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Abu Alqam R, Alkhwildi LA, Almaghrabi MT, Alali FK, Khashab RM, Bamatraf MS, Altamimi LA, Alshammari AJ, Alsuhaim A, Fadel ZT. Hand Rejuvenation Using Autologous Fat Grafting: A Systematic Review of Recommended Doses, Complications, and Patient Satisfaction. Aesthetic Plast Surg 2025; 49:1734-1749. [PMID: 39806138 DOI: 10.1007/s00266-024-04641-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Accepted: 12/12/2024] [Indexed: 01/16/2025]
Abstract
INTRODUCTION Hand rejuvenation addresses aging-related changes such as subcutaneous fat loss, skin degradation, and photodamage. Autologous fat transfer (AFT) has emerged as a promising treatment, offering durable volume augmentation and regenerative effects. This study aims to systematically review the evidence on the techniques, outcomes, and complications of AFT for hand rejuvenation. METHODS A systematic review was conducted following the PRISMA guidelines, searching databases such as MEDLINE, SCOPUS, DOAJ, and PUBMED from inception to April 2024. Inclusion criteria were studies reporting on hand rejuvenation using fat grafting, including randomized clinical trials, observational studies, case reports, and case series. Data extraction and risk of bias assessment were performed independently by multiple reviewers blindly. RESULTS Eleven studies published between 2001 and 2019 were included, comprising 303 patients with a strong female predominance. Study designs varied, with three randomized clinical trials, seven case series, and one prospective study. High satisfaction rates were consistently reported, with complications being generally infrequent and minor. Various fat grafting techniques were employed, with manual aspiration being the predominant fat harvesting method. Follow-up periods ranged from 5 to 38 months, facilitating thorough evaluation of treatment outcomes. CONCLUSION AFT for hand rejuvenation is effective and safe, offering high patient satisfaction and minimal complications. Long-term fat retention and regenerative effects of adipose-derived stem cells contribute to success. However, fat graft resorption may require multiple treatments. Future research should standardize assessment tools, volumetrically measure graft resorption, and conduct high-quality trials to optimize protocols. LEVEL OF EVIDENCE II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Rakan Abu Alqam
- College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Lama A Alkhwildi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Maan T Almaghrabi
- Division of Plastic Surgery, Department of Surgery, King Abdulaziz Medical City, National Guard Hospital Affairs, Riyadh, Saudi Arabia
| | - Feryal K Alali
- College of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Ranad Mohammed Khashab
- College of Medicine and Surgery, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia
| | - Maha Salem Bamatraf
- College of Medicine and Surgery, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia
| | - Lamees A Altamimi
- College of Medicine, King Abdullah Medical City, Makkah, Saudi Arabia
| | | | | | - Zahir T Fadel
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Gryskiewicz J, Slavin BV, Slavin BR, Nayak VV, Pierrot RG, Taghioff SM, Alameddine KO, Singh D, Chopra K, Coelho PG. The Aesthetic Surgery Education and Research Foundation (ASERF): A 30-Year Retrospective Analysis. Aesthet Surg J 2024; 44:658-667. [PMID: 38195091 DOI: 10.1093/asj/sjae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/11/2024] Open
Abstract
Federal government research grants provide limited funding to plastic surgeon-scientists, with reconstructive research taking precedence over aesthetic research. The Aesthetic Surgery Education and Research Foundation (ASERF) is a nonprofit, 501(c)(3) organization that seeks to support innovative, diverse research endeavors within aesthetic surgery. A total of 130 ASERF-funded studies and 32 non-funded applications from 1992 to 2022 were reviewed. Kruskal Wallis, Fisher's exact, and chi-squared tests were utilized to assess the potential relationship between self-identified gender, practice setting, geographical location, and study type with individual grant amounts and grant funding decision. Although significant differences were observed between male and female grant recipient h-indices (P < .05), there were no differences in the amount of funding they received (P > .05). Grant amounts were also consistent between study types as well as principal investigator practice settings and geographical locations (P > .05). The subanalysis revealed that the practice setting of the primary investigator (PI) was the only variable to exhibit a significant association with the decision to award funding (P < .05). Further, of the 61 applicants between 2017 and 2022, only 2 PIs self-identified as female. ASERF serves as an excellent funding source for global aesthetic surgery. To promote further research diversification, increased emphasis should be placed on recruiting applicants from outside academia and those who identify as female or gender nonbinary.
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Araujo S, Sganzella MF, Sagiorato RN, Leite MN, Caetano GF, Aparecida de Aro A, Esquisatto MAM, Frade MAC, de Andrade TAM, Santos GMT. Human adipose-derived stem cells in fibrin glue carrier modulate wound healing phases in rats. CURRENT RESEARCH IN BIOTECHNOLOGY 2022. [DOI: 10.1016/j.crbiot.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Challita R, Sleiman Z, Bazzi N, Ghanime G. Our experience with lipofilling in secondary rhinoplasty, into a new era. Dermatol Ther 2021; 34:e14989. [PMID: 34004042 DOI: 10.1111/dth.14989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 02/20/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022]
Abstract
Rhinoplasty is a commonly performed cosmetic surgery. Clinicians are facing an increased demand on non-surgical procedures, therefore liquid rhinoplasty is gaining popularity. Given the characteristic of lipofilling to rejuvenate and improve skin texture, fat grafting can be used to reshape the nose in secondary rhinoplasty. Fat was injected in 27 patients with a mean age of 42 years. Volume of fat ranged from 1.5 to 4.5 cc with a mean of 2.2 cc. Patients were seen at 1 week, 3 months, 6 months, and 1 year. Patient satisfaction was measured using the Rhinoplasty Outcome Evaluation questionnaire and plastic surgeons' evaluation. After 1 year follow up, 20 patients were satisfied with the results at 1 year. The aesthetic outcome was noted as very good in 11 patients, good in 9 patients, and poor in 3 patients. Most of the patients had an improvement in skin texture with trophic effect on the skin. No complications were seen in our series According to this study, nasal lipofilling is a safe and efficacious filler in secondary rhinoplasty. However, more studies are needed to assess the indications and limitations of nose lipofilling.
