Prefabricated flap composed by skin and terminal gastromental vessels. Experimental study in rabbits

Unmanipulated native fat exposed to high-energy diet, but not autologous grafted fat by itself, may lead to overexpression of Ki67 and PAI-1

“…It is known that the adipose tissue provides a source of stem cells (i.e., cells that are capable of differentiating into other cell types of the same embryonic origin) (Baglioni et al 2009; Baumert et al 2007; Dhanasekaran et al 2012; Oloumi et al 2006; Kobayashi et al 2006) and exhibits great angiogenic potential (Figueiredo et al 2010; Oloumi et al 2006) for restoring ischemic tissues and actinic lesions (Claro et al 2012; Illouz 1988; Goldsmith et al 1967; Liebermann-Meffert 2000; Morison 1903; Williams and White 1991). The movement of this tissue from its primary site to a different environment might expose it to metaplasia.…”

“…Considering that the angiogenesis is intense just after adipose tissue grafting or translocation (Figueiredo et al 2010), what represents one among many theories for its potential for breast cancer, a chronic higher concentration of CD68-labelled macrophage was expected. However, this data was not found in this study and the CD68 expression was similar in all adipose tissue samples.…”

“…The gene expression of Ki67 was used in order to evaluate the proliferation rate of adipose tissue from different body compartments, as well as its behavior on high-energy diet and after its translocation to a different environment. The possibility of transposed fat creating a proliferative status in the host microenvironment is considered mostly due to the knowledge that the adipose tissue promotes angiogenesis, deeply explored in the great omentum experiments (Baumert et al 2007; Figueiredo et al 2010; Goldsmith et al 1967; O’Shaughnessy 1937; Oloumi et al 2006), what theoretically may represent another threat for breast cancer. In this study, the adipose tissue per se, did not show any change in its proliferative rate according to its origin site or after its translocation to a different environment.…”

“…Moreover, beyond the adipocyte, some theories raised doubts regarding the procedure by itself, due to the great angiogenic potential of the adipose tissue observed in some clinical and experimental studies (Dhanasekaran et al 2012; Figueiredo et al 2010; Goldsmith et al 1967; Liebermann-Meffert 2000; Morison 1903; O’Shaughnessy 1937; Oloumi et al 2006; Williams and White 1991), that may lead to chronic inflammation and cell proliferation to the microenvironment of lipofilling host site and its surroundings. Thus, there are some issues that must be considered when studying fat grafting: (1) the unpredictable amount of grafted fat present in the sample extracted from the host site, because the long-term graft retention is inaccurate and its absorption can vary from less than 10% to more than 90%; (2) as fat graft is composed not only by adipocytes but also by many other cells and components present in fat tissue, the whole elements of the adipose tissue though, must be analyzed after fat grafting; (3) the grafted tissue must be analyzed in vivo in order to study its behavior in the host site and of its surroundings and; (4) the subjects must be genetically similar and, as controlled as possible, in relation to its diet intake and lifestyle.…”

Integra Acellular Collagen as a Vascular Carrier for Skin Flap Prefabrication in Rats

“…Since then, prefabricated free flaps have been investigated by different authors. [21][22][23][24][25] Although neovascularization is a natural and indispensable part of wound healing and can be selectively combined with vascular implantation and microsurgical techniques to create customized neovascularized free flaps, 26 flap prefabrication techniques still need further investigation as a result of the fact that the precise mechanisms of neovascularization are not well understood yet. 27 The survival of prefabricated flaps mostly depends on the status of angiogenesis in the prefabricated flaps through vascular induction.…”