利用猪脂肪移植模型开展转化研究:手术方法、并发症和预期结果

Surgeries Pub Date : 2024-04-04 DOI:10.3390/surgeries5020020
Shawn J. Loder, Alexandra M. Vagonis, Bahaa Shaaban, Amr Elmeanawy, F. B. Bengur, Yadira Villalvazo, Vincent W. Nerone, Yusuf Surucu, Pooja Humar, J. A. Arellano, Hamid Malekzadeh, Andreea Gavrilescu, Rachel E. Ricketts, J. P. Rubin, L. Kokai
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引用次数: 0

摘要

自体脂肪移植(或称脂肪移植)是一种重要的外科手术方法,它可以在个人体内重新定位脂肪组织,从而增加容积。虽然自体脂肪移植被广泛应用于整形和再造手术中,但也存在一些明显的缺点,包括无法预测的容积保持率。因此,研究人员主要利用异种移植免疫受损小鼠模型,开展了大量研究,以确定能改善疗效的手术或治疗方法。大型动物模型是将临床前实验室研究转化为临床实验的重要一步,以前利用猪进行的研究已成功应用于脂肪移植研究,但不同研究的方案存在差异,而且以前的出版物没有充分描述猪的品种对实验结果的影响。在本报告中,我们将介绍猪脂肪移植模型的关键属性,包括以下内容:(1) 模型选择;(2) 供体部位和手术采集方法;(3) 组织处理;(4) 受体部位位置和准备;(5) 术后护理;以及 (6) 纵向脂肪移植评估。我们在模型中比较了约克夏和尤卡坦品种的使用经验,结果显示约克夏脂肪组织是纤维化的,极难通过吸脂术获得,而且加工成注射形式需要大量人力。而尤卡坦犬的脂肪组织与人类组织更为相似,可以通过手术切除腹股沟脂肪垫轻易获得,适合用手术剪刀剪碎,而且可注射组织的有效率高达 95%。我们发现,手术袋的形成减少了移植物的移位和扩散,从而方便了移植物的取回,且不会明显影响移植物的保留。使用 5 毫升移植物,16 例移植物 3 个月的最终容量保持率为 19% ± 17%(或 1.14 毫升 ± 1.08 毫升)。虽然在研究过程中使用超声波并不能很容易地估算移植物的体积,但它是一种很有用的方法,可以直观地看到移植物的放置位置,并确保将移植物注射到皮下脂肪层。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Utilizing a Porcine Fat Grafting Model for Translational Research: Surgical Approach, Complications, and Expected Outcomes
Autologous fat grafting, or lipotransfer, is an important surgical approach to relocate adipose tissue within an individual to create volume. While used extensively in plastic and reconstructive surgery, significant drawbacks exist, including unpredictable volume retention. Thus, considerable research has been undertaken to identify surgical or therapeutic approaches that improve outcomes, primarily utilizing a xenograft immunocompromised mouse model. Large animal models are an important step in translating preclinical laboratory studies to the clinic, and previous studies utilizing pigs have been applied successfully for fat grafting research, but protocol variability exists across studies, and no previous publication has adequately described the impact of the swine breed on the experimental outcomes. In this report, we provide information on the critical attributes of the swine fat grafting model, including the following: (1) model selection; (2) donor site and surgical harvest approach; (3) tissue processing; (4) recipient site location and preparation; (5) post-operative care; and (6) longitudinal fat grafting assessments. Our experience comparing the use of Yorkshire and Yucatan breeds in our model showed that Yorkshire adipose tissue was fibrotic, extremely difficult to obtain through liposuction, and labor intensive to process into injectable formats. Alternatively, Yucatan adipose was more similar to human tissue, could be readily obtained through the surgical excision of inguinal fat pads, was amenable to mincing with surgical scissors, and yielded injectable tissue with a 95% efficiency. We determined that generation of a surgical pocket reduced the graft migration and spread, consequently facilitating the graft retrieval without significantly impacting retention. Using 5 cc grafts, the ultimate 3-month volume retention in 16 grafts was 19% ± 17% (or 1.14 cc ± 1.08 cc). While the use of ultrasound did not readily enable graft volume approximation during the study, it was a useful method to visualize the graft placement and ensure injection into the subcutaneous adipose layers.
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