Lei Hua, Xiao Ran
Beijing Leihua Aesthetic and Plastic Clinic.
Research Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Craniofac Surg. 2020 Jan/Feb;31(1):313-318. doi: 10.1097/SCS.0000000000005878.
Over the past decade, some studies have focused on whether platelet-rich plasma (PRP) can promote the survival of fat grafts after transplantation. However, the results of these studies have been controversial because of the variations in research methods and assessment methodologies.
In this study, the authors aspirated fat particles from the abdomen of a healthy woman, mixed them with PRP, and injected them into the backs of nude mice subcutaneously, which simulates the clinical model. The control group was designed to mix aspired fat with normal saline. The fat grafts were removed 10 weeks after transplantation, stained with hematoxylin and eosin, and sliced into pathological sections, which were subsequently scanned and analyzed using the Digital Slide Scanning System (PRECICE, Beijing, China).
The total area of the graft section and the necrotic adipose tissue area in the control group were significantly larger than that in the PRP group. The fibrosis tissue area in the PRP group was significantly larger than that in the control group. There were no statistically significant differences in the viable adipocyte area, the cyst area, and the mature blood vessel number between the PRP and control groups.
In this study, PRP did not cause an increase in the number of viable adipocytes; however, it did increase the amount of inflammation, which promoted necrotic tissue absorption and the proliferation of granulation tissue. Further research, including research on normalization of fat preparation and grafting, unification of the PRP preparation and application scheme, and optimization of histological measurement and analysis methods, is needed to assess the effect of PRP on fat grafting.
在过去十年中，一些研究聚焦于富血小板血浆（PRP）能否促进移植后脂肪移植物的存活。然而，由于研究方法和评估方法的差异，这些研究的结果一直存在争议。
在本研究中，作者从一名健康女性的腹部抽取脂肪颗粒，将其与PRP混合，然后皮下注射到裸鼠背部，以此模拟临床模型。对照组则将抽取的脂肪与生理盐水混合。移植10周后取出脂肪移植物，用苏木精和伊红染色，制成病理切片，随后使用数字切片扫描系统（PRECICE，中国北京）进行扫描和分析。
对照组移植物切片的总面积和坏死脂肪组织面积显著大于PRP组。PRP组的纤维化组织面积显著大于对照组。PRP组和对照组在存活脂肪细胞面积、囊肿面积和成熟血管数量方面无统计学显著差异。
在本研究中，PRP并未导致存活脂肪细胞数量增加；然而，它确实增加了炎症反应，促进了坏死组织吸收和肉芽组织增殖。需要进一步研究，包括脂肪制备和移植标准化的研究、PRP制备和应用方案的统一以及组织学测量和分析方法的优化，以评估PRP对脂肪移植的影响。
