Analysis of surviving autologous adipocytes in reconstructive and plastic surgery

[V. S. Ašanin]

117 listova

Medicina - Plastična, rekonstruktivna i estetska hirurgija / Medicine - Plastic, reconstructive and aesthetic surgery

Uvod. Savremeno doba je obeležilo razvoj tehnika uzimanja i transplantacije autolognog masnog tkiva u svrhu rekonstrukcija meko-tkivnih defekata sa jedne strane, a sa druge strane javila se potreba za istraživanjem njegovih regenerativnih potencijala. Masno tkivo kao jedan od najvećih endokrinih organa u ljudskom organizmu, reguliše brojne metaboličke procese, ne samo masti već i drugih endokrinih sistema. U njegovim sekretornim aktivnostima učestvuju, naizgled, jednostavna masna ćelija i njegov ćelijski bogat ekstracelularni matriks. Povećana zainteresovanost brojnih istraživača se pojavila nakon izdvajanja mezenhimnih matičnih ćelija iz frakcije vaskularne strome masnog tkiva. Međutim, obezbediti sigurno preživljavanje autolognog masnog tkiva je veliki zadatak savremenih istraživača. Sam proces preživljavanja adipocita ili diferencijacija progenitorskih ćelija adipocita u druge ćeliske linije i dalje je kontraverzno pitanje. Prednost korišćenja masnog tkiva je u njegovoj dostupnosti u većim količinama, potencijalno lakoj implementaciji u pojedine delove tela, biološke kompatibilnosti, niskog antigenog potencijala i minimalnog donorskog morbiditeta. Ciljevi istraživanja. Naš cilj je bio da ispitamo preoperativne i postoperativne morfološke i volumetrijske karakteristike transplantiranog masnog tkiva recipijentnog tkiva potkolenice magnetnom rezonancom. U cilju utvrđivanja morfoloških i funkcionalnih ćeliskih promena radili smo histološka i imunohistohemijaska ispitivanja masnog tkiva subkutano aspirirane masti iz donorskog i recipijentnog regiona. Materijal i metod. Studija je obuhvatila 67 ispitanika ženskog pola starosti između 20 i 58 godina sa hipoplazijom potkolenice Tip III - posteriorna hipoplazija sa slabo razvijenim m.gastrocnemis-om i m. soleus-om. Ispitanike smo, pre operacije i jedan, tri i šest meseci posle operacije, fotografisali i antropološki merili: telesnu masu, indeks telesne mase, obime pojedinih delova potkolenica. Takođe, pre operativno i šest meseci postoperativno smo radili magnetnu rezonancu potkolenica radi utvrđivanja morfološke različitosti u recipijentnom regionu. U toku operacije uzimali smo uzorke različito pripremljenih transplantanata masti iz donorskog regiona, koji su histološki i imunohistohemijski ispitivani. Isti postupak uzorkovanja masti iz recipijentnog regiona radili smo šest meseci nakon operacije...

The contemporary era is hallmarked by development of techniques of harvesting and transplantation of autologous fat tissue aimed at reconstruction of soft tissue defects, but at the same time this also raised the need of further research of its regenerative potentials. As one of the biggest endocrine systems in the human body, fat tissue regulates numerous metabolic processes, not only of fats but also of other endocrine processes. Seemingly simple fat cell and its rich extracellular matrix participate in a number of secretory activities however there was an increased interest of many researchers after extraction of mesenchymal stem cells from the vascular stroma of the fat tissue. But, providing a certain survival of autologous fat tissue remained a great challenge of a contemporary researcher. The very process of adipocytes survival, or differentiation of progenitor adipocyte cells into other cell lines is still a controversial issue nevertheless the advantages of using a fat tissue are numerous because of its accessibility, potentially easy implementation in various body parts, biological compatibility, low antigen potential and minimal donor’s morbidity. Aims. Our goal was to explore preoperative and postoperative morphological and volumetric characteristics of transplanted fat tissue in recipient region of the lower leg, by MRI. In order to determine morphological and functional cell alterations we used histological and immunochemical analysis of the subcutaneously aspirated fat tissue from both donor’s and recipient’s region. Material and method. The study included 67 subjects, all female with hypoplasia of lower leg type III – posterior hypoplasia with underdeveloped m.gastrocnemis and m. soleus - aged between 20 and 58 years. All patients were photographed and anthropologically measured before the surgery, and one, three and six months after the surgery, namely: body mass, BMI, circumferences of lower legs in various sections. Also, before the surgery and six months after the surgery we performed MRI of lower legs in order to determine morphological differences in the recipient’s region...

uvećanje potkolenica, transplantacija masti, magnetna rezonanca, preživljavanje masti, resorpcija masti, stromalna vaskularna frakcija, faktori rasta, vaskularno endotelni faktor rasta, VEGF, epidermalni faktor rasta, EGF, trombocitni faktor rasta, PDGF, mesenhimne ćelije

lower leg augmentation, fat transplantation, MRI, fat tissue survival, fat reabsorption, stromal vascular fraction, growth factors, vascular endothelial growth factor VEGF, epidermal growth factor EFG, thrombocytes growth factor PDGF, mesenchyme cells, lipo-filling

616-089.843(043.3)

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