Diffusion and perfusion: the keys to fat grafting
Khouri RK., Khouri RE., Lujan-Hernandez JR., Khouri KR., Lancerotto L., Orgill DP.
Laboratory Study, published in Plast Reconstr Surg Glob Open (2014) — summary generated from the PubMed abstract.
Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.
- Level A · Stronger Clinical Evidence
- Level B · Emerging clinical evidence with positive signals
- Level C · Early human research exploring benefits
- Level D · Scientific groundwork from lab and animal studies
- Emerging · Emerging topic under active research
This page is generated from the PubMed record. The Thai description is an automated summary of bibliographic fields and the abstract, not a full translation, and is not medical advice.
- Study type
- Laboratory Study
- Journal
- Plast Reconstr Surg Glob Open (2014)
- Reported sample size
- —
- Source database
- Europe PMC
- PMID
- 25426403
- PMCID
- PMC4229279
- DOI
- 10.1097/gox.0000000000000183
- Citations
- 104
Abstract (original English)
Background Fat grafting is now widely used in plastic surgery. Long-term graft retention can be unpredictable. Fat grafts must obtain oxygen via diffusion until neovascularization occurs, so oxygen delivery may be the overarching variable in graft retention. Methods We studied the peer-reviewed literature to determine which aspects of a fat graft and the microenvironment surrounding a fat graft affect oxygen delivery and created 3 models relating distinct variables to oxygen delivery and graft retention. Results Our models confirm that thin microribbons of fat maximize oxygen transport when injected into a large, compliant, well-vascularized recipient site. The "Microribbon Model" predicts that, in a typical human, fat injections larger than 0.16 cm in radius will have a region of central necrosis. Our "Fluid Accommodation Model" predicts that once grafted tissues approach a critical interstitial fluid pressure of 9 mm Hg, any additional fluid will drastically increase interstitial fluid pressure and reduce capillary perfusion and oxygen delivery. Our "External Volume Expansion Effect Model" predicts the effect of vascular changes induced by preoperative external volume expansion that allow for greater volumes of fat to be successfully grafted. Conclusions These models confirm that initial fat grafting survival is limited by oxygen diffusion. Preoperative expansion increases ox
What this study does not prove
- • This study does not prove SVF is an approved treatment or a replacement for standard care.
- • This is preclinical work; animal or laboratory results cannot be applied to humans.
Evidence level
Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.
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