Cleveland Emily C, Albano Nicholas J, Hazen Alexes
New York, N.Y. From New York University Institute of Reconstructive Plastic Surgery.
Plast Reconstr Surg. 2015 Oct;136(4):706-713. doi: 10.1097/PRS.0000000000001581.
The use of autologous adipose tissue harvested through liposuction techniques for soft-tissue augmentation has become commonplace among cosmetic and reconstructive surgeons alike. Despite its longstanding use in the plastic surgery community, substantial controversy remains regarding the optimal method of processing harvested lipoaspirate before grafting. This evidence-based review builds on prior examinations of the literature to evaluate both established and novel methods for lipoaspirate processing.
A comprehensive, systematic review of the literature was conducted using Ovid MEDLINE in January of 2015 to identify all relevant publications subsequent to the most recent review on this topic. Randomized controlled trials, clinical trials, and comparative studies comparing at least two of the following techniques were included: decanting, cotton gauze (Telfa) rolling, centrifugation, washing, filtration, and stromal vascular fraction isolation.
Nine articles comparing various methods of processing human fat for autologous grafting were selected based on inclusion and exclusion criteria. Five compared established processing techniques (i.e., decanting, cotton gauze rolling, centrifugation, and washing) and four publications evaluated newer proprietary technologies, including washing, filtration, and/or methods to isolate stromal vascular fraction.
The authors failed to find compelling evidence to advocate a single technique as the superior method for processing lipoaspirate in preparation for autologous fat grafting. A paucity of high-quality data continues to limit the clinician's ability to determine the optimal method for purifying harvested adipose tissue. Novel automated technologies hold promise, particularly for large-volume fat grafting; however, extensive additional research is required to understand their true utility and efficiency in clinical settings.
通过吸脂技术获取自体脂肪组织用于软组织填充，在整形美容外科医生和重建外科医生中已很常见。尽管其在整形外科领域长期应用，但对于移植前处理吸脂物的最佳方法仍存在大量争议。本循证综述基于之前对文献的研究，评估已有的和新的吸脂物处理方法。
2015年1月使用Ovid MEDLINE对文献进行全面、系统的综述，以识别该主题最新综述之后的所有相关出版物。纳入比较以下至少两种技术的随机对照试验、临床试验和比较研究：倾析法、棉纱布（泰尔弗）滚动法、离心法、冲洗法、过滤法和基质血管成分分离法。
根据纳入和排除标准，选择了9篇比较各种处理人脂肪用于自体移植方法的文章。5篇比较了已有的处理技术（即倾析法、棉纱布滚动法、离心法和冲洗法），4篇出版物评估了更新的专有技术，包括冲洗法、过滤法和/或分离基质血管成分的方法。
作者未能找到令人信服的证据来支持将单一技术作为处理吸脂物以准备自体脂肪移植的最佳方法。高质量数据的匮乏继续限制临床医生确定纯化收获的脂肪组织的最佳方法的能力。新型自动化技术有前景，特别是对于大容量脂肪移植；然而，需要进行大量额外研究以了解它们在临床环境中的真正效用和效率。
