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Resumen Objetivo: Describir la evolución que presentaron los pacientes con la aplicación de injerto graso autólogo con plasma rico en plaquetas (IGAPRP) en defectos de espesor completo (DET). Método: Durante el periodo del 15 de abril al 30 de septiembre de 2021 se analizaron los DET de pacientes que recibieron IGAPRP. Resultados: Se realizaron de 3 a 4 procedimientos de aplicación de IGAPRP para su integración con un tiempo promedio de estancia hospitalaria de 19.6±0.5 días. El tamaño de la lesión fue de 17.5 a 280 cm2 (95.1±81.6 cm2, profundidad de 1.1±1.1 cm). Volumen de grasa injertada en los DET fue de 14.7±7.9 ml. No se identificaron casos con infección. La comparación de la dimensión de los defectos a través de los procedimientos reveló una diferencia de 95.13 cm2 con hallazgos estadísticamente significativos (p<0.001). Limitaciones del estudio: La población de estudio limitada a solo 6 pacientes no nos permite sacar conclusiones significativas con respecto al efecto del tratamiento. A pesar hubo diferencias significativas en el volumen y área de los DET. Se requiere un estudio multicéntrico para evaluar completamente la eficacia de estos tratamientos en pacientes con DET. Valor: El uso de IGAPRP podría disminuir secuelas y complicaciones del uso de colgajos para la reconstrucción de DET. Conclusiones: La aplicación de IGAPRP demostró ser una opción eficaz y segura para la granulación de DET en nuestros pacientes para su posterior cobertura con un injerto cutáneo de espesor parcial.
Abstract: Objective: To describe the evolution of patients with the application of autologous fat grafting with platelet-rich plasma (IGAPRP) in full-thickness defects (TED). Method: During the period from April 15, 2021 to September 30, 2021, the TEDs of patients who received IGAPRP were analyzed. Results: 3 to 4 IGAPRP application procedures were performed for its integration with an average hospital stay of 19.6±0.5 days. Lesion size ranged from 17.5 to 280 cm2 (95.1±81.6 cm2, Depth 1.1±1.1 cm). Volume of grafted fat in the TEDs was 14.7±7.9 ml. No cases of infection were identified. The comparison of the dimensions of the defects through the procedures revealed a difference of 95.13 cm2 with statistically significant findings (p<0.001). Study limitations: The study population limited to only 6 patients does not allow us to draw significant conclusions regarding the effect of treatment. Despite there were significant differences in the volume and area of ??the TEDs. A multicenter study is required to fully evaluate the efficacy of these treatments in patients with TED. Value: The use of IGAPRP could reduce sequelae and complications of the use of flaps for TED reconstruction. Conclusions: The application of IGAPRP proved to be an effective and safe option for TED granulation in our patients for subsequent coverage with a split-thickness skin graft.
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Objective:To investigate the causes of buccal masses after temporal autologous fat grafting, and to summarize the therapeutic methods to avoid medical disputes.Methods:Ten female patients (25-40 years; mean age, 33.1±7.5 years) with buccal mass complication after temporal autologous fat grafting were retrospectively analyzed, and statistics was done on their fat injection history, postoperative buccal mass symptom onset time, intraoperative mass conditions, postoperative pathological and fluid bacterial culture results, and postoperative recovery.Results:The unilateral temporal fat injection volume was 15-30 ml, and the buccal masses occurred 1-6 months after temporal autologous fat grafting. Lipoid masses were found in the buccal space during the operation, and some of them contained liquid. The postoperative pathological results indicated local necrosis in fibrotic adipose tissues. All the fluid bacteria cultures were negative, only one showed positive culture of acid-fast bacilli. 6-12 months postoperative follow-up visit was performed, and 9 patients recovered and 1 patient recovered after re-operation.Conclusions:The overfilled fat and liquefied necrotic fat after temporal fat grafting may move down to buccal space to form buccal masses, which should be treated by operation early to achieve a good prognosis.
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Objective To evaluate the effect and mechanism of cysteine rich protein 61, namely CCN family member 1(CCN1) on the survival of adipose tissues in rats after autologous fat grafting. Methods At 1 week after the establishment of autologous fat grafting rat models, all animals were randomly divided into the CCN1 group (n=20) and control group (n=20). The survival of fat grafts, the morphology of fat graft tissues, the proportion of active adipocytes and the number of new blood vessels of rats were statistically compared between two groups. The levels of differential expressed messenger ribonucleic acid (mRNA) in the fat graft tissues of rats were compared between two groups by high-throughput sequencing and subsequently subject to cluster analysis. The expression levels of related proinflammatory cytokines of fat graft tissues of rats were statistically compared between two groups. Results The weight retention rate of adipose tissues in the CCN1 group was significantly higher than that in the control group (P < 0.05). In the CCN1 group, the integrity of adipocytes was considerably higher, the degree of vesiculation and vacuolation, the degree of inflammatory cell aggregation and the degree of fibrosis were significantly lower than those in the control group (all P < 0.000 1). Immunofluorescence staining demonstrated that the proportion of active adipocytes with uniform morphology was higher in the CCN1 group, whereas the proportion of active adipocytes was lower and the cells were observed in different sizes accompanied by vesiculation in the control group. Compared with the control group, the quantity of new blood vessels was significantly higher, and the expression levels of platelet derived growth factor (PDGF) and fibroblast growth factor (FGF) mRNA were remarkably higher in the CCN1 group (all P < 0.05). High-throughput sequencing analysis showed that the data at the transcriptome levels significantly differed between two groups. In the CCN1 group, the gene expression levels of cell surface markers, inflammatory cytokines and chemokines related to M1 macrophages tended to decline. Real-time fluorescent quantitative polymerase chain reaction (RT-qPCR) revealed that the mRNA expression levels of interleukin (IL)-8, IL-1 and Toll-like receptor (TLR) 2 in the CCN1 group were significantly lower than those in the control group (P < 0.01-0.05). Conclusions During autologous fat grafting, supplement of exogenous CCN1 may effectively promote the neovascularization of adipose tissues and improve the survival rate of fat graft probably by mediating the transformation of macrophages into M2 phenotype via down-regulating the TLR2 expression level.
