脂肪注射的机械纯化：细胞产量、细胞生长与脂肪体积维持的关系。

BACKGROUND: The mechanical manipulations of fat tissue represented from centrifugation, filtration, washing, and fragmentation were considered the most effective strategies aiming to obtain purified lipofilling with different impacts both in terms of adipose-derived stem cells amount contained in stromal vascular fraction, and fat volume maintenance. OBJECTIVES: The present work aimed to report results in fat volume maintenance obtained by lipofilling purification based on the combined use of washing and filtration, in a clinical study, and to deeply investigate the adipose-derived stem cells yield and growth capacity of the different stromal vascular fraction extraction techniques with an in vitro approach. METHODS: A preliminary prospective, case-control study was conducted. 20 patients affected by face and breast soft tissue defects were treated with lipofilling and divided into two groups: n = 10 patients (study group) were treated with lipofilling obtained by washing and filtration procedures, while n = 10 (control group) were treated with lipofilling obtained by centrifugation according to the Coleman technique. 6 months after the lipofilling, the volume maintenance percentage was analyzed by clinical picture and magnetic resonance imaging comparisons. Additionally, extracted stromal vascular fraction cells were also in vitro analyzed in terms of adipose-derived stem cell yield and growth capacity. RESULTS: A 69% ± 5.0% maintenance of fat volume after 6 months was observed in the study group, compared with 44% ± 5.5% in the control group. Moreover, the cellular yield of the control group resulted in 267,000 ± 94,107 adipose-derived stem cells/mL, while the study group resulted in 528,895 ± 115,853 adipose-derived stem cells /mL, with a p-value = 0.1805. Interestingly, the study group showed a fold increase in cell growth of 6758 ± 0.7122, while the control group resulted in 3888 ± 0.3078, with a p < 0.05 (p = 0.0122). CONCLUSIONS: The comparison of both groups indicated that washing and filtration were a better efficient system in lipofilling preparation, compared to centrifugation, both in terms of volume maintenance and adipose-derived stem cell growth ability. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

背景：离心、过滤、洗涤和破碎等机械操作被认为是最有效的策略，可以获得不同影响的纯化脂肪填充，包括基质血管成分中所含脂肪源性干细胞的数量和脂肪体积的维持。

目的：本研究旨在报告基于洗涤和过滤联合使用的脂肪填充净化在临床研究中获得的脂肪体积维持效果，并通过体外方法深入研究不同基质血管成分提取技术的脂肪源性干细胞产量和生长能力。

方法：进行了一项初步的前瞻性病例对照研究。20 名面部和乳房软组织缺损患者接受脂肪填充治疗，并分为两组：n=10 名患者（研究组）接受洗涤和过滤程序获得的脂肪填充治疗，n=10 名（对照组）接受根据 Coleman 技术的离心获得的脂肪填充治疗。脂肪填充治疗 6 个月后，通过临床图片和磁共振成像比较分析体积维持百分比。此外，还对提取的基质血管成分细胞进行了体外分析，以评估脂肪源性干细胞的产量和生长能力。

结果：研究组脂肪体积 6 个月后维持率为 69%±5.0%，对照组为 44%±5.5%。此外，对照组的细胞产量为 267,000±94,107 个脂肪源性干细胞/mL，而研究组为 528,895±115,853 个脂肪源性干细胞/mL，p 值为 0.1805。有趣的是，研究组细胞生长倍数为 6758±0.7122，而对照组为 3888±0.3078，p<0.05（p=0.0122）。

结论：与离心相比，洗涤和过滤在脂肪填充制备方面是一种更有效的系统，无论是在体积维持还是脂肪源性干细胞生长能力方面，都优于离心。

证据水平 III：本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述，请参考目录或在线作者指南 http://www.springer.com/00266 。