Polymer Therapy: A Novel Treatment to Improve Fat Graft Viability

Abstract

The authors demonstrate that poloxamers, with membrane-sealing capability, can increase graft survival. Among these poloxamers, P188 demonstrated statistically significant improvement in apoptosis, graft survival by weight, cell viability, DNA content, and histology.

Autologous Fat Processing Via the Revolve System: Quality and Quantity of Fat Retention Evaluated in an Animal Model

“…The fat bolus was injected subcutaneously into the flanks using a 14-gauge angiocatheter and a 3-mL syringe, as described previously. 23 The nude mouse model was developed to model fat graft retention and health but is not intended to model clinical fat grafting techniques. In this study, percent retention of fat grafts was calculated from the weight of each graft at injection and at explant.…”

The Fate of Adipocytes after Nonvascularized Fat Grafting

“…In other studies, cell viability and apoptosis assays were performed with the entire piece of adipose tissue, and adipocytes were not specifically evaluated. 19 However, we cannot discriminate viable adipocytes from dead adipocytes with standard stains such as hematoxylin and eosin; a dead adipocyte (a round lipid droplet) can be easily mistaken for a live adipocyte. Because an adipocyte has a large size (50 to 150 m diameter), a single adipocyte is sliced into many histologic sections (with a regular thickness of 3 to 10 m), and thus a single histologic section does not generally show most nuclei of healthy adipocytes.…”

Targeted Protection of Donor Graft Vasculature Using a Phosphodiesterase Inhibitor Increases Survival and Predictability of Autologous Fat Grafts

“…[38][39][40][41] It has been approved by the U.S. Food and Drug Administration since 1998, has a significant safety record and, at doses used in this study, potentially lacks many of the regulatory hurdles that plague other graft vascularization strategies. [11][12][13] In this study, we demonstrate a novel use for this widely used therapeutic as an adjuvant to infiltrating solutions (such as local anesthesia) to enhance endothelium survival during graft ischemia.…”

“…[5][6][7]26 We can significantly attribute our inconsistent clinical experience with fat grafting to a lack of knowledge about how fat grafts vascularize. We are intrinsically attuned to the importance of rapid tissue vascularization; our own laboratory 10 and others 3,8,9,[11][12][13][18][19][20][27][28][29] have sought to augment tissue fat graft vascularity through methods of "doping" or "enriching" fat grafts with VEGF-based biological compounds or progenitor/stem cells. Although attractive, these methods prove laborious, time-consuming, expensive, and often impractical for clinical translation.…”

“…However, current strategies to accelerate graft vascularization are currently limited by their lack of clinical translatability and efficacy. [10][11][12][13][14][15][16][17][18][19][20][21][22] Our own experience has shown that graft vascularization is not simply a process where the recipient bed vasculature invades a "devascularized" graft; rather, the recipient bed vasculature interacts with the endogenous graft microvasculature in a coordinated process to rapidly vascularize the ischemic graft tissue. 23,24 Currently, there are no studies in the literature that characterize the existence or the effect of endogenous graft microvasculature during graft vascularization.…”