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What is the current optimal fat grafting processing technique? A systematic review.
A Jorien Tuin1, Patrick N Domerchie2, Rutger H Schepers1
1Department of Oral & Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, The Netherlands.
Summary
Fat grafting processing using permeability methods, like the gauze technique, yielded better adipocyte viability and stem cell counts than centrifugation. However, clinical evidence for superiority remains limited due to study variations.
Area of Science:
- Regenerative Medicine
- Biomaterials Science
- Plastic Surgery
Background:
- Advancements in fat grafting processing techniques and graft survival theories necessitate comparative analysis.
- Systematic review of current fat graft processing methods is crucial for clinical preference.
Purpose of the Study:
- To systematically review and compare different fat grafting processing techniques.
- To evaluate the impact of processing methods on graft viability, cell counts, and clinical outcomes.
Main Methods:
- Comprehensive literature search of PubMed, Embase, Cinahl, and Cochrane databases up to August 2015.
- Inclusion of studies comparing various fat grafting processing techniques.
- Assessment of outcomes including adipocyte viability, adipose-derived stromal/stem cell (ASC) numbers, growth factors, graft volume/quality, and patient satisfaction.
Main Results:
- Permeability-based techniques (e.g., gauze/towel) showed superior adipocyte viability and ASC numbers compared to centrifugation.
- Centrifugation pellet layers had higher ASC counts than middle layers.
- No significant differences in patient satisfaction were noted; a wash filter device outperformed centrifugation for volume retention in one human study.
Conclusions:
- Processing techniques utilizing permeability principles demonstrate advantages over centrifugation in terms of adipocyte viability and ASC yield.
- Despite promising in vitro and animal study results, current evidence does not definitively establish clinical superiority for any single processing technique due to study heterogeneity.
