期刊
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
卷 81, 期 -, 页码 9-25出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.bjps.2023.01.003
关键词
Fat graft; Lipofilling; Lipotransfer; Processing; Adipose-derived stem; stromal cells; Complications
类别
This systematic review examines the processing methods of autologous fat grafting and evaluates the long-term patient outcomes. The results suggest that processing the fat through washing and filtration, especially when combined with commercial devices, leads to better long-term outcomes compared to centrifugation and decantation methods. In facial fat grafting, ASC enrichment methods and commercial devices seem to have superior long-term volume retention.
Background: Autologous fat grafting (AFG) is a versatile technique in reconstructive and cosmetic surgery. Graft processing is a key source of variability resulting in unreliable clinical outcomes, with no consensus on the optimal methodology. This systematic review identifies the evidence base supporting different processing paradigms.Methods: A systematic literature search was conducted using the PubMed, Scopus and The Cochrane Foundation databases. Studies comparing AFG processing methods and reporting long-term patient outcomes were identified.Results: Twenty-four studies (2413 patients) were identified. Processing techniques evaluated included centrifugation, decantation, washing, filtration, gauze rolling, as well as commercial devices and adipose-derived stem/stromal cell (ASC) enrichment methods. Objective volumetric and subjective patient-reported outcomes were discussed. There was a variable reporting of complications and volume retention rates. Complications were infrequent; palpable cysts (0-20%), surgical-site infections (0-8%) and fat necrosis (0-58.4%) were the most reported. No significant differences in long-term volume retention between techniques were found in AFG in the breast. In head and neck patients, greater volume retention was documented in ASC enrichment (64.8-95%) and commercial devices (41.2%) compared to centrifugation (31.8-76%). Conclusions: Graft processing through washing and filtration, including when incorporated into commercial devices, results in superior long-term outcomes compared to centrifugation and decantation methods. ASC enrichment methods and commercial devices seem to have superior long-term volume retention in facial fat grafting.& COPY; 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
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