采用组织液化技术的脂肪移植作为乳房重建的辅助手段
Fat Grafting with Tissue Liquefaction Technology as an Adjunct to Breast Reconstruction.
作者信息
Dolen Utku, Cohen Justin B, Overschmidt Bo, Tenenbaum Marissa M, Myckatyn Terence M
机构信息
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 1040 N. Mason, Ste 124, St Louis, MO, 63141, USA.
出版信息
Aesthetic Plast Surg. 2016 Dec;40(6):854-862. doi: 10.1007/s00266-016-0690-1. Epub 2016 Aug 11.
BACKGROUND
Tissue liquefaction technology (TLT) delivers warmed saline from the liposuction cannula tip at low pressure pulses to disaggregate adipocytes. This technology differs significantly from that used in other liposuction devices including water jet-assisted liposuction. Here we introduce our early experience with this technology in the setting of fat transfer for revision breast reconstruction.
METHODS
A retrospective chart review of 136 consecutive patients who underwent fat harvest with TLT and subsequent transfer into 237 breast reconstructions was conducted at a single institution. This two-surgeon series examined donor and recipient site complication rates over a median follow-up of 143 days [87-233].
RESULTS
The overall complication rate was 28.7 %, of which the majority (22.1 %) was fat necrosis at the recipient site as documented by any clinical, imaging, or pathologic evidence. The abdomen served as the donor site for half of the cases. Donor site complications were limited to widespread ecchymosis of the donor site notable in 10.4 % of cases. Twenty-five percent of patients had received postmastectomy radiotherapy prior to fat transfer. Prior to revision with fat transfer, implant-based breast reconstruction was used in 75.5 % of cases, and autologous flaps in the remainder. Fat transfer was combined with other reconstructive procedures 94.1 % of the time.
CONCLUSIONS
TLT can be used to harvest adipocytes for fat transfer with donor site morbidity and recipient site complications comparable to other modalities. The efficiency and quality of harvested fat makes this technology appealing for wide spread adoption during fat transfer.
LEVEL OF EVIDENCE IV
This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
背景
组织液化技术(TLT)通过吸脂套管尖端以低压脉冲输送温热盐水来分解脂肪细胞。该技术与其他吸脂设备(包括水刀辅助吸脂)所使用的技术有显著差异。在此,我们介绍我们在脂肪移植用于乳房再造修复中的早期经验。
方法
在单一机构对136例连续接受TLT脂肪采集并随后用于237例乳房再造的患者进行回顾性病历审查。这个由两位外科医生参与的系列研究在中位随访期143天[87 - 233]内检查了供区和受区的并发症发生率。
结果
总体并发症发生率为28.7%,其中大多数(22.1%)是受区脂肪坏死,有任何临床、影像学或病理证据可证明。一半的病例以腹部作为供区。供区并发症仅限于供区广泛瘀斑,10.4%的病例较为明显。25%的患者在脂肪移植前接受过乳房切除术后放疗。在进行脂肪移植修复前,75.5%的病例采用了基于植入物的乳房再造,其余采用自体皮瓣。94.1%的情况下脂肪移植与其他重建手术联合使用。
结论
TLT可用于采集脂肪细胞进行脂肪移植,其供区发病率和受区并发症与其他方式相当。采集脂肪的效率和质量使该技术在脂肪移植中具有广泛应用的吸引力。
证据级别IV:本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述,请参考目录或在线作者指南www.springer.com/00266 。