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Sample records for autologous fat grafts

  1. [Autologous fat grafting and rhinoplasty].

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    Nguyen, P S; Baptista, C; Casanova, D; Bardot, J; Magalon, G

    2014-12-01

    Revision rhinoplasty can be very challenging especially in cases of thin skin. Autologous fat graft is utilized in numerous applications in plastic surgery; however, its use relative to the nasal region remains uncommon. Adipose tissue, by virtue of its volumetric qualities and its action on skin trophicity, can be considered to be a gold standard implant. From 2006 until 2012, we have treated patients by lipofilling in order to correct sequelae of rhinoplasty. The mean quantity of adipose tissue injected was 2.1cm(3) depending on the importance of the deformity and the area of injection: irregularity of the nasal dorsum, visible lateral osteotomies, saddle nose. Following the course of our practice, we conceived micro-cannulas that allow a much greater accuracy in the placement of the graft and enable to perform interventions under local anesthesia. These non-traumatic micro-cannulas do not cause post-operative ecchymosis and swelling which shorten the recovery time for the patient. On patients who have undergone multiple operations, lipofilling can be a simple and reliable alternative to correct imperfections that may take place after a rhinoplasty. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  2. Autologous Fat Grafting for Whole Breast Reconstruction

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    Benjamin H. L. Howes, MBBS

    2014-03-01

    Full Text Available Summary: This is the first reported case of a patient who had a single-stage large-volume breast reconstruction with autologous fat grafting, following rotation flap approach (RoFA mastectomy. The purpose of this case study was to evaluate the viability of reconstruction of the breast by autologous fat grafting alone, in the context of RoFA mastectomy. The hypothesis was that there would be minimal interval loss of autologous fat on the whole breast reconstruction side. Right RoFA mastectomy was used for resection of an invasive primary breast cancer and resulted in the right breast skin envelope. Eleven months later, the patient underwent grafting of 400 ml of autologous fat into the skin envelope and underlying pectoralis major muscle. Outcome was assessed by using a validated 3D laser scan technique for quantitative breast volume measurement. Other outcome measures included the BREAST-Q questionnaire and 2D clinical photography. At 12-month follow-up, the patient was observed to have maintenance of volume of the reconstructed breast. Her BREAST-Q scores were markedly improved compared with before fat grafting, and there was observable improvement in shape, contour, and symmetry on 2D clinical photography. The 2 new techniques, RoFA mastectomy and large-volume single-stage autologous fat grafting, were used in combination to achieve a satisfactory postmastectomy breast reconstruction. Novel tools for measurement of outcome were the 3D whole-body laser scanner and BREAST-Q questionnaire. This case demonstrates the potential for the use of fat grafting for reconstruction. Outcomes in a larger patient populations are needed to confirm these findings.

  3. Autologous Fat Grafting Improves Facial Nerve Function

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    Marco Klinger

    2015-01-01

    Full Text Available We describe the case of a 45-year-old male patient who presented a retractile and painful scar in the nasolabial fold due to trauma which determined partial motor impairment of the mouth movements. We subsequently treated him with autologous fat grafting according to Coleman’s technique. Clinical assessments were performed at 5 and 14 days and 1, 3, and 6 months after surgical procedure and we observed a progressive release of scar retraction together with an important improvement of pain symptoms. A second procedure was performed 6 months after the previous one. We observed total restoration of mimic movements within one-year follow-up. The case described confirms autologous fat grafting regenerative effect on scar tissue enlightening a possible therapeutic effect on peripheral nerve activity, hypothesizing that its entrapment into scar tissue can determine a partial loss of function.

  4. The science behind autologous fat grafting

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    Elisa Bellini

    2017-12-01

    Despite ongoing concerns about survival and longevity of fat grafts after implantation and unpredictability of long-term outcome, fat has been successfully used as a filler in many differ clinic situation.

  5. Autologous Fat Grafting Combined with Facelifting.

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    Tzikas, Thomas

    2017-06-01

    There are multiple factors contributing to facial aging. Rejuvenation of the aging face, therefore, requires a multimodal approach to attain an overall natural and uniform result that is long lasting. Fat grafting has become a very important method for restoring facial soft-tissue atrophy, while facelifting procedures address the ptosis and descent of facial and neck tissue. These modalities performed together offer the patient a comprehensive approach to attain a more attractive and youthful facial appearance. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  6. Enrichment of autologous fat grafts with ex-vivo expanded adipose tissue-derived stem cells for graft survival

    DEFF Research Database (Denmark)

    Kølle, Stig-Frederik Trojahn; Fischer-Nielsen, Anne; Mathiasen, Anders Bruun

    2013-01-01

    Autologous fat grafting is increasingly used in reconstructive surgery. However, resorption rates ranging from 25% to 80% have been reported. Therefore