Oranges Carlo M, Striebel Julia, Tremp Mathias, Madduri Srinivas, Kalbermatten Daniel F, Schaefer Dirk J
Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, Basel University Hospital, Basel, Switzerland; Department of Biomedicine, University of Basel, Basel, Switzerland; and Department of Biomedical Engineering, University of Basel, Basel, Switzerland.
Plast Reconstr Surg Glob Open. 2018 Feb 8;6(2):e1649. doi: 10.1097/GOX.0000000000001649. eCollection 2018 Feb.
The fat grafting process includes the 4 phases of tissue harvesting, processing, recipient-site preparation, and reinjection. Among them, the preparation of the recipient site has never been exhaustively reviewed. We aim to provide a comprehensive overview of the methods to prepare the recipient site through external expansion with the resulting outcomes.
PubMed/Medline database was searched for studies on fat grafting recipient site preparation by applying the following algorithm: ((fat grafting) OR (lipofilling) OR (lipograft) AND (recipient site)). A priori criteria were used to review the resulting articles and identify those dealing with external expansion.
Fourteen studies published from 2008 through 2016 met inclusion criteria (4 case reports, 6 retrospective, and 4 prospective studies), representing 1,274 treated patients. Two devices for preexpansion were used with different protocols: BRAVA system and Kiwi VAC-6000M with a PalmPump. The 13 studies that applied the BRAVA system reported large fat volume transplantation to the breast (average > 200 cc). The most common complications were localized edema (14.2%), temporary bruising, and superficial skin blisters (11.3%), while the most serious was pneumothorax (0.5%). The majority of the studies reported enhancement of fat graft survival, which ranged between 53% and 82% at 6 months to 1 year follow-up, and high satisfaction of patients and surgeon.
External expansion and fat grafting is a promising technique for breast reconstruction and augmentation. However, due to the overall low level of evidence of the available studies, further research is needed to validate the procedure.
脂肪移植过程包括组织采集、处理、受区准备和再注射四个阶段。其中，受区准备从未得到过详尽的综述。我们旨在全面概述通过外部扩张来准备受区的方法及其结果。
在PubMed/Medline数据库中检索关于脂肪移植受区准备的研究，检索算法如下：（（脂肪移植）或（脂肪填充）或（脂肪移植术）且（受区））。采用先验标准对检索到的文章进行综述，并确定那些涉及外部扩张的文章。
2008年至2016年发表的14项研究符合纳入标准（4篇病例报告、6篇回顾性研究和4篇前瞻性研究），共涉及1274例接受治疗的患者。两种用于预扩张的设备采用了不同的方案：BRAVA系统和带有掌上泵的Kiwi VAC - 6000M。应用BRAVA系统的13项研究报告了向乳房大量移植脂肪（平均>200 cc）。最常见的并发症是局部水肿（14.2%）、暂时性瘀斑和浅表皮肤水泡（11.3%），最严重的是气胸（0.5%）。大多数研究报告脂肪移植存活率提高，在6个月至1年的随访中，存活率在53%至82%之间，患者和外科医生的满意度较高。
外部扩张和脂肪移植是一种有前景的乳房重建和增大技术。然而，由于现有研究的总体证据水平较低，需要进一步研究来验证该手术。
