• Title/Summary/Keyword: fat graft

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Experimental In-Vivo Models Used in Fat Grafting Research for Volume Augmentation in Soft Tissue Reconstruction

  • Lujan-Hernandez, Jorge;Appasani, Raghu;Sullivan, Kylee;Siegel-Reamer, Leah;Lalikos, Janice F.
    • Archives of Plastic Surgery
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    • v.44 no.5
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    • pp.361-369
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    • 2017
  • As the popularity of fat grafting research increases, animal models are being used as the source of pre-clinical experimental information for discovery and to enhance techniques. To date, animal models used in this research have not been compared to provide a standardized model. We analyzed publications from 1968-2015 to compare published accounts of animal models in fat grafting research. Data collected included: species used, graft characteristics (donor tissue, recipient area, amount injected, injection technique), time of sacrifice and quantification methods. Mice were most commonly used (56% of studies), with the "athymic nude" strain utilized most frequently (44%). Autologous fat was the most common source of grafted tissue (52%). Subcutaneous dorsum was the most common recipient site (51%). On average, $0.80{\pm}0.60mL$ of fat was grafted. A single bolus technique was used in 57% of studies. Fat volume assessment was typically completed at the end of the study, occurring at less than 1 week to one year. Graft volume was quantified by weight (63%), usually in conjunction with another analysis. The results demonstrate the current heterogeneity of animal models in this research. We propose that the research community reach a consensus to allow better comparison of techniques and results. One example is the model used in our laboratory and others; this model is described in detail. Eventually, larger animal models may better translate to the human condition but, given increased financial costs and animal facility capability, should be explored when data obtained from small animal studies is exhausted or inconclusive.

Management of Traumatic Cerebrospinal Fluid Rhinorrhea using External Ethmoidectomy Approach (비외사골동수술법을 이용한 외상성 뇌척수액 비루의 치료)

  • 임상철;조재식
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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    • pp.169-173
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    • 1997
  • Cerebrospinal fluid (CSF) rhinorrhea usually occurs as a result of trauma including operation. Unheated CSF rhinorrhea may induce major morbidity such as meningitis and brain abscess, etc. This paper presents a review of four cases of traumatic CSF rhinorrhea Sites of CSF leakage were easily found out by intrathecal fluorescent dye injection. Surgery was performed by external ethmoidectomy approach and dural tear and bone defect was repaired with abdominal fat and free mucosal graft taken from amputated middle turbinates. We conclude that repair using free fat and mucosal graft via external ethmoidectomy approach could be accepted as the intial method of CSF rhinorrhea management.

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Prognosis of closure of large sinus membrane perforations using pedicled buccal fat pads and a resorbable collagen membrane: case series study

  • Kim, Young-Kyun;Yun, Pil-Young;Oh, Ji-Su;Kim, Su-Gwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.4
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    • pp.188-194
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    • 2014
  • For large membrane perforations that develop during sinus-bone grafting, we performed repairs using a pedicled buccal fat pad and a resorbable collagen membrane simultaneously with the bone graft. This study included eight patients. Postoperative maxillary sinusitis developed in two patients, which we managed with incision and drainage, and antibiotics. Ultimately, six patients received 12 implants, three of which failed (75% success). Implant replacement was performed after the removal of the failed replacement, at which point the prosthetic treatment was considered complete. In all of the six cases that we were able to follow-up with, the sinus-bone graft was healing favorably. We observed that the sinus bone height decreased gradually with time. Based on these case series, we conclude that our procedure of repairing large sinus-membrane perforations with a pedicled buccal fat pad and a collagen membrane is a reliable technique.