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Objective@#To investigate the effect of adding glutathion(GSH) to tumescent solution on autologous fat graft survival.@*Methods@#14 male and female New Zealand rabbits were divided into experimental group and control group randomly, 7 in each group. Experimental group: The donor areas of the rabbits were injected with 3 ml of tumescent solution with GSH. Control group: The donor areas of the rabbits were injected with 3 ml regular tumescent solution. DCFH-DA probe was used for fluorescent staining of harvested fat cells. Then stained fat cells were measured for the intracellular reactive oxygen species(ROS)content by fluorescence microplate. The grafts were harvested at 3 months after transplantation and assessed by general observation, volume measurement, wet weight measurement, HE staining for the number of fat cells, and CD34 immunohistochemical staining for the measurement of micro-vascular density. T test was performed by using SPSS 24.0.@*Results@#The intracellular ROS content of harvested fat cells in experimental group was lower than that in control group, and the difference was statistically significant (P<0.05). At 3 months after transplantation, the wet weight of fat grafts in experimental group was (1133.21±87.97) mg and that in control group was (718.79±79.27) mg. The volume of fat grafts in experimental group was (1.00±0.04) ml and that in control group was (0.59±0.03) ml. The number of fat cells in experimental group was (746.6±15.7)/10 high magnification vision and that in control group was (350.1±32.4)/10 high magnification vision. The density in group experimental was (8.1±2.0)/high magnification vision and that in control group was (6.7±2.4)/high magnification vision. The grafts′ volume, wet weight, and the number of fat cells in experimental group were higher than those in control group, and the differences were statistically significant (P<0.05). The difference of micro-vascular density between experimental group and control group had no statistical significance (P>0.05).@*Conclusions@#The addition of GSH to tumescent solution optimizes the process of autologous fat harvest, thereby improving the survival of fat graft.
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Scars formed by various injuries can affect the appearance and psychology of patients. Therefore, more and more people pay attention to the prevention and treatment of scar. With the development of the autologous fat grafting, it has been gradually applied to the prevention and treatment of scar. At present, it has been confirmed by scholars that the autologous fat grafting could be an effective method to prevent and treat scar from basic research and clinical practice. At the same time, the deficiency of autologous fat grafting in the prevention and treatment of scar was also pointed out. This paper reviews the application, mechanism, and deficiency of autologous fat grafting in scar prevention and treatment.
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Objective To discuss the clinical effect of facial contour remodeling using transplantation of the autologous granular fat grafting combined with botulinum toxin A injection.Methods Negative-pressure liposuction was carried out in the inner thigh or abdomen using liposuction needle connected with an injector,to let stand for layered,discharge lower layer water,rinse,extract the fat particles into a 2 ml syringe,inject into facial depression area with multipoint,multiple-tunnel,and multilayer manner,over injection of about 20％-30％ every time.89 patients received the injection;some accepted two injections;13 cases were injected in temple (14.6％),and 16 in forehead (17.98％).30 of them received subcutaneous injection of botulinum toxin A,each side dose was less than 20 U.Results Patients had been followed up for 3-36 months,and obvious improvements were observed in facial contour in the frontal and temporal region as well as the skin texture;the survival rate of fat granule reached to 60％-80％.No hematoma,nodes and infection been observed.Patients combined with botulinum toxin A injection had more ideal facial contour and more satisfaction.Conclusions Autologous fat granules transplantation in the face has stable clinical effect,and combining with botulinum toxin A injection can improve facial contour.It is a safe,ideal treatment in facial rejuvenation and facial contour remodeling and it therefore can be widely recommended in clinical treatment.
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Objective To evaluate the therapeutic effect of autologous fat grafting in secondary cleft lip.Methods Grafting of autologous fat granules was applied to correct lip under-capacity.The technique was used in 40 patients with secondary cleft lip from June 2011 to December 2015.The ratios between the point of upper lip peak to vermilion height and to white lip height on the affected side were measured by Photoshop CS6.Results Satisfactory results were achieved with all 40 patients;the lip contour and morphology improved.The preoperative ratio was 0.417±0.190 and the postoperative ratio was 0.499±0.197, which increased average 26.02%, with statistically significant (P<0.05).Conclusions Autologous fat grafting to correct lip under-capacity with secondary cleft lip is a safe, effective and micro-invasive method which can be sustained over a lengthy period.