早期应用富血小板血浆凝胶对自体脂肪组织移植存活率的影响

Platelet-rich plasma fibrin glue in the early stage for survival rate of autogeneic fat graft

背景:自体颗粒脂肪组织填充广泛用于修复重建领域,移植后组织大量被吸收可严重影响远期效果。目的:观察早期应用富血小板血浆对自体移植脂肪组织存活率的影响。方法:取健康成年人腹部脂肪组织颗粒进行纯化,同时抽取少量静脉血,采用离心法提取自体富血小板血浆,利用纤维蛋白胶的物理特性制备含有富血小板血浆的脂肪组织复合移植物,在裸鼠背部中线两侧各分离一个腔隙,富血小板血浆组将脂肪组织颗粒-富血小板血浆凝胶随机注射入一侧腔隙深筋膜下,对侧仅注入脂肪组织颗粒作为对照组。结果与结论:移植后1个月和3个月,与对照组比较,富血小板血浆组移植脂肪局部的血管增生均较明显(P<0.05),脂肪质量保持率均较高(P<0.05);移植物脂肪细胞纤维坏死率均较低(P<0.05)。提示早期应用富血小板血浆凝胶可促进移植脂肪组织局部的血管再生,增加脂肪组织的质量保持率,减少脂肪移植后的纤维坏死程度。

BACKGROUND：Autogeneic fat is the ideal filling material in aesthetic and reconstructive surgery. However, the autogeneic fat graft produces serious impact on long-term effect because much fat would be absorbed after transplantation. Accordingly, difficulties in this field are how to increase the survival rate of autogeneic fat graft. OBJECTIVE：To investigate the effect of platelet-rich plasma （PRP） on the survival rate of autogeneic free grain fat grafts. METHODS：The fat was harvested from abdominal region of healthy adults and purified. At the same time, venous blood was taken from concurrent patients and PRP was prepared by centrifugation. The grafts were made using fibrin glue combined with PRP according to the physical characteristics of fibrin glue. A subdermal pocket was created in each side of the dorsal midline, the grafts which carried fat particle and PRP fibrin glue were randomly implanted below the deep fascia of the pocket as an experimental group, and simple fat particles were grafted into another pocket as a control group. RESULTS AND CONCLUSION： At 1 and 3 months after implantation, compared with the control group, angiogenesis surrounding the implanted fat particles was significantly obvious （P 0.05）, the maintenance rate of free fat graft was significantly high （P 0.05）, and fibrous proliferation and steatonecrosis rate was significantly low （P 0.05） in the experimental group. Results showed that PRP fibrin glue can increase angiogenesis and weight maintenance rate of the free fat grafts in the early stage, and at the same time, it can also decrease the fibrous proliferation and steatonecrosis rate of the free fat grafts.