Department of Plastic Surgery, Army Medical University Xinqiao Hospital, No.83, Xinqiao Main Street, Shapingba District, Chongqing, 400000, China.
Center of Scar and Wound Treatment, Chinese Academy of Medical Sciences and Peking Union Medical College Plastic Surgery Hospital and Institute, No.33, Badachu Road, Shijingshan District, Beijing, 100000, China.
Aesthetic Plast Surg. 2024 Sep;48(18):3658-3668. doi: 10.1007/s00266-024-04159-y. Epub 2024 Jul 16.
Oil compromises graft outcomes via inflammation, which accounts for the unpredictability of volume retention rates as low as 20%. Existing techniques for oil removal are relatively inefficient. In this study, a novel approach was taken to prepare concentrated deoiled fat (CDF) by utilizing flocculation and centrifugation to remove the oil. The hypothesis put forward in this study was that CDF would exhibit improved volume retention and quality by enhancing purification efficiency and reducing inflammation.
This basic research involved both in vitro and in vivo experiments using samples obtained from women who underwent abdominal liposuction. The CDF was prepared by flocculation and centrifugation. In the vitro experiments, the microstructure of fat was assessed using Calcein acetoxymethyl ester (AM) staining for living cells and propidium iodide (PI) staining for dead nuclei in two groups: Coleman fat group and CDF group. Additionally, the glucose uptake capacity of these two groups was evaluated using the glucose transport test (GTT). In the vivo experiments, the study included three groups: two experimental groups (low-volume concentrated deoiled fat, LCDF; high-volume concentrated deoiled fat, HCDF) and one control group (Coleman fat), with 10 healthy female BALB/c nude mice in each group, 1ml of the graft was injected subcutaneously to each mouse. After 8 weeks, the fat grafts were harvested and subjected to volume evaluation, HE staining and immunostaining for perilipin to assess graft outcomes.
In the vitro experiments, the concentration rate of the CDF was found to be 79.6% that of Coleman fat, with 15.1% more oil separated. Cell viability, as assessed by AM/PI staining, did not show a significant difference between the two grafts, but the results of the GTT showed that the tissue viability of the CDF was higher than that of Coleman fat. In the vivo experiments, the CDF had higher volume retention than Coleman fat, as measured by water displacement. Histopathologic scoring indicated that HCDF group and LCDF group had a more intact fat structure with fewer vacuoles, inflammation, and fibrosis compared to Coleman fat. Additionally, the percentages of perilipin-positive area in the LCDF group and HCDF group were higher than in the Coleman group, indicating improved graft quality and outcome with the use of concentrated deoiled fat.
"Concentrated deoiled fat" refers to an autologous fat graft from which oil has been removed by flocculation and centrifugation. This process increases volume retention and viable cells and decreases infiltrated inflammatory cells.
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 www.springer.com/00266 .
油通过炎症影响移植物的效果,这解释了体积保持率低至 20%的不可预测性。现有的去油技术相对效率较低。在这项研究中,我们采用了一种新的方法,通过絮凝和离心来制备浓缩去油脂肪(CDF)。本研究提出的假设是,通过提高纯化效率和减少炎症,CDF 将改善体积保留和质量。
本基础研究使用了从接受腹部脂肪抽吸术的女性身上获得的样本,同时进行了体外和体内实验。通过絮凝和离心制备 CDF。在体外实验中,使用活细胞的钙黄绿素乙酰氧基甲酯(AM)染色和死核的碘化丙啶(PI)染色,评估两组脂肪的微观结构:Coleman 脂肪组和 CDF 组。此外,通过葡萄糖转运试验(GTT)评估两组的葡萄糖摄取能力。在体内实验中,研究包括三组:两个实验组(低容量浓缩去油脂肪,LCDF;高容量浓缩去油脂肪,HCDF)和一个对照组(Coleman 脂肪),每组有 10 只健康雌性 BALB/c 裸鼠,每只鼠皮下注射 1ml 移植物。8 周后,取出脂肪移植物进行体积评估、HE 染色和 perilipin 免疫染色,以评估移植物的结果。
在体外实验中,发现 CDF 的浓缩率为 Coleman 脂肪的 79.6%,分离出的油多 15.1%。AM/PI 染色评估的细胞存活率在两种移植物之间没有显著差异,但 GTT 的结果表明 CDF 的组织存活率高于 Coleman 脂肪。在体内实验中,通过水置换法测量,CDF 的体积保持率高于 Coleman 脂肪。组织病理学评分表明,与 Coleman 脂肪相比,HCDF 组和 LCDF 组的脂肪结构更完整,空泡、炎症和纤维化更少。此外,LCDF 组和 HCDF 组的 perilipin 阳性面积百分比高于 Coleman 组,表明使用浓缩去油脂肪可改善移植物质量和效果。
“浓缩去油脂肪”是指通过絮凝和离心去除油的自体脂肪移植物。该过程增加了体积保持率和有活力的细胞,减少了浸润的炎症细胞。
证据水平 V: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,请参阅目录或在线作者指南 www.springer.com/00266。