Intraoperative Expansion Technique for Soft Tissue Necrosis after Liposuction (지방흡입술 후 연부 조직 괴사에 대한 술중 조직확장법을 이용한 치료)

  • Kim, Jae Hyun;Suh, In Suck;Tak, Kyoung Seok
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.462-468
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    • 2009
  • Purpose: The liposuction has been generalized & undergone in the field of plastic surgery and it has had a great influence on fat graft. But despite of liposuction and fat injection being performed widely, we did not focus on complication associated with donor site. So we reported satisfactory result with the intraoperative sustained limited expansion & direct closure to donor site tissue necrosis after liposuction and analyzed the cause & measures of donor site necrosis with the literature investigation Methods: From November 2007 to June 2008, we treated four cases of tissue necrosis and infection surrounding the thigh and forearm. Necrosis after liposuction was 1 case, donor site necrosis after fat injection were 3 cases and MRSA was detected in 2 cases. first, we debrided the necrotic tissue and treated with potadine gauze soaking dressing & susceptible antibiotics. After confirmation of healthy granulation tissue, we used intraoperative sustained limited expansion and closed directly of defect & observed the results. Results: The patient was displeased and worried with the unexpected damage concerning the donor site and the procedure concerning time and financial exhaustion, but after confirming no contracture of the scar tissues and only a thin or slightly widened line of scar, showed satisfaction. Conclusion: Because it is fastidious to avoid donor site complication after liposuction & fat injection, enough explanation and understanding on possible complication to donor site are necessary and careful surgery procedure & materials are required. But if donor site necrosis were occurred although close consideration of possible causes of necrosis, we should think about not only wound healing process but also the sequela like scar contracture & cosmetic effect and treat the most adequate method to satisfying both concerns.

AN EXPERIMENTAL STUDY ON FAT CELL VIABLITY ACCORDING TO DIFFERENT HARVESTING TECHNIQUES (지방 채취 방법에 따른 지방 세포의 생존성에 대한 연구)

  • Lee, Won-Deok;Choi, Jin-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.1
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    • pp.22-29
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    • 2008
  • Purpose: The purpose of this study is to test the efficacy of various methods of fat harvesting in animal model by viability comparison with assay including cell counting, MTT assay, and histologic evaluation. Materials and methods: New Zealand white rabbits experiments were used. Groin fat pads were subjected to different harvest method varying ingredients of solution(Experiment 1: T1 solution= lidocaine 1000mg/L, epinephrine 1mg/L, sodium bicarbonate 10mgEq/L, Triamcinolone 10mgEq/L; T2 solution=lidocaine 1000mg/L, epinephrine 1mg/L, sodium bicarbonate 0mgEq/L, Triamcinolone 0mgEq/L) and pressure exerted on harvesting with Luer-Lock syringe connected to suction cannula.(Experiment 2: P1 group=3cc intermittent pressure; P2 group=10cc sustained pressure) Fat cell viability was assessed with cell counting with a hemocytometer, MTT assay, and histologic evaluation. Results: Experiment 1 Cell count: T1=2.4/3.4/4.2, T2=9.6/8.4/7.2($\times10^5$ per mL); MTT assay: T1=0.516/0.41/0.453/0.412/0.421, T2=0.925/0.765/0.54/0.634/0.614 in 21 days(absorbance); Histology: T1 showed elongated and, different in size and shape, and ruptured adipocytes with only a few normal adipocytes whereas T2 showed central core of fat with almost intact fat cells Experiment 2 Cell count: P1=1.2/3.2/4.2, P2=1.2/2.4/3.8($\times10^5$ per mL); MTT assay:P1=0.256/0.245/0.258/0.21/0.264, P2=0.12/0.231/0.245/0.313/0.281 in 21 days(absorbance); Histology: P1 showed somewhat evenly distributed normal-looking fat cells and P2 showed relatively irregular shape of fat cells with small blood vessel amongst adiopocytes. Conclusion: Viability was higher in ‘modified tumescent solution’without sodium bicarbonate and triamcinolone and we also found no significantly different viability between using intermittent pressure and using sustained pressure. But in terms of initial viability of fat cell, we can assume that lower intermittent pressure would make better clinical results.