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Affiliation(s)
- Raymond Challita
- Department of Plastic & Reconstructive Surgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Ziad Sleiman
- Department of Plastic & Reconstructive Surgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Nagham Bazzi
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - George Ghanime
- Department of Plastic & Reconstructive Surgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.,Head Division, Department of Plastic & Reconstructive Surgery, Lebanese University Hospital Geitawi, Beirut, Lebanon
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Mamsen FP, Munthe-Fog L, Kring MKM, Duscher D, Taudorf M, Katz AJ, Kølle SFT. Differences of embedding adipose-derived stromal cells in natural and synthetic scaffolds for dermal and subcutaneous delivery. Stem Cell Res Ther 2021; 12:68. [PMID: 33468240 PMCID: PMC7814704 DOI: 10.1186/s13287-020-02132-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/28/2020] [Indexed: 12/14/2022] Open
Abstract
Background In recent years, adipose-derived stromal cells (ASCs) have been heavily studied for soft tissue regeneration, augmentation, and dermal wound healing. Methods In this review, we investigated the trends in injectable scaffolds for ASC delivery in the dermis, and injectable or implantable scaffolds for ASC delivery in the subcutis. A total of 547 articles were screened across three databases; of these, 22 studies were found to be eligible and were included. The scaffolds were subdivided and analyzed based on their tissue placement (dermis or subcutis), delivery method (injected or implanted), and by the origin of the materials (natural, synthetic, and combinatory). Results ASCs embedded in scaffolds generally showed improved viability. Neovascularization in the transplanted tissue was greater when undifferentiated ASCs were embedded in a combinatory scaffold or if differentiated ASCs were embedded in a natural scaffold. ASCs embedded in natural materials underwent more adipogenic differentiation than ASCs embedded in synthetic scaffolds, indicating an etiologically unknown difference that has yet to be described. Increased mechanical strength of the scaffold material correlated with improved outcome measurements in the investigated studies. Wound healing studies reported reduced healing time in all except one article due to contraction of the control wounds. Conclusions In future clinical trials, we recommend embedding ASCs in injectable and implantable scaffolds for enhanced protection, retained viability, and improved therapeutic effects. Trial registration This review was registered with PROSPERO: ID=CRD42020171534. Graphical abstract The use of scaffolds as a vehicle for ASC delivery generally improved cell viability, angiogenesis, and wound healing in vivo compared to utilizing ASCs alone. ASCs embedded in natural materials induced more adipogenesis than ASCs embedded in synthetic materials. Adipogenic-induced ASCs further increased this effect. The included studies indicate that the seeded scaffold material influences the differentiation of ASCs in vivo. All studies investigating the mechanical strength of ASC scaffolds reported improved outcome measurements with improved mechanical strength. The results suggest that scaffolds, in general, are favorable for ASC delivery. We recommend initiating clinical studies using scaffolds based on mechanical properties and tunability to improve ASC viability. For fat regeneration, natural scaffolds are recommended.
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Affiliation(s)
- Frederik Penzien Mamsen
- Department of Plastic Surgery, Stemform, Gyngemose Parkvej 74, DK-2860, Copenhagen, Denmark.
| | - Lea Munthe-Fog
- Department of Plastic Surgery, Stemform, Gyngemose Parkvej 74, DK-2860, Copenhagen, Denmark
| | | | - Dominik Duscher
- Department of Plastic and Hand Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaningerstrasse 22, 81675, Munich, Germany
| | - Mikkel Taudorf
- Department of Radiology, Rigshospitalet, University Hospital of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Adam J Katz
- Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA
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Effect of Breast Cancer and Adjuvant Therapy on Adipose-Derived Stromal Cells: Implications for the Role of ADSCs in Regenerative Strategies for Breast Reconstruction. Stem Cell Rev Rep 2020; 17:523-538. [PMID: 32929604 DOI: 10.1007/s12015-020-10038-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2020] [Indexed: 12/14/2022]
Abstract
Tissue engineering using Adipose Derived Stromal Cells (ADSCs) has emerged as a novel regenerative medicine approach to replace and reconstruct soft tissue damaged or lost as a result of disease process or therapeutic surgical resection. ADSCs are an attractive cell source for soft tissue regeneration due to the fact that they are easily accessible, multipotent, non-immunogenic and pro-angiogenic. ADSC based regenerative strategies have been successfully translated to the clinical setting for the treatment of Crohn's fistulae, musculoskeletal pathologies, wound healing, and cosmetic breast augmentation (fat grafting). ADSCs are particularly attractive as a source for adipose tissue engineering as they exhibit preferential differentiation to adipocytes and support maintenance of mature adipose graft volume. The potential for reconstruction with an autologous tissue sources and a natural appearance and texture is particularly appealing in the setting of breast cancer; up to 40% of patients require mastectomy for locoregional control and current approaches to post-mastectomy breast reconstruction (PMBR) are limited by the potential for complications at the donor and reconstruction sites. Despite their potential, the use of ADSCs in breast cancer patients is controversial due to concerns regarding oncological safety. These concerns relate to the regeneration of tissue at a site where a malignancy has been treated and the impact this may have on stimulating local disease recurrence or dissemination. Pre-clinical data suggest that ADSCs exhibit pro-oncogenic characteristics and are involved in stimulating progression, and growth of tumour cells. However, there have been conflicting reports on the oncologic outcome, in terms of locoregional recurrence, for breast cancer patients in whom ADSC enhanced fat grafting was utilised as an alternative to reconstruction for small volume defects. A further consideration which may impact the successful translation of ADSC based regenerative strategies for post cancer reconstruction is the potential effects of cancer therapy. This review aims to address the effect of malignant cells, adjuvant therapies and patient-specific factors that may influence the success of regenerative strategies using ADSCs for post cancer tissue regeneration.
