Current Applications and Indications of Allograft Adipose Matrix: A Systematic Review.

IF 3.4 2区 医学 Q1 SURGERY
Sara B A Morel, Neil Vranis, Justin Perez, Andreas Nikolis, Ashkan Ghavami, Tyler Safran
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引用次数: 0

Abstract

Background: Autologous fat transfer remains a staple in aesthetic and reconstructive surgery due to its regenerative capacity and tissue integration. However, limitations such as donor site morbidity and unpredictable volume retention persist. Allograft adipose matrix (AAM), a product made from human fat tissue which serves as a natural scaffold to promote adipogenesis, offers a promising alternative, serving as a scaffold for adipogenesis and delivering key extracellular matrix components. This review examines clinical applications and outcomes in soft tissue augmentation.

Methods: A systematic review was conducted via PubMed/MEDLINE/Cochrane/EMBASE using "Allograft Adipose Matrix," "Decellularized Adipose Matrix," "Renuva," and "Leneva." Studies published up to May 30, 2024, involving human or animal AAM treatment were included. Data on demographics, clinical use, injection protocols, outcomes, volume retention, and complications were extracted and analyzed.

Results: From 352 studies, 10 involving humans and 9 involving animals were included. Human studies included 93 patients. Indications for AAM included: foot and dorsal hand rejuvenation, abdominal and buttocks contouring, temple atrophy, breast and genitalia augmentation, pressure ulcers, and facial rejuvenation. AAM injection volumes varied, with retention rates ranging from 21.5% to 100%. The most common complications were erythema, swelling, injection site pain, and burning, all resolving easily. Patient satisfaction scores ranged from 72.9% to 100%.

Conclusion: AAM provides a promising biomaterial for soft tissue augmentation. Histological analysis supports its role in adipogenesis and neovascularization. Animal studies suggest enhancements through combination therapies, including AAM with autologous fat, platelet-rich plasma, or synthetic scaffolds. Further research is needed to optimize decellularization protocols, improve bioactivity and tissue incorporation.

Level of evidence: Level IV, review article.

Important points: - Allograft Adipose Matrix is a promising alternative to autologous fat transfer, offering benefits such as regenerative support, scaffold-based adipogenesis, and reduced donor site morbidity, with various applications.- Clinical studies showed favorable outcomes, including high patient satisfaction and manageable, self-resolving complications.- Further research is needed to enhance efficacy, particularly by improving volume retention, standardizing protocols, and exploring combination therapies, as well as conducting larger, long-term clinical studies.

异体脂肪基质移植的应用和适应症:系统综述。
背景:自体脂肪移植由于其再生能力和组织整合能力,在美容和重建手术中仍然是主要的。然而,局限性,如供体部位的发病率和不可预测的体积潴留仍然存在。同种异体脂肪基质(AAM)是一种由人类脂肪组织制成的产品,作为促进脂肪形成的天然支架,提供了一种有前途的替代方案,作为脂肪形成的支架并提供关键的细胞外基质成分。本文综述了软组织增强术的临床应用和结果。方法:通过PubMed/MEDLINE/Cochrane/EMBASE对“同种异体移植脂肪基质”、“脱细胞脂肪基质”、“Renuva”和“Leneva”进行系统评价。截至2024年5月30日发表的涉及人类或动物AAM治疗的研究被纳入。提取并分析了人口统计学、临床使用、注射方案、结果、容量保留和并发症的数据。结果:352项研究中,10项涉及人类,9项涉及动物。人类研究包括93例患者。AAM的适应症包括:足部和手背年轻化、腹部和臀部轮廓化、太阳穴萎缩、乳房和生殖器增大、压疮和面部年轻化。AAM的注入量不同,保留率从21.5%到100%不等。最常见的并发症是红斑、肿胀、注射部位疼痛和灼烧,这些都很容易消退。患者满意度评分从72.9%到100%不等。结论:AAM是一种很有前途的软组织增强生物材料。组织学分析支持其在脂肪形成和新血管形成中的作用。动物研究表明,通过联合治疗,包括AAM与自体脂肪、富血小板血浆或合成支架,可以增强这种功能。需要进一步的研究来优化脱细胞方案,提高生物活性和组织整合。证据等级:四级,综述文章。异体脂肪基质移植是自体脂肪移植的一种很有前途的替代方法,具有再生支持、基于支架的脂肪生成、降低供体部位发病率等优点,应用广泛。-临床研究显示了良好的结果,包括患者满意度高,并发症可控,可自行解决。-需要进一步的研究来提高疗效,特别是通过改善体积保留,标准化方案,探索联合疗法,以及进行更大规模的长期临床研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.00
自引率
13.90%
发文量
1436
审稿时长
1.5 months
期刊介绍: For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis. Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
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