| The Effect of Pressure and Shear on Autologous Fat Grafting. | |
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MedLine Citation:
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PMID: 23385989 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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INTRODUCTION:: Fat grafting has become routine in Plastic surgery due to low donor site morbidity, low complication rate, and fast recovery time. The optimal technique, however, has yet to be defined. Two critical variables are pressure and shear, both defined as force divided by area. In this study, we examined the role of pressure and shear on human fat grafts in a nude mouse model. METHODS:: Negative Pressure: Tumescent liposuction was performed on fresh panniculectomy specimens. Suction pressure was either -15 inches Hg or -25 inches. Lipoaspirate was centrifuged at 1200G and injected into the flanks of nude. Positive Pressure: Positive pressure was applied to lipoaspirate up to 6 atmospheres for up to 3 minutes and then injected into nude mice. Shear Stress: Lipoaspirate was centrifuged at 1200G for 3 minutes and then injected with a fast flow rate (3-5 cc/sec) or slow flow rate (0.5-1 cc/sec). After 4 weeks, the fat grafts were analyzed for weight and histology. RESULTS:: Negative Pressure: There were no differences in weight or histology with high versus low suction pressures. Positive Pressure: Application of positive pressures up to 6 atmospheres for up to 3 minutes did not create a significant difference in graft weight or histology at 4 weeks. Shear Stress: In vivo, a slow injection pressure yielded a 38% increase in weight (p<0.001) compared to fast injection. Histology was similarly affected. CONCLUSION:: Higher aspiration pressures up to -0.83 atm did not affect fat grafts viability in vivo. Positive pressure up to 6 atmospheres also did not affect fat graft viability. The degree of shear stress, which is a function of flow rate, did significantly affect fat graft viability. Fat grafts injected slowly with low shear stress significantly outperformed fat injected with high shear stress. These data suggest shear stress is a more important variable regarding fat graft viability than pressure. LEVEL OF EVIDENCE:: Not applicable. |
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Authors:
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Jeffrey H Lee; John C Kirkham; Michael C McCormack; Alexa M Nicholls; Mark A Randolph; William G Austen |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-2-4 |
Journal Detail:
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Title: Plastic and reconstructive surgery Volume: - ISSN: 1529-4242 ISO Abbreviation: Plast. Reconstr. Surg. Publication Date: 2013 Feb |
Date Detail:
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Created Date: 2013-2-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1306050 Medline TA: Plast Reconstr Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Massachusetts General Hospital, Boston, MA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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