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Abstract
Fat grafting has been shown to improve diseased soft issue. Although the mechanism behind fat grafting’s regenerative properties is currently debated, published studies agree that there is an associated vasculogenic effect. A systematic literature review was conducted to elucidate the biochemical pathways responsible for establishing neo-vasculature to grafted fat.
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Abstract
BACKGROUND Autologous fat grafting is a dynamic modality used in plastic surgery as an adjunct to improve functional and aesthetic form. However, current practices in fat grafting for soft-tissue augmentation are plagued by tremendous variability in long-term graft retention, resulting in suboptimal outcomes and repetitive procedures. This systematic review identifies and critically appraises the evidence for various enrichment strategies that can be used to augment and improve the viability of fat grafts. METHODS A comprehensive literature search of the Medline and PubMed databases was conducted for animal and human studies published through October of 2017 with multiple search terms related to adipose graft enrichment agents encompassing growth factors, platelet-rich plasma, adipose-derived and bone marrow stem cells, gene therapy, tissue engineering, and other strategies. Data on level of evidence, techniques, complications, and outcomes were collected. RESULTS A total of 1382 articles were identified, of which 147 met inclusion criteria. The majority of enrichment strategies demonstrated positive benefit for fat graft survival, particularly with growth factors and adipose-derived stem cell enrichment. Platelet-rich plasma and adipose-derived stem cells had the strongest evidence to support efficacy in human studies and may demonstrate a dose-dependent effect. CONCLUSIONS Improved understanding of enrichment strategies contributing to fat graft survival can help to optimize safety and outcomes. Controlled clinical studies are lacking, and future studies should examine factors influencing graft survival through controlled clinical trials in order to establish safety and to obtain consistent outcomes.
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Abstract
BACKGROUND Autologous lipografting for improvement of facial skin quality was first described by Coleman in 2006. The current dogma dictates that adipose tissue-derived stromal cells that reside in the stromal vascular fraction of lipograft contribute to skin rejuvenation (e.g., increased skin elasticity), a more homogenous skin color, and softening of skin texture. Nowadays, many studies have been reported on this "skin rejuvenation" effect of autologous fat grafting. This systematic review was undertaken to assess the efficacy of autologous lipografting on skin quality. METHODS The MEDLINE, Embase, Cochrane Central, Web of Science, and Google Scholar databases were searched for studies evaluating the effect of autologous lipografting on facial skin quality (May 11, 2018). Outcomes of interest were skin texture, color, and elasticity in addition to histologic outcomes and number of complications. RESULTS Nine studies were included, with 301 patients treated in total. No meta-analysis could be performed because of heterogeneity of the metrics and outcomes. Eight studies reported increased skin elasticity; improvement in skin texture; and a more homogeneous skin color after treatment with lipografting, cellular stromal vascular fraction, or nanofat. One study reported no increased skin elasticity after lipografting. Histologic improvement was seen after lipografting and adipose tissue-derived stromal cell injections. However, in general, the level of evidence of the included studies was low. No serious complications were reported. CONCLUSION Autologous facial lipografting and cellular stromal vascular fraction and adipose tissue-derived stromal cell injections hardly seem to improve facial skin quality but can be considered a safe procedure.
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Abstract
Adipose-derived stem cells (ADSC) have come to be viewed as a ubiquitous solution for aesthetic and reconstructive problems involving loss of tissue volume and age or radiation-induced loss of tissue pliability and vascularity. As the theoretical potential of "stem cell therapy" has captured the public imagination, so the commercial potential of novel therapies is being exploited beyond scientifically sound, hypothesis-driven paradigms and in the absence of evidence establishing clinical efficacy and safety. Moreover, with variations in methods of isolation, manipulation, and reintroduction described, it is unclear how the practitioner with an interest in ADSC can harness the clinical potential in reproducible and scientifically measurable ways. This Continuing Medical Education (CME) article presents a summary of our understanding of what ADSC are, their utility within the field of aesthetic surgery, and the current and future directions for adipose stem cell research.
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Affiliation(s)
- Graeme Ewan Glass
- Attending Plastic and Craniofacial Surgeon, Department of Surgery, Sidra Medicine, Doha, Qatar; and Weill Cornell Medical College, Ar-Rayyan, Qatar
| | - Patrizia Ferretti
- Professor of Regenerative Biology, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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Zhang S, Duan E. Fighting against Skin Aging: The Way from Bench to Bedside. Cell Transplant 2018; 27:729-738. [PMID: 29692196 PMCID: PMC6047276 DOI: 10.1177/0963689717725755] [Citation(s) in RCA: 370] [Impact Index Per Article: 52.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 07/05/2017] [Accepted: 07/14/2017] [Indexed: 12/31/2022] Open
Abstract
As the most voluminous organ of the body that is exposed to the outer environment, the skin suffers from both intrinsic and extrinsic aging factors. Skin aging is characterized by features such as wrinkling, loss of elasticity, laxity, and rough-textured appearance. This aging process is accompanied with phenotypic changes in cutaneous cells as well as structural and functional changes in extracellular matrix components such as collagens and elastin. In this review, we summarize these changes in skin aging, research advances of the molecular mechanisms leading to these changes, and the treatment strategies aimed at preventing or reversing skin aging.
