Hivernaud Vincent, Lefourn Bruno, Robard Myriam, Guicheux Jérôme, Weiss Pierre
INSERM, LIOAD, UMR-S 791, Nantes, France; Université de Nantes, UMR-S 791, LIOAD, UFR Odontologie, Nantes, France; ONIRIS, UMR-S 791, LIOAD, Nantes, France.
Clinique Bretéché, Département de Chirurgie Plastique et Reconstructive, Nantes, France.
J Plast Reconstr Aesthet Surg. 2017 Feb;70(2):248-256. doi: 10.1016/j.bjps.2016.11.022. Epub 2016 Dec 14.
Autologous fat grafting is a widely used technique that gives natural results when treating soft tissue deficiencies. However, there is no consensus on which is the best procedure to use, leading to unpredictable results because of fat graft resorption.
This study compared four commercial lipotransfer devices by analyzing the behavior of the processed adipose tissue and outcome of the adipose graft in an in vivo model.
Four different protocols that used manual, power-assisted or water-assisted lipoaspiration and then decantation, centrifugation, or filtration were used on each of eight patients to process lipoaspirate. Harvested adipose tissue was assessed in vitro for tissue resorption, oil formation, and cytokine secretion. Graft resorption rate was calculated and histological analyses were performed after subcutaneously injecting the harvested adipose tissue in a murine model.
All protocols resulted in very low oil formation and histologically healthy grafts. The tissue volume was significantly greater after 2 days in culture when using manual lipoaspiration and soft centrifugations/washing steps (Microfill/Macrofill) compared to Water-Assisted Lipoaspiration/Decantation (BodyJet) and Power-Assisted Lipoaspiration/Filtration (PAL + PureGraft). These results were confirmed in mice 1 month after subcutaneous injection, with greater efficiency obtained with protocols that used (A) manual aspiration, (B) soft centrifugations, and (C) washing steps.
We confirmed that the choice of technique used to process adipose tissue during lipotransfer surgery can highly influence fat grafting efficacy. In our study, the use of manual aspiration combined with soft centrifugations led to the best results in the selected models.
自体脂肪移植是一种广泛应用的技术，在治疗软组织缺损时能产生自然的效果。然而，对于哪种是最佳的操作方法尚无共识，由于脂肪移植吸收，导致结果不可预测。
本研究通过分析处理后的脂肪组织的行为以及在体内模型中脂肪移植的结果，比较了四种商用脂肪移植设备。
对八名患者中的每一位使用四种不同的方案，即手动、动力辅助或水辅助吸脂，然后进行倾析、离心或过滤来处理吸脂物。对收获的脂肪组织进行体外评估，以检测组织吸收、油脂形成和细胞因子分泌情况。计算移植吸收率，并在小鼠模型中皮下注射收获的脂肪组织后进行组织学分析。
所有方案均导致极低的油脂形成和组织学上健康的移植物。与水辅助吸脂/倾析（BodyJet）和动力辅助吸脂/过滤（PAL + PureGraft）相比，使用手动吸脂和轻柔离心/冲洗步骤（Microfill/Macrofill）时，培养2天后组织体积明显更大。皮下注射1个月后在小鼠身上证实了这些结果，使用（A）手动抽吸、（B）轻柔离心和（C）冲洗步骤的方案效率更高。
我们证实，脂肪移植手术中用于处理脂肪组织的技术选择可高度影响脂肪移植效果。在我们的研究中，手动抽吸结合轻柔离心在所选模型中产生了最佳结果。
