。三组间移植物存活率和组织学发现（坏死和血管生成）无显著差异。但组织学分析发现，与其他两组相比，金属筛组的脂肪细胞活力显著较低，且炎症反应更明显。研究结果表明，在脂肪移植活力方面，封闭离心技术并不优于开放纱布技术，而金属筛浓缩方法作为一种制备方法是有缺陷的，因为它会导致移植脂肪降解。