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Affiliation(s)
- Shoubing Zhang
- Department of Histology and Embryology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
- Central laboratory of Molecular and Cellular Biology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Enkui Duan
- State Key Lab of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China
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A Microbiological and Ultrastructural Comparison of Aseptic versus Sterile Acellular Dermal Matrix as a Reconstructive Material and a Scaffold for Stem Cell Ingrowth. Plast Reconstr Surg 2017; 140:97-108. [PMID: 28654596 DOI: 10.1097/prs.0000000000003448] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recent data suggest an increased risk for infection when acellular dermal matrix is used in breast reconstruction. This may be because some acellular dermal matrices are actually not terminally sterilized but are instead "aseptically processed." This study evaluates aseptic and sterile matrices for evidence of bacterial contamination and whether or not terminal sterilization affects matrix collagen architecture and stem cell ingrowth. METHODS Five separate samples of 14 different matrices were analyzed by fluorescent in situ hybridization using a bacterial DNA probe to detect bacterial DNA on the matrices. Separate samples were incubated for bacteria, acid-fast bacilli, and fungi for 2 to 6 weeks to detect living organisms. The impact of terminal sterilization on the collagen network and stem cell ingrowth on the matrices was then assessed. RESULTS Traces of bacterial DNA were encountered on all matrices, with more bacteria in the aseptic group compared with the sterile group (3.4 versus 1.6; p = 0.003). The number of positive cultures was the same between groups (3.8 percent). Electron microscopy demonstrated decreased collagen organization in the sterile group. Stem cell seeding on the matrices displayed a wide variation of cellular ingrowth between matrices, with no difference between aseptic and sterile groups (p = 0.2). CONCLUSIONS Although there was more evidence of prior bacterial contamination on aseptically processed matrices compared with sterile matrices; clinical cultures did not differ between groups. Terminal sterilization does not appear to affect stem cell ingrowth but may come at the cost of damaging the collagen network. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, V.
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Youn CS, Hong JY, Park KY, Kim BJ, Nam Kim M. A review of hydrolifting: A new modality for skin rejuvenation. J COSMET LASER THER 2017; 20:28-33. [DOI: 10.1080/14764172.2017.1358459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | - Ji Yeon Hong
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Kui Young Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Beom Joon Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Myeung Nam Kim
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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Simonacci F, Bertozzi N, Grieco MP, Grignaffini E, Raposio E. Procedure, applications, and outcomes of autologous fat grafting. Ann Med Surg (Lond) 2017; 20:49-60. [PMID: 28702187 PMCID: PMC5491488 DOI: 10.1016/j.amsu.2017.06.059] [Citation(s) in RCA: 207] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 06/23/2017] [Accepted: 06/24/2017] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To systematically review the procedure, applications, and outcomes of autologous fat grafting, a promising technique with various clinical applications. PATIENTS AND METHODS Literature review of publications concerning autologous fat grafting. RESULTS Since its introduction, lipofilling has become increasingly popular; however, its results are variable and unpredictable. Several modifications have been made to the procedures of fat harvesting, processing, and injecting. Surgical excision and low negative-pressure aspiration with large-bore cannulas minimize adipocyte damage during fat harvesting. The "wet" method of fat harvesting involves fluid injection at the donor site and facilitates lipoaspiration while minimizing pain and ecchymosis. For fat processing, centrifugation at a low speed is preferable to high-speed centrifugation, gravity separation or filtration. Fat injection at the recipient site should be performed using small-gauge cannulas in a fanning out pattern over multiple sessions, rather than a single session. Fat grafts exhibit not only dermal filler properties but also regenerative potential owing to the presence of stem cells in fat tissue. Thus, the clinical applications of autologous fat grafting include correction of secondary contour defects after breast reconstruction, release of painful scar contractures, and treatment of burn scars and radiodermatitis. Lipofilling is also used in aesthetic surgery, such as facial and hand rejuvenation, augmentation rhinoplasty, and breast and gluteal augmentation. The complications of lipofilling are minimal and include bruising, swelling, pain, infection, necrosis, and calcification. CONCLUSIONS Lipofilling is a low-risk procedure that can be used to correct soft-tissue defects in the face, trunk, and extremities, with minimal discomfort for patients.
