Safety Profiles of Fat Processing Techniques in Autologous Fat Transfer for Breast Reconstruction
Safety Profiles of Fat Processing Techniques in Autologous Fat Transfer for Breast Reconstruction
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DOI：
10.1097/prs.0000000000005424
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发表时间：
2019-04-01
影响因子：
3.6
通讯作者：
Lee, Bernard T.
中科院分区：
文献类型：
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作者：
Ruan, Qing Zhao;Rinkinen, Jacob R.;Lee, Bernard T.
背景：自体脂肪移植在乳房重建中很常见，因为它可以用于轮廓畸形。作者使用他们的机构数据库检查了三种不同的脂肪移植处理技术的并发症和安全性。方法：回顾性分析2012年至2016年在同一医院进行乳房重建术后自体脂肪移植的患者。根据脂肪采集技术将个体分为三组：(1)离心，(2)特尔法纱布，或(3)旋转。评估两组间的并发症。结果：共鉴定出267例自体脂肪移植（离心168例，Telfa 44例，Revolve 55例）。离心移植术中油囊肿发生率最高（12.5%,p = 0.034），术后临床不良事件发生率最高（13.7%,p = 0.002），总并发症发生率最高（25.6%,p = 0.001）。使用Telfa导致油囊肿形成率最低（0%,p = 0.002）和总并发症发生率最低（2.3%,p = 0.001）。在三种移植技术中，离心移植在初次移植后重复注射的频率最高（19.6%,p = 0.029）。相比之下，Revolve的重复注射率仅为5.45%，与离心分离法相比显著降低（p = 0.011）。多因素分析显示，移植物总体积增大（p = 0.002）和离心离心的使用（p = 0.002）是临床术后不良事件的重要危险因素。结论：不同的脂肪转移技术在术后结果上存在显著差异。自体脂肪离心移植术并发症发生率最高，而Telfa和Revolve移植术的安全性相似。
Background: Autologous fat transfer is common in breast reconstruction because of its versatility for use in contour deformities. The authors examined three different fat grafting processing techniques for complications and safety profile using their institutional database. Methods: Retrospective review was performed of patients from a single institution who had undergone autologous fat transfer following breast reconstruction from 2012 to 2016. Individuals were separated into three cohorts according to fat harvest technique: (1) centrifugation, (2) Telfa gauze, or (3) Revolve. Complications between the groups were assessed. Results: A total of 267 cases of autologous fat transfer were identified (centrifugation, n = 168; Telfa, n = 44; and Revolve, n = 55). Grafting by means of centrifugation was associated with the greatest incidence of oil cysts (12.5 percent; p = 0.034), postoperative adverse events observed in the clinic (13.7 percent; p = 0.002), and total complications (25.6 percent; p = 0.001). The use of Telfa resulted in the lowest rates of oil cyst formation (0 percent; p = 0.002) and total complications (2.3 percent; p = 0.001). Grafting by means of centrifugation was also associated with the highest frequency of repeated injections among the three techniques after initial grafting (19.6 percent; p = 0.029). In contrast, Revolve demonstrated a repeated injection rate of just 5.45 percent, significantly lower when independently compared with centrifugation (p = 0.011). Multivariate analysis demonstrated that higher total graft volume (p = 0.002) and the use of centrifugation (p = 0.002) were significant risk factors for adverse events seen in the clinic postoperatively. Conclusions: Significant differences in postoperative outcomes exist between varying fat transfer techniques. Autologous fat transfer by means of centrifugation harbored the highest rates of complication, whereas Telfa and Revolve exhibited similar safety profiles.