A Jorien Tuin1, Patrick N Domerchie2, Rutger H Schepers3, Joep C N Willemsen4, Pieter U Dijkstra5, Fred K L Spijkervet3, Arjan Vissink3, Johan Jansma3. 1. Department of Oral & Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, The Netherlands. Electronic address: a.j.tuin@umcg.nl. 2. Department of Surgery, Scheper Hospital Emmen, University of Groningen, The Netherlands. 3. Department of Oral & Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, The Netherlands. 4. Department of Plastic Surgery, University Medical Center Groningen, University of Groningen, The Netherlands. 5. Department of Rehabilitation, University Medical Center Groningen, University of Groningen, The Netherlands.
Abstract
BACKGROUND: With the advents of new processing techniques and new graft survival theories in fat grafting, the question is: Which processing technique is of preference? This study systematically reviewed literature regarding current techniques for processing fat grafts. METHODS: PubMed, Embase, Cinahl, and Cochrane databases were searched until August 2015. Studies comparing different fat grafting processing techniques were included. Outcomes were viability of adipocytes, number of adipose-derived stromal/stem cells (ASC) and growth factors in vitro, volume and quality of the graft in animal studies, and satisfaction and volume retention in human studies. RESULTS: Thirty-five studies were included. Adipocyte viability and ASC numbers were the best using the gauze/towel technique (permeability principle) compared to centrifugation. With regard to centrifugation, the pellet contained more ASCs compared to the middle layer. The animal studies' and patients' satisfaction results were not distinctive. The only study assessing volume retention in humans showed that a wash filter device performed significantly better than centrifugation. CONCLUSION: In this study, processing techniques using permeability principles proved superior to centrifugation (reinforced gravity principle) regarding viability and ASC number. Due to the variety in study characteristics and reported outcome variables, however, none of the processing techniques in this study demonstrated clinical evidence of superiority.
BACKGROUND: With the advents of new processing techniques and new graft survival theories in fat grafting, the question is: Which processing technique is of preference? This study systematically reviewed literature regarding current techniques for processing fat grafts. METHODS: PubMed, Embase, Cinahl, and Cochrane databases were searched until August 2015. Studies comparing different fat grafting processing techniques were included. Outcomes were viability of adipocytes, number of adipose-derived stromal/stem cells (ASC) and growth factors in vitro, volume and quality of the graft in animal studies, and satisfaction and volume retention in human studies. RESULTS: Thirty-five studies were included. Adipocyte viability and ASC numbers were the best using the gauze/towel technique (permeability principle) compared to centrifugation. With regard to centrifugation, the pellet contained more ASCs compared to the middle layer. The animal studies' and patients' satisfaction results were not distinctive. The only study assessing volume retention in humans showed that a wash filter device performed significantly better than centrifugation. CONCLUSION: In this study, processing techniques using permeability principles proved superior to centrifugation (reinforced gravity principle) regarding viability and ASC number. Due to the variety in study characteristics and reported outcome variables, however, none of the processing techniques in this study demonstrated clinical evidence of superiority.
Authors: Maroesjka Spiekman; Joris A van Dongen; Joep C Willemsen; Delia L Hoppe; Berend van der Lei; Martin C Harmsen Journal: J Tissue Eng Regen Med Date: 2017-02-03 Impact factor: 3.963
Authors: Francesco De Francesco; Silvia Mannucci; Giamaica Conti; Elena Dai Prè; Andrea Sbarbati; Michele Riccio Journal: Int J Mol Sci Date: 2018-07-15 Impact factor: 5.923