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Affiliation(s)
- Francesco Simonacci
- Department of Medicine and Surgery, Plastic Surgery Division, University of Parma, Parma, Italy
- Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
| | - Nicolò Bertozzi
- Department of Medicine and Surgery, Plastic Surgery Division, University of Parma, Parma, Italy
- Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
| | - Michele Pio Grieco
- Department of Medicine and Surgery, Plastic Surgery Division, University of Parma, Parma, Italy
- Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
| | - Eugenio Grignaffini
- Department of Medicine and Surgery, Plastic Surgery Division, University of Parma, Parma, Italy
- Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
| | - Edoardo Raposio
- Department of Medicine and Surgery, Plastic Surgery Division, University of Parma, Parma, Italy
- Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Parma, Italy
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Application of adipose-derived stromal cells in fat grafting: Basic science and literature review. Exp Ther Med 2017; 14:2415-2423. [PMID: 28962175 PMCID: PMC5609216 DOI: 10.3892/etm.2017.4811] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/06/2017] [Indexed: 02/07/2023] Open
Abstract
Autologous fat is considered the ideal material for soft-tissue augmentation in plastic and reconstructive surgery. The primary drawback of autologous fat grafting is the high resorption rate. The isolation of mesenchymal stem cells from adipose tissue inevitably led to research focusing on the study of combined transplantation of autologous fat and adipose derived stem cells (ADSCs) and introduced the theory of ‘cell-assisted lipotransfer’. Transplantation of ADSCs is a promising strategy, due to the high proliferative capacity of stem cells, their potential to induce paracrine signalling and ability to differentiate into adipocytes and vascular cells. The current study examined the literature for clinical and experimental studies on cell-assisted lipotransfer to assess the efficacy of this novel technique when compared with traditional fat grafting. A total of 30 studies were included in the present review. The current study demonstrates that cell-assisted lipotransfer has improved efficacy compared with conventional fat grafting. Despite relatively positive outcomes, further investigation is required to establish a consensus in cell-assisted lipotransfer.
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De Francesco F, Guastafierro A, Nicoletti G, Razzano S, Riccio M, Ferraro GA. The Selective Centrifugation Ensures a Better In Vitro Isolation of ASCs and Restores a Soft Tissue Regeneration In Vivo. Int J Mol Sci 2017; 18:ijms18051038. [PMID: 28498335 PMCID: PMC5454950 DOI: 10.3390/ijms18051038] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/26/2017] [Accepted: 04/28/2017] [Indexed: 01/13/2023] Open
Abstract
Autologous fat grafting procedures in plastic surgery have been extensively used to reinforce soft tissue in congenital or acquired tissue impairments. With this background, the aim of this study is firstly to examine the impact of a selective centrifugation on existing adipose stem cells (ASCs) in terms of stemness profile maintenance and, secondly, to investigate the effect of restoring volume in reconstruction on patients affected by soft tissue damage. After centrifugation, the fat graft products were separated into two layers and subsequently examined in vitro for the expression of CD34, CD90, CD117, CD105, CD29, CD31, CD44, CD73, CD133, CD14 and CD45 markers by flow cytometry and gene expression analyses were performed for Sox2, WNT3A, END, CD44, FUT4, COLL1, CTNNB1, hbEGF, KRTLG, MMP2 and VIM genes. The results showed that in the middle-high density (MHD) layer there was a peak concentration of ASCs, compared to another layer obtained after centrifugation. Research carried out on patients under treatment for soft tissue regeneration using cells obtained from MHD layer selection will be fundamental in comparative analysis. These studies will lead to an adequate standardization of outcomes, provided that treatment is performed through cell selection. Therefore, a unique procedure in tissue reconstruction and regeneration through fat grafting is presented here.
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Affiliation(s)
- Francesco De Francesco
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples 80128, Italy.
- Department of Reconstructive Plastic Surgery-Hand Surgery, AOU "Ospedali Riuniti", Ancona 60126, Italy.
| | - Antonio Guastafierro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples 80128, Italy.
| | - Gianfranco Nicoletti
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples 80128, Italy.
| | - Sergio Razzano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples 80128, Italy.
| | - Michele Riccio
- Department of Reconstructive Plastic Surgery-Hand Surgery, AOU "Ospedali Riuniti", Ancona 60126, Italy.
| | - Giuseppe A Ferraro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples 80128, Italy.
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Hoseini SJ, Ghazavi H, Forouzanfar F, Mashkani B, Ghorbani A, Mahdipour E, Ghasemi F, Sadeghnia HR, Ghayour-Mobarhan M. Fibroblast Growth Factor 1-Transfected Adipose-Derived Mesenchymal Stem Cells Promote Angiogenic Proliferation. DNA Cell Biol 2017; 36:401-412. [PMID: 28281780 PMCID: PMC5421621 DOI: 10.1089/dna.2016.3546] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/28/2017] [Accepted: 02/08/2017] [Indexed: 01/10/2023] Open
Abstract
The aim of this study was to investigate, for the first time, the effects of using adipose-derived mesenchymal stem cells (AD-MSCs) transfected with an episomal plasmid encoding fibroblast growth factor 1 (FGF1) (AD-MSCsFGF1), in providing the microenvironment required for angiogenic proliferation. The isolated rat AD-MSCs were positive for mesenchymal (CD29 and CD90) and negative for hematopoietic (CD34 and CD45) surface markers. Adipogenic and osteogenic differentiation of the AD-MSCs also occurred in the proper culture media. The presence of FGF1 in the conditioned medium from the AD-MSCsFGF1 was confirmed by Western blotting. G418 and PCR were used for selection of transfected cells and confirmation of the presence of FGF1 mRNA, respectively. Treatment with the AD-MSCFGF1-conditioned medium significantly increased the NIH-3T3 cell proliferation and human umbilical vein endothelial cell (HUVEC) tube formation compared to conditioned medium from nontransfected AD-MSCs (p < 0.001). In conclusion, the AD-MSCsFGF1 efficiently secreted functional FGF1, which promoted angiogenic proliferation. Using AD-MSCsFGF1 may provide a useful strategy in cell therapy, which can merge the beneficial effects of stem cells with the positive biological effects of FGF1 in various disorders, especially tissue defects, neurodegenerative, cardiovascular and diabetes endocrine pathologies, which remain to be tested in preclinical and clinical studies.
