Fontes Tomás, Brandão Inês, Negrão Rita, Martins Maria João, Monteiro Rosário
Departamento de Biomedicina - Unidade de Bioquímica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
Instituto de Investigação e Inovação em Saúde (I3S), Universidade do Porto, Porto, Portugal.
Ann Med Surg (Lond). 2018 Nov 13;36:212-218. doi: 10.1016/j.amsu.2018.11.005. eCollection 2018 Dec.
Autologous fat grafting is widely used for soft-tissue augmentation and replacement in reconstructive and aesthetic surgery providing a biocompatible, natural and inexpensive method. Multiple approaches have been developed in the past years, varying in the location of adipose tissue donor-sites, use of wetting solutions, harvesting, processing and placing techniques. Despite many advances in this subject, the lack of standardization in the protocols and the unpredictability of the resorption of the grafted tissue pose a significant limitation for graft retention and subsequent filling. In this review, we discuss several approaches and methods described over the last years concerning the harvesting of autologous fat grafts. We focus on contents such as the best donor-site, differences between existing harvesting techniques (namely tissue resection, hand aspiration or liposuction techniques), recommended harvesting cannula diameters, pressure application and volume of wetting solution injected prior aspiration. Results and comparisons between methods tend to vary according to the outcome measured, thus posing a limitation to pinpoint the most efficient methods to apply in fat grafting. Additionally, the lack of a standard assay to determine viability or volume augmentation of fat grafting remains another limitation to obtain universally accepted grafting procedures and protocols.
自体脂肪移植在重建手术和美容手术中被广泛用于软组织的增大和替代，提供了一种生物相容性好、自然且廉价的方法。在过去几年中已开发出多种方法，这些方法在脂肪组织供区位置、润洗溶液的使用、采集、处理和植入技术方面各不相同。尽管在该领域取得了许多进展，但方案缺乏标准化以及移植组织吸收的不可预测性对移植脂肪的留存和后续填充构成了重大限制。在本综述中，我们讨论了过去几年中描述的几种关于自体脂肪移植采集的方法。我们重点关注最佳供区、现有采集技术（即组织切除、手动抽吸或抽脂技术）之间的差异、推荐的采集套管直径、抽吸前施加的压力以及注入的润洗溶液体积等内容。方法之间的结果和比较往往因所测量的结果而异，因此难以确定在脂肪移植中应用的最有效方法。此外，缺乏一种用于确定脂肪移植活力或体积增大的标准检测方法仍然是获得普遍接受的移植程序和方案的另一个限制因素。