Autologous Fat Transfer in Lupus Panniculitis Facial Lipoatrophy

  • Kongkunnavat, Natthapong;Prathyajuta, Jirapat;Tonaree, Warangkana
    • Archives of Plastic Surgery
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    • v.49 no.4
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    • pp.527-530
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    • 2022
  • Lupus panniculitis (LP) often presents with tender nodules and intermittent ulcers that then heal with scarring and lipoatrophy. The current mainstay of treatment is medical treatment. Research regarding the treatment of lipoatrophy from LP with autologous fat grafting is limited. We would like to share our experience in this rare case, which was treated with autologous fat transfer. A 48-year-old female presented with erythematous plaque, tender nodules, and ulcers following by a depression of the lesion at the left temporal area. The patient also had indurated erythematous plaque at her left cheek. Both lesions were aggravated by sunlight exposure. After several investigations, she was diagnosed as LP with secondary lipoatrophy and tumid lupus erythematosus at her left temporal and left cheek, respectively. She received antimalarial drug and topical steroids. The patient underwent two sessions of autologous fat transfer. She was satisfied with the volume and contour improvement in the scar following the injection of 8 and 3.7 mL of fat. Furthermore, the patient reported the remission of tender nodules and ulcers since the first fat graft injection. In conclusion, the autologous fat transfer is a simple and effective treatment for lipoatrophy and scar secondary to LP with promising results.

Cell-Assisted Lipotransfer for the Treatment of Parry-Romberg Syndrome

  • Castro-Govea, Yanko;De La Garza-Pineda, Oscar;Lara-Arias, Jorge;Chacon-Martinez, Hernan;Mecott-Rivera, Gabriel;Salazar-Lozano, Abel;Valdes-Flores, Everardo
    • Archives of Plastic Surgery
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    • v.39 no.6
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    • pp.659-662
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    • 2012
  • Progressive facial hemiatrophy, also known as Parry-Romberg syndrome, is a progressive and self-limited deformation of the subcutaneous tissue volume on one side of the face that creates craniofacial asymmetry. We present the case of a patient with a five-year history of progressive right facial hemiatrophy, who underwent facial volumetric restoration using cell-assisted lipotransfer (CAL), which consists of an autologous fat graft enriched with adipose-derived stem cells (ASCs) extracted from the same patient. ASCs have the capacity to differentiate into adipocytes. They also promote angiogenesis, release angiogenic growth factors, and some can survive as stem cells. The use of autologous fat as a filler in soft tissue atrophy has been satisfactory in patients with mild and moderate Parry-Romberg syndrome. Currently, CAL has showed promising results in the long term by decreasing the rate of fat reabsorption. The permanence and stability of the graft in all the injected areas has showed that autologous fat grafts enriched with stem cells could be a promising technique for the correction of defects caused by this syndrome.

The Adipofascial V-Y Advancement Flap with Skin Graft for Coverage of the Full-Thickness Burns of the Gluteal Region

  • Lee, Yoo Jung;Park, Myong Chul;Park, Dong Ha;Lee, Il Jae
    • Archives of Reconstructive Microsurgery
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    • v.25 no.1
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    • pp.15-18
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    • 2016
  • Any types of burn injury that involve more than deep dermis often require reconstructive treatment. In gluteal region, V-Y fasciocutaneous advancement flap is frequently used to cover the defect. However, in case of large burn wounds, this kind of flap cannot provide adequate coverage because of the lack of normal surrounding tissues. We suggest V-Y adipofascial flap using the surrounding superficially damaged tissue. We present the case of a patient who was referred for full-thickness burn on gluteal region. We performed serial debridement and applied vacuum-assisted closure device to defective area as wound preparation for coverage. When healthy granulation tissue grew adequately, we covered the defect with surrounding V-Y adipofascial flap and the raw surface of the flap was then covered with split-thickness skin graft. We think the use of subcutaneous fat as an adipofascial flap to cover the deeper defect adjacent to the flap is an excellent alternative especially in huge defect with uneven depth varying from subcutaneous fat to bone exposure in terms of minimal donor site morbidity and reliability of the flap. Even if the flap was not intact, it was reuse of the adjacent tissue of the injured area, so it is relatively safe and applicable.