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Affiliation(s)
- Seyed Javad Hoseini
- Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Ghazavi
- Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Forouzanfar
- Department of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Baratali Mashkani
- Department of Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ahmad Ghorbani
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elahe Mahdipour
- Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Faezeh Ghasemi
- Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid Reza Sadeghnia
- Neurocognitive Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Cardiovascular Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Seo E, Lim JS, Jun JB, Choi W, Hong IS, Jun HS. Exendin-4 in combination with adipose-derived stem cells promotes angiogenesis and improves diabetic wound healing. J Transl Med 2017; 15:35. [PMID: 28202074 PMCID: PMC5311833 DOI: 10.1186/s12967-017-1145-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 02/08/2017] [Indexed: 01/09/2023] Open
Abstract
Background Diminished wound healing is a major complication of diabetes mellitus and can lead to foot ulcers. However, there are limited therapeutic methods to treat this condition. Exendin-4 (Ex-4), a glucagon-like peptide-1 receptor agonist, is known to have many beneficial effects on diabetes. In addition, mesenchymal stem cells are known to have wound healing effects. We investigated the effects of Ex-4 in combination with human adipose tissue-derived stem cells (ADSCs) on diabetic wound healing in a diabetic animal model. Methods Diabetic db/db (blood glucose levels, >500 mg/dl) or C57BL/6 mice were subjected to wounding on the skin of the back. One day after wounding, each wound received ADSCs (2.5 × 105 cells) injected intradermally around the wound and/or Ex-4 (50 μl of 100 nM Ex-4) topically applied on the wound with a fine brush daily. Wound size was monitored and wound histology was examined. Human endothelial cells and keratinocyte cells were used to assess angiogenesis and vascular endothelial growth factor expression in vitro. Results Topical administration of Ex-4 or injection of ADSCs resulted in a rapid reduction of wound size in both diabetic and normoglycemic animals compared with vehicle treatment. Histological analysis also showed rapid skin reconstruction in Ex-4-treated or ADSC-injected wounds. A combination of Ex-4 and ADSCs showed a significantly better therapeutic effect over either treatment alone. In vitro angiogenesis assays showed that both Ex-4 and ADSC-conditioned media (CM) treatment improved migration, invasion and proliferation of human endothelial cells. ADSC-CM also increased migration and proliferation of human keratinocytes. In addition, both Ex-4 and ADSC-CM increased the expression of vascular endothelial growth factor. Co-culture with ADSCs increased migration and proliferation of these cells similar to that found after ADSC-CM treatment. Conclusions We suggest that Ex-4 itself is effective for the treatment of diabetic skin wounds, and a combination of topical treatment of Ex-4 and injection of ADSCs has a better therapeutic effect. Thus, a combination of Ex-4 and ADSCs might be an effective therapeutic option for the treatment of diabetic wounds, such as foot ulcers.
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Affiliation(s)
- Eunhui Seo
- College of Pharmacy and Gachon Institute of Pharmaceutical Science, Gachon University, Incheon, 21936, Republic of Korea.,Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon, 21999, Republic of Korea
| | - Jae Soo Lim
- College of Pharmacy and Gachon Institute of Pharmaceutical Science, Gachon University, Incheon, 21936, Republic of Korea
| | - Jin-Bum Jun
- College of Pharmacy and Gachon Institute of Pharmaceutical Science, Gachon University, Incheon, 21936, Republic of Korea
| | - Woohyuk Choi
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon, 21999, Republic of Korea.,Division of Life Sciences, Korea University, Seoul, 02841, Republic of Korea
| | - In-Sun Hong
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon, 21999, Republic of Korea
| | - Hee-Sook Jun
- College of Pharmacy and Gachon Institute of Pharmaceutical Science, Gachon University, Incheon, 21936, Republic of Korea. .,Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon, 21999, Republic of Korea. .,Gachon Medical Research Institute, Gil Hospital, Incheon, 21565, Republic of Korea.
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Gennai A, Zambelli A, Repaci E, Quarto R, Baldelli I, Fraternali G, Bernardini FP. Skin Rejuvenation and Volume Enhancement with the Micro Superficial Enhanced Fluid Fat Injection (M-SEFFI) for Skin Aging of the Periocular and Perioral Regions. Aesthet Surg J 2017; 37:14-23. [PMID: 27241362 DOI: 10.1093/asj/sjw084] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2016] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Adipose-derived stromal and stem cells (ADSC) in autologous fat promises regenerative advantages, and injected into the dermal and subdermal layers, enhances rejuvenation and volume. However, extremely superficial fat injection with current techniques is limited. OBJECTIVES Efficacy and viability evaluation of fat harvested with extremely small side port (0.3 mm) cannulae without further tissue manipulation for the correction of aging/thin skin in the periocular and perioral regions. METHODS Micro-superficial enhanced fluid fat injection (M-SEFFI) harvests adipose tissue with a multi-perforated cannula (0.3 mm), and autologous platelet rich plasma (PRP) is added. The tissue is injected into the dermal region of the periocular and perioral zones. Efficacy and viability were evaluated by histological and cell culture analysis. Clinical assessment included retrospective evaluation according to 1 = no effect, 2 = fair effect, 3 = good effect, 4 = excellent effect. RESULTS Between June 2014 and July 2015, 65 patients (7 men; mean age 49.7 years) were treated with M-SEFFI. No intraoperative complications or visible lumpiness were recorded. Analysis demonstrated mature, viable adipocytes with a strong stromal component. Following PRP addition, there was a greater proliferation noted in the M-SEFFI compared to the SEFFI (0.5 mm). Mean follow-up was 4.1 months. Clinical assessment by surgeons and patients at 1 month was 3.52 and 3.74, and 6 months 3.06 and 2.6 respectively. CONCLUSIONS M-SEFFI is effective and viable for lump free skin rejuvenation and volume enhancement, through the extraction of smoother ADSC rich, autologous fat tissue that does not require further tissue manipulation, to correct skin aging. LEVEL OF EVIDENCE 4 Therapeutic.
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Affiliation(s)
- Alessandro Gennai
- Dr Gennai is a plastic surgeon in private practice in Bologna and Milan, Italy. Drs Zambelli and Bernardini are oculoplastic surgeons in private practice in Genova, Italy. Dr Repaci is a Researcher and Dr Quarto is the Chairman, Department of Experimental Medicine, University of Genova, Genova, Italy. Dr Baldelli is a Plastic Surgeon, Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Genova, Italy. Dr Fraternali is a Pathologist, Department of Pathology, University of Genova, Genova, Italy
| | - Alessandra Zambelli
- Dr Gennai is a plastic surgeon in private practice in Bologna and Milan, Italy. Drs Zambelli and Bernardini are oculoplastic surgeons in private practice in Genova, Italy. Dr Repaci is a Researcher and Dr Quarto is the Chairman, Department of Experimental Medicine, University of Genova, Genova, Italy. Dr Baldelli is a Plastic Surgeon, Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Genova, Italy. Dr Fraternali is a Pathologist, Department of Pathology, University of Genova, Genova, Italy
| | - Erica Repaci
- Dr Gennai is a plastic surgeon in private practice in Bologna and Milan, Italy. Drs Zambelli and Bernardini are oculoplastic surgeons in private practice in Genova, Italy. Dr Repaci is a Researcher and Dr Quarto is the Chairman, Department of Experimental Medicine, University of Genova, Genova, Italy. Dr Baldelli is a Plastic Surgeon, Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Genova, Italy. Dr Fraternali is a Pathologist, Department of Pathology, University of Genova, Genova, Italy
| | - Rodolfo Quarto
- Dr Gennai is a plastic surgeon in private practice in Bologna and Milan, Italy. Drs Zambelli and Bernardini are oculoplastic surgeons in private practice in Genova, Italy. Dr Repaci is a Researcher and Dr Quarto is the Chairman, Department of Experimental Medicine, University of Genova, Genova, Italy. Dr Baldelli is a Plastic Surgeon, Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Genova, Italy. Dr Fraternali is a Pathologist, Department of Pathology, University of Genova, Genova, Italy
| | - Ilaria Baldelli
- Dr Gennai is a plastic surgeon in private practice in Bologna and Milan, Italy. Drs Zambelli and Bernardini are oculoplastic surgeons in private practice in Genova, Italy. Dr Repaci is a Researcher and Dr Quarto is the Chairman, Department of Experimental Medicine, University of Genova, Genova, Italy. Dr Baldelli is a Plastic Surgeon, Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Genova, Italy. Dr Fraternali is a Pathologist, Department of Pathology, University of Genova, Genova, Italy
| | - Giulio Fraternali
- Dr Gennai is a plastic surgeon in private practice in Bologna and Milan, Italy. Drs Zambelli and Bernardini are oculoplastic surgeons in private practice in Genova, Italy. Dr Repaci is a Researcher and Dr Quarto is the Chairman, Department of Experimental Medicine, University of Genova, Genova, Italy. Dr Baldelli is a Plastic Surgeon, Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Genova, Italy. Dr Fraternali is a Pathologist, Department of Pathology, University of Genova, Genova, Italy
| | - Francesco P Bernardini
- Dr Gennai is a plastic surgeon in private practice in Bologna and Milan, Italy. Drs Zambelli and Bernardini are oculoplastic surgeons in private practice in Genova, Italy. Dr Repaci is a Researcher and Dr Quarto is the Chairman, Department of Experimental Medicine, University of Genova, Genova, Italy. Dr Baldelli is a Plastic Surgeon, Department of Integrated Surgical and Diagnostic Sciences, University of Genova, Genova, Italy. Dr Fraternali is a Pathologist, Department of Pathology, University of Genova, Genova, Italy
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Positive Effects of Subdermal Lipotransfer on Pig’s Upper Eyelid Skin: Mature Adipocytes or Adipose-Derived Stem Cells Alone Contribute Little and Only Cotransplantation of Them Can Generate Benefits. Ophthalmic Plast Reconstr Surg 2017; 33:40-46. [DOI: 10.1097/iop.0000000000000640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wound Healing and Angiogenesis through Combined Use of a Vascularized Tissue Flap and Adipose-Derived Stem Cells in a Rat Hindlimb Irradiated Ischemia Model. Plast Reconstr Surg 2016; 137:1486-1497. [PMID: 27119923 DOI: 10.1097/prs.0000000000002062] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Treatment of critical limb ischemia is sometimes difficult because of the patient's condition, and some novel approaches are needed. METHODS The hindlimbs of Sprague-Dawley rats, after 20-Gy x-ray irradiation and surgical occlusion, were divided into four groups: with a superficial fascial flap, 5.0 × 10 adipose-derived stromal/stem cells, and both combined. The rats were tested for laser tissue blood flow, immunohistologic blood vessel density, and foot paw punch hole wound healing. Green fluorescent protein-tagged Sprague-Dawley rats were used for further investigation by cell tracking for 2 weeks. RESULTS Laser tissue blood flow demonstrated a significant increase in the combined treatment of flap and adipose-derived stem cells at both 1 and 2 weeks. There were no significant differences between the treatment groups treated with flaps alone and those treated with adipose-derived stem cells alone. Wound healing was significantly increased following combined treatment at 1 week, and there was no wound by 2 weeks except for the no-flap and no-adipose-derived stem cell group. The number of vessels depicted by von Willebrand factor showed a significant increase in the combined treatment group, at both 1 week and 2 weeks. In the cell tracking group, at 2 weeks, the green fluorescent protein-tagged adipose-derived stem cells were significantly more positive in the no-flap group than in the flap group. CONCLUSIONS Adipose-derived stem cells may be a potent cell source in irradiated and occluded limbs by enhancing tissue blood flow and blood vessel density. Adipose-derived stem cells may play an important role in some difficult ischemic conditions in terms of wound healing.
