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Objective: To investigate the effect of hydrogel from acellular porcine adipose tissue (HAPA) on the survival of transplanted adipose tissue. Methods: For in vitro study, adipose tissue and HAPA-adipose tissue complex were cultured in normoxia and hypoxia atmospheres for 24 and 72 hours. TUNEL and Perilipin immunofluorescence staining were performed to observe the effect of HAPA on apoptosis and survival of adipocities. For in vivo study, 42 healthy male nude mice (4-6 weeks old) weighing 15-18 g were randomly divided into adipose group (group A), 10%HAPA group (group B), 20%HAPA group (group C), 30%HAPA group (group D), 40%HAPA group (group E), and 50%HAPA group (group F) according to different HAPA/adipose tissue volume ratio ( n=7). For each group, 1 mL adipose tissue or HAPA-adipose tissue complex was injected subcutaneously into the dorsum of the nude mice. At 4 weeks after transplantation, 7 nude mice in each group were sacrificed and grafts were harvested, gross observation, volume measurement, ultrasound examination, and histologic staining (HE staining, CD31 and Perilipin immunofluorescence stainings) were applied. Results: Hypoxia showed a tendency of promoting adipose tissue necrosis and apoptosis, while HAPA exhibited an obvious effect of inhibiting cell apoptosis in vitro study ( P0.05). With the increase of HAPA's volume ratio, HE staining proved an improved fat integrity while a gradually decreased vacuoles and fibrosis. CD31 immunohistochemical staining showed that the number of neo-vascularisation in groups E and F were significantly higher than those in groups A-D ( P<0.05). Perilipin immunofluorescence staining showed that with the increase of HAPA volume ratio, the number of living adipocytes increased gradually, and more new adipocytes could be seen in the field of vision. Conclusion: As the volume ratio of HAPA gradually increased, the survival of transplanted adipose tissue also increased, but the volume retention rate decreased gradually. 30%HAPA was considered the relative optimal volume ratio for its superior adipose tissue survival and volume retation rate.
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RESUMEN Introducción: El resultado estético de la reconstrucción mamaria depende de varios factores difíciles de evaluar, la aplicación de la lipotransferencia ofrece alternativas para lograr mejores resultados estéticos y mayor satisfacción de las pacientes. Objetivo: Introducir la técnica de lipotransferencia en el instituto nacional de oncología de Cuba Métodos: Se realizó un estudio descriptivo, prospectivo, de corte longitudinal, en 10 pacientes a las que se les practicó técnica de lipotransferencia para reconstrucción mamaria por cáncer, que fueron operadas en el Instituto Nacional de Oncología y Radiobiología (INOR), en el período comprendido entre noviembre de 2016 y noviembre de 2018. Resultados: La técnica fue aplicada con mejores resultados estéticos en pacientes reconstruidas con expansión tisular. Se logró mejorar la disponibilidad de tejidos y amortiguar los daños de la radioterapia. La cantidad de grasa infiltrada fue hasta 400 ml, lo que propició mejorar la calidad de los tejidos y el contorno de la mama reconstruida. Obteniéndose con ello mejor simetría. Conclusiones: La aplicación de esta técnica complementaria, permite obtener mejores resultados estéticos y de esta mejor simetría en pacientes reconstruidas por cáncer de mama(AU)
ABSTRACT Introduction: The aesthetic result of breast reconstruction depends on several factors that are difficult to evaluate. The application of lipotransference offers alternatives to achieve better aesthetic results and greater patient satisfaction. Objective: To introduce the lipotransference technique in the Cuban National Institute of Oncology Methods: A descriptive, prospective, longitudinal-section study was carried out in 10 patients who underwent lipotransfer technique for breast reconstruction due to cancer, who underwent surgery at the National Institute of Oncology and Radiobiology (INOR), in the period between November 2016 and November 2018. Results: The technique was applied with better aesthetic results in reconstructed patients with tissue expansion. Tissue availability was improved and the damage from radiation therapy was cushioned. The amount of fat infiltrated was up to 400 ml, which favored improving the quality of the tissues and the contour of the reconstructed breast. Thus obtaining better symmetry. Conclusions: The application of this complementary technique allows obtaining better aesthetic results and this better symmetry in patients reconstructed for breast cancer(AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Breast Neoplasms/epidemiology , Mammaplasty/methods , Plastic Surgery Procedures/adverse effects , Myocutaneous Flap/transplantation , Epidemiology, Descriptive , Prospective Studies , Longitudinal StudiesABSTRACT
Background: Taken care therapeutics of breast cancer is in constant evolution. She links, according to the stadium of illness, a specific treatment of the cancer and mammary reconstruction which makes integral part of the treatment of breast cancer today. The lipofilling or lipostructure is one of the techniques used in mammary reconstruction.Methods: A descriptive retrospective study on lipofilling accomplished in Hospital complex of Dax, France from January 1st, 2016 till October 31st, 2017 was accomplished, to assess the rate of aesthetic and psychological satisfaction of the patients on the basis of breast Q, then to assess its effectiveness and its security. The statistical analysis was made with the software Excel of Microsoft Office 2007.Results: Authors could record 52 lipofillings at 40 patients among 1212 gynecological surgical operations is 4.29% surgical activities. 47 cases (90.38%) of lipofilling were accomplished at 35 patients after a surgery for breast cancer accomplishing a frequency of 3.87% of surgical activity. The women from 49 to 54 years old are the most concerned the median age of which was of 52 years (37 and 73 years) and the patients are still sexually active in 26 cases (74.29%). The mastectomy was practiced in 32 cases (91.45%). An immediate reconstruction was accomplished at 29 (82.86%) patients. The back big rag autologous was used in 22 cases (62.85%). In 33 cases (94.27%), the lipofilling was accomplished to supplement the reconstruction among which by the back big rag at 22 patients (62.5%) and by mammary prosthesis at 11 patients (31.42%). One took a sample in 32 cases of a volume from 400 to 700 ml of grease average of which was 456.38 ml (200-800 ml). A volume from 200 to 300 ml was injected at 17 patients (36.17%) with an average of 264.14 ml (100-600 ml). No repetition of the cancer was recorded during this study. A score of more than 60 was recorded in every domain for the valuation of satisfaction in more than 90% cases.Conclusions: With the evolution of the taking care of the cancers of breast, mammary reconstruction by lipofilling is a technology which goes know a big development. It is a new way of natural reconstruction at the mastectomy patients who wish, more and more a less aggressive surgical gesture with good result.
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Background@#Autologous fat grafting has gained popularity in breast augmentation. Various methods can be used to estimate the volume retention rate. This systematic review aimed to establish whether the type of method used for measuring breast volume is a factor that influences the reported volume retention rate.@*Methods@#Studies were identified using the electronic databases PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science from inception of the database up to February 2019. Articles describing autologous fat grafting for breast augmentation were selected based on pre-determined inclusion and exclusion criteria. The characteristics of the included studies were summarized, and the reported volume retention rate from the studies was compared. A quality assessment of all included articles was performed using the methodological index for non-randomized studies criteria.@*Results@#A total of 618 articles were identified, of which 12 studies, with a total of 1337 cases, were eligible. The retention rate of injected adipose tissue varied when the method of fat grafting and volume analysis used were both the same, as well as when the method of fat grafting was the same but the method of volumetric evaluation used was different.@*Conclusions@#Currently, the tools available for estimating the volume retention rate come with limitations. In order to objectively evaluate the percentage of graft retention, a standard protocol that applies to the different methods should be established in the future.