Effect of external volume expansion on the survival of fat grafts

Introduction: External volume expansion (EVE) is one method, which has been utilised for increasing the survival of adipose tissue grafts. EVE releases positive pressure from the graft and also induces intense levels of edema that decreases diffusion of metabolites essential for graft survival initi...

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Main Authors: Raghuveer Reddy, Subramania Iyer, Mohit Sharma, Sundeep Vijayaraghavan, P. Kishore, Jimmy Mathew, A. K. K. Unni, P. Reshmi, Rakesh Sharma, Chaya Prasad
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2016-05-01
Series:Indian Journal of Plastic Surgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.191322
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author Raghuveer Reddy
Subramania Iyer
Mohit Sharma
Sundeep Vijayaraghavan
P. Kishore
Jimmy Mathew
A. K. K. Unni
P. Reshmi
Rakesh Sharma
Chaya Prasad
author_facet Raghuveer Reddy
Subramania Iyer
Mohit Sharma
Sundeep Vijayaraghavan
P. Kishore
Jimmy Mathew
A. K. K. Unni
P. Reshmi
Rakesh Sharma
Chaya Prasad
author_sort Raghuveer Reddy
collection DOAJ
description Introduction: External volume expansion (EVE) is one method, which has been utilised for increasing the survival of adipose tissue grafts. EVE releases positive pressure from the graft and also induces intense levels of edema that decreases diffusion of metabolites essential for graft survival initially. The ideal timing of external volume expansion in relation to the injection of the fat to facilitate survival is not yet clear. Aims and Objectives: This study was undertaken to evaluate and compare the efficacy of external volume expansion applied at variable time points in relation to the injection of the fat. Materials and Methods: Athymic mouse was the animal model and human lipo-aspirate mixed with PRP was used as graft. An indigenous dome shaped silicone device was fabricated to deliver a negative pressure of -30 mm of Hg. The EVE was applied at variable time intervals. At the end of 4 weeks visual, histological and radiological features of the injected fat were compared. The adipose tissue was stained with human vimentin to ascertain the origin of the retained fat. Results: All the grafts, which had EVE, had significantly better volume retention and vascularity. The groups which underwent a delayed EVE or prior expansion followed by concomitant graft injection and expansion showed the most optimal vascularity and graft retention. Conclusions: A delayed EVE or prior expansion followed by concomitant graft injection and expansion may be the most ideal combinations to optimize graft take. However, on account of the relatively small sample size, there was a limitation in drawing statistically significant conclusions for certain variables.
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spelling doaj-art-cb3766f68b8c4d209737bdcc33f99fe32025-08-20T02:02:10ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2016-05-01490215115810.4103/0970-0358.191322Effect of external volume expansion on the survival of fat graftsRaghuveer Reddy0Subramania Iyer1Mohit Sharma2Sundeep Vijayaraghavan3P. Kishore4Jimmy Mathew5A. K. K. Unni6P. Reshmi7Rakesh Sharma8Chaya Prasad9Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, IndiaDepartment of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, IndiaDepartment of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, IndiaDepartment of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, IndiaDepartment of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, IndiaDepartment of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, IndiaDepartment of Animal Research Facility, Amrita Institute of Medical Sciences, Kochi, Kerala, IndiaDepartment of Animal Research Facility, Amrita Institute of Medical Sciences, Kochi, Kerala, IndiaDepartment of Oral Pathology, Amrita Institute of Dental Sciences, Kochi, Kerala, IndiaDepartment of Clinical Pathology, Amrita Institute of Medical Sciences, Kochi, Kerala, IndiaIntroduction: External volume expansion (EVE) is one method, which has been utilised for increasing the survival of adipose tissue grafts. EVE releases positive pressure from the graft and also induces intense levels of edema that decreases diffusion of metabolites essential for graft survival initially. The ideal timing of external volume expansion in relation to the injection of the fat to facilitate survival is not yet clear. Aims and Objectives: This study was undertaken to evaluate and compare the efficacy of external volume expansion applied at variable time points in relation to the injection of the fat. Materials and Methods: Athymic mouse was the animal model and human lipo-aspirate mixed with PRP was used as graft. An indigenous dome shaped silicone device was fabricated to deliver a negative pressure of -30 mm of Hg. The EVE was applied at variable time intervals. At the end of 4 weeks visual, histological and radiological features of the injected fat were compared. The adipose tissue was stained with human vimentin to ascertain the origin of the retained fat. Results: All the grafts, which had EVE, had significantly better volume retention and vascularity. The groups which underwent a delayed EVE or prior expansion followed by concomitant graft injection and expansion showed the most optimal vascularity and graft retention. Conclusions: A delayed EVE or prior expansion followed by concomitant graft injection and expansion may be the most ideal combinations to optimize graft take. However, on account of the relatively small sample size, there was a limitation in drawing statistically significant conclusions for certain variables.http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.191322external volume expansionfat graftfat graft with external volume expansion
spellingShingle Raghuveer Reddy
Subramania Iyer
Mohit Sharma
Sundeep Vijayaraghavan
P. Kishore
Jimmy Mathew
A. K. K. Unni
P. Reshmi
Rakesh Sharma
Chaya Prasad
Effect of external volume expansion on the survival of fat grafts
Indian Journal of Plastic Surgery
external volume expansion
fat graft
fat graft with external volume expansion
title Effect of external volume expansion on the survival of fat grafts
title_full Effect of external volume expansion on the survival of fat grafts
title_fullStr Effect of external volume expansion on the survival of fat grafts
title_full_unstemmed Effect of external volume expansion on the survival of fat grafts
title_short Effect of external volume expansion on the survival of fat grafts
title_sort effect of external volume expansion on the survival of fat grafts
topic external volume expansion
fat graft
fat graft with external volume expansion
url http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.191322
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