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Foroglou P, Karathanasis V, Demiri E, Koliakos G, Papadakis M. Role of adipose-derived stromal cells in pedicle skin flap survival in experimental animal models. World J Stem Cells 2016; 8:101-105. [PMID: 27022440 PMCID: PMC4807308 DOI: 10.4252/wjsc.v8.i3.101] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/23/2015] [Accepted: 01/21/2016] [Indexed: 02/06/2023] Open
Abstract
The use of skin flaps in reconstructive surgery is the first-line surgical treatment for the reconstruction of skin defects and is essentially considered the starting point of plastic surgery. Despite their excellent usability, their application includes general surgical risks or possible complications, the primary and most common is necrosis of the flap. To improve flap survival, researchers have used different methods, including the use of adipose-derived stem cells, with significant positive results. In our research we will report the use of adipose-derived stem cells in pedicle skin flap survival based on current literature on various experimental models in animals.
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Affiliation(s)
- Pericles Foroglou
- Pericles Foroglou, Vasileios Karathanasis, Efterpi Demiri, Department of Plastic Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Vasileios Karathanasis
- Pericles Foroglou, Vasileios Karathanasis, Efterpi Demiri, Department of Plastic Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Efterpi Demiri
- Pericles Foroglou, Vasileios Karathanasis, Efterpi Demiri, Department of Plastic Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - George Koliakos
- Pericles Foroglou, Vasileios Karathanasis, Efterpi Demiri, Department of Plastic Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Marios Papadakis
- Pericles Foroglou, Vasileios Karathanasis, Efterpi Demiri, Department of Plastic Surgery, Papageorgiou General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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GASPAR A, CONSTANTIN D, SECIU AM, MOLDOVAN L, CRACIUNESCU O, GANEA E. Human adipose-derived stem cells differentiation into epidermal cells and interaction with human keratinocytes in coculture. Turk J Biol 2016. [DOI: 10.3906/biy-1502-36] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Kruglikov IL, Scherer PE. Dermal Adipocytes: From Irrelevance to Metabolic Targets? Trends Endocrinol Metab 2016; 27:1-10. [PMID: 26643658 PMCID: PMC4698208 DOI: 10.1016/j.tem.2015.11.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/03/2015] [Accepted: 11/04/2015] [Indexed: 01/12/2023]
Abstract
Dermal white adipose tissue (dWAT) has received little appreciation in the past as a distinct entity from the better recognized subcutaneous white adipose tissue (sWAT). However, recent work has established dWAT as an important contributor to a multitude of processes, including immune response, wound healing and scarring, hair follicle (HF) growth, and thermoregulation. Unique metabolic contributions have also been attributed to dWAT, at least in part due to its thermic insulation properties and response to cold exposure. Dermal adipocytes can also undergo an adipocyte-myofibroblast transition (AMT), a process that is suspected to have an important role in several pathophysiological processes within the skin. Here, we discuss emerging concepts regarding dWAT physiology and its significance to a variety of cellular processes.
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Affiliation(s)
| | - Philipp E Scherer
- Touchstone Diabetes Center, Departments of Internal Medicine and Cell Biology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
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Lipofilling (fat grafting) in the secondary prevention of ischial tuberosity and pelvic pressure ulcers. Spinal Cord 2015; 54:39-45. [PMID: 26481707 DOI: 10.1038/sc.2015.184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 08/27/2015] [Accepted: 09/10/2015] [Indexed: 01/09/2023]
Abstract
STUDY DESIGN Retrospective study. OBJECTIVES Lipofilling was proposed to adult chronic spinal cord injury patients with history of ischial tuberosity pressure ulcers surgery, at risk of recurrence of pressure ulcers due to unsatisfactory adipose tissue thickness. SETTING Fondation Hopale, Berck, France. METHODS The three staged (Coleman) procedure for fat grafting consisted of water-jet assisted liposuction (Harvest-Jet), decantation, and reinjection of the autologous fat in three-dimensional plan. RESULTS Ten consecutive patients (eight paraplegics and two tetraplegics) benefited from bilateral ischial lipofilling, with additional lipofilling of the sacrum (three patients) and the trochanters (two patients). All patients attended the seating clinic with pressure mapping before and after lipofilling for appropriate cushion prescription. Mean follow-up time was 16 months (4-24 months). Complications were limited to stage I (two patients) and stage II (one patient) pressure ulcers, due to negligence. Excellent results with minimal fat wasting (between 10% and 25%) underneath the ischial tuberosity were seen in eight patients, with significant improvement of adipose tissue thickness. Total fat waste was seen in two patients, one of whom following dramatic weight loss. Results were always good in the sacrum and trochanteric areas. Lipofilling allowed longer sitting times (three patients), improved skin quality (nine patients), improved quality of life (six patients), 'a better feeling of positioning in their wheelchair' (four patients), and decrease in pelvic pain (three patients). DISCUSSION AND CONCLUSION Pelvic lipofilling is safe, cost-effective, and can now be considered in the primary prevention of pelvic pressure ulcers in patients with insufficient adipose tissue.
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