A Rabbit Model of Fat Graft Recipient Site Preconditioning Using External Negative Pressure

Background Fat is widely used in soft tissue augmentation. Nevertheless, it has an unpredictably high resorption rate. Clinically, external expansion with negative pressure is used to increase fat graft survival. In this study, fat graft recipient sites were preconditioned by external application of negative pressure in order to test for improvements in vascularity and fat graft survival.

Methods Negative pressure was applied randomly to either the left or right dorsal ear of 20 New Zealand male white rabbits at a pressure of -125 mm Hg. The negative pressure was removed one week after the skin perfusion was measured. The skin flap at each ear was elevated, and 1 g of fat was grafted above the dorsal perichondrium. After one week, the fat weight, microvessel density, mature vessel density of the skin and fat, and amount of glycerol released were measured. Three months after the grafting, the same measurements were performed, with the exception of glycerol release.

Results The fat survival rate of the experimental group (75.4%±3.9%) was higher than that of the control group (53.1%±4.3%) (P<0.001). Skin perfusion was higher in the experimental group. The glycerol release in the experimental group was significantly higher than in the control. The microvessel density of the skin and fat was significantly higher in the experimental group. Three months after the grafting, the skin and fat mature vessel density was significantly higher in the experimental groups.

Conclusions Negative pressure prior to fat grafting increased the vascularity of the recipient site, and, accordingly, enhanced fat graft survival.

Keywords

Transplant donor site - Topical negative-pressure therapy - Adipose tissue - Autografts

This article was presented at the 4th Research and Reconstructive Forum on April 3-4, 2014 in Busan, Korea.

Publication History

Received: 06 August 2014

Accepted: 30 September 2014

Article published online:
05 May 2022

• REFERENCES

• 1 Langer S, Sinitsina I, Biberthaler P. et al. Revascularization of transplanted adipose tissue: a study in the dorsal skinfold chamber of hamsters. Ann Plast Surg 2002; 48: 53-59
• 2 Del Vecchio DA, Del Vecchio SJ. The graft-to-capacity ratio: volumetric planning in large-volume fat transplantation. Plast Reconstr Surg 2014; 133: 561-569
• 3 Yazawa M, Mori T, Tuchiya K. et al. Influence of vascularized transplant bed on fat grafting. Wound Repair Regen 2006; 14: 586-592
• 4 Schintler MV. Negative pressure therapy: theory and practice. Diabetes Metab Res Rev 2012; 28 (Suppl. 01) 72-77
• 5 Timmers MS, Le Cessie S, Banwell P. et al. The effects of varying degrees of pressure delivered by negative-pressure wound therapy on skin perfusion. Ann Plast Surg 2005; 55: 665-671
• 6 Kairinos N, Solomons M, Hudson DA. Negative-pressure wound therapy I: the paradox of negative-pressure wound therapy. Plast Reconstr Surg 2009; 123: 589-598
• 7 Khouri RK, Eisenmann-Klein M, Cardoso E. et al. Brava and autologous fat transfer is a safe and effective breast augmentation alternative: results of a 6-year, 81-patient, prospective multicenter study. Plast Reconstr Surg 2012; 129: 1173-1187
• 8 Khouri RK, Rigotti G, Cardoso E. et al. Megavolume autologous fat transfer: part I. Theory and principles. Plast Reconstr Surg 2014; 133: 550-557
• 9 Heit YI, Lancerotto L, Mesteri I. et al. External volume expansion increases subcutaneous thickness, cell proliferation, and vascular remodeling in a murine model. Plast Reconstr Surg 2012; 130: 541-547
• 10 Gigliofiorito P, Marangi GF, Langella M. et al. The effects of negative pressure on blood supply and the adipogenic role of edema. Plast Reconstr Surg 2013; 131: 931e-932e
• 11 Oh DS, Cheon YW, Jeon YR. et al. Activated platelet-rich plasma improves fat graft survival in nude mice: a pilot study. Dermatol Surg 2011; 37: 619-625
• 12 Baran CN, Celebioglu S, Sensoz O. et al. The behavior of fat grafts in recipient areas with enhanced vascularity. Plast Reconstr Surg 2002; 109: 1646-1651
• 13 Park B, Kong JS, Kang S. et al. The effect of epidermal growth factor on autogenous fat graft. Aesthetic Plast Surg 2011; 35: 738-744
• 14 Tamura E, Fukuda H, Tabata Y. Adipose tissue formation in response to basic fibroblast growth factor. Acta Otolaryngol 2007; 127: 1327-1331
• 15 Erba P, Ogawa R, Ackermann M. et al. Angiogenesis in wounds treated by microdeformational wound therapy. Ann Surg 2011; 253: 402-409
• 16 Scherer SS, Pietramaggiori G, Mathews JC. et al. Short periodic applications of the vacuum-assisted closure device cause an extended tissue response in the diabetic mouse model. Plast Reconstr Surg 2009; 124: 1458-1465
• 17 Nishimura T, Hashimoto H, Nakanishi I. et al. Microvascular angiogenesis and apoptosis in the survival of free fat grafts. Laryngoscope 2000; 110: 1333-1338
• 18 Kato H, Mineda K, Eto H. et al. Degeneration, regeneration, and cicatrization after fat grafting: dynamic total tissue remodeling during the first 3 months. Plast Reconstr Surg 2014; 133: 303e-313e
• 19 Zhu M, Cohen SR, Hicok KC. et al. Comparison of three different fat graft preparation methods: gravity separation, centrifugation, and simultaneous washing with filtration in a closed system. Plast Reconstr Surg 2013; 131: 873-880
• 20 Chen SZ, Li J, Li XY. et al. Effects of vacuum-assisted closure on wound microcirculation: an experimental study. Asian J Surg 2005; 28: 211-217
• 21 Del Vecchio DA, Bucky LP. Breast augmentation using preexpansion and autologous fat transplantation: a clinical radiographic study. Plast Reconstr Surg 2011; 127: 2441-2450
• 22 Del Vecchio D, Rohrich RJ. A classification of clinical fat grafting: different problems, different solutions. Plast Reconstr Surg 2012; 130: 511-522