Ghazouane R, Bertrand B, Philandrianos C, Veran J, Abellan M, Francois P, Velier M, Orneto C, Piccerelle P, Magalon J
Pharmaceutical Technology Department, Aix-Marseille University, Marseille, France.
Cell Culture and Therapy Laboratory, Hôpital de la Conception, AP-HM, CIC BT, 1409, Marseille, France.
Aesthetic Plast Surg. 2017 Oct;41(5):1217-1221. doi: 10.1007/s00266-017-0905-0. Epub 2017 Jun 21.
Fat grafting has emerged as a reference procedure in daily plastic surgery practice. Unpredictable fat resorption is the main clinical problem. For this purpose, the addition of PRP to enhance fat revascularization is now an easy and popular procedure. However, no consensus exists regarding the respective volume of fat and PRP used to obtain the ideal mixture. This study investigated the rheological properties of microfat mixed with different proportions of PRP. Results obtained were compared with commercialized hyaluronic acid fillers.
Microfat and PRP preparations were performed using standardized techniques. Lipoaspirate residue and blood were obtained from six patients undergoing aesthetic facial microlipofilling. Elastic modulus G' and tan δ (proportion of elasticity versus fluidity) were obtained for the following conditions: microfat alone and microfat mixed with 10, 30 or 50% of PRP.
An expected decrease in elastic modulus was observed by adding increase volumes of PRP. Two groups of products with different rheological properties were considered based on statistical differences highlighted regarding the value of G'. Mean tan δ varied from 0.20 ± 0.04 (microfat alone) to 0.28 ± 0.08 (50% microfat/50% PRP). Microfat mixed with 10% of PRP presents consistency comparable to stiffer fillers, whereas microfat mixed with 30 or 50% corresponds to softer fillers.
Rheological differences were highlighted given the proportion of PRP added to the microfat. Further studies assessing the impact of increased doses of platelets in microfat/PRP mixtures on clinical outcomes should also be investigated. Our findings will help clinicians to choose a mixture that meets their specific needs for a given indication.
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脂肪移植已成为日常整形手术中的一种参考术式。不可预测的脂肪吸收是主要的临床问题。为此，添加富血小板血浆（PRP）以促进脂肪血管再生如今是一种简便且常用的方法。然而，对于用于获得理想混合物的脂肪和PRP各自的体积，尚无共识。本研究调查了与不同比例PRP混合的微脂肪的流变学特性。将所得结果与商业化透明质酸填充剂进行比较。
采用标准化技术制备微脂肪和PRP。从6例接受面部美学微脂肪填充的患者获取脂肪抽吸残余物和血液。针对以下情况获得弹性模量G'和tan δ（弹性与流动性的比例）：单独的微脂肪以及与10%、30%或50%PRP混合的微脂肪。
随着PRP添加量增加，观察到弹性模量预期下降。基于G'值突出显示的统计学差异，考虑了两组具有不同流变学特性的产品。平均tan δ从0.20±0.04（单独的微脂肪）变化至0.28±0.08（50%微脂肪/50%PRP）。与10%PRP混合的微脂肪呈现出与较硬填充剂相当的稠度，而与30%或50%PRP混合的微脂肪则对应较软的填充剂。
鉴于添加到微脂肪中的PRP比例，突出显示了流变学差异。还应开展进一步研究，评估微脂肪/PRP混合物中血小板剂量增加对临床结果的影响。我们的研究结果将有助于临床医生选择符合特定适应证特定需求的混合物。
本期刊要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266。
