Document Detail

The effect of pressure and shear on autologous fat grafting.
MedLine Citation:
PMID:  23385989     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Fat grafting has become routine in plastic surgery because of low donor-site morbidity, a 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, the authors examined the effect of pressure and shear on human fat grafts in a nude mouse model.
METHODS: For negative pressure, tumescent liposuction was performed on fresh panniculectomy specimens. Suction pressure was either -15 inHg or -25 inHg. Lipoaspirate was centrifuged at 1200 g and injected into the flanks of nude mice. For positive pressure, positive pressure was applied to lipoaspirate up to 6 atm for up to 3 minutes and then injected into nude mice. For shear stress, lipoaspirate was centrifuged at 1200 g for 3 minutes and then injected with a fast flow rate (3 to 5 cc/second) or slow flow rate (0.5 to 1 cc/second). After 4 weeks, the fat grafts were analyzed for weight and histology.
RESULTS: For negative pressure, there were no differences in weight or histology with high versus low suction pressures. For positive pressure, application of positive pressures up to 6 atm for up to 3 minutes did not create a significant difference in graft weight or histology at 4 weeks. For shear stress, in vivo, a slow injection pressure yielded a 38 percent increase in weight (p < 0.001) compared with fast injection. Histology was similarly affected.
CONCLUSIONS: Higher aspiration pressures up to -0.83 atm did not affect fat graft viability in vivo. Positive pressure up to 6 atm 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 that shear stress is a more important variable regarding fat graft viability than pressure.
Jeffrey H Lee; John C Kirkham; Michael C McCormack; Alexa M Nicholls; Mark A Randolph; William G Austen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  131     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-30     Completed Date:  2013-07-16     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1125-36     Citation Subset:  AIM; IM    
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MeSH Terms
Adipose Tissue / injuries,  transplantation*
Graft Survival / physiology*
Lipectomy / adverse effects*,  methods*
Mice, Nude
Models, Animal
Pressure / adverse effects*
Stress, Mechanical
Surgery, Plastic / methods*
Tissue and Organ Harvesting / adverse effects,  methods
Transplantation, Autologous
Comment In:
Plast Reconstr Surg. 2013 May;131(5):1137-8   [PMID:  23629093 ]
Plast Reconstr Surg. 2014 Mar;133(3):420e-421e   [PMID:  24572889 ]
Plast Reconstr Surg. 2014 Feb;133(2):222e-3e   [PMID:  24469197 ]
Plast Reconstr Surg. 2014 Mar;133(3):419e-420e   [PMID:  24572888 ]
Plast Reconstr Surg. 2014 Feb;133(2):223e-4e   [PMID:  24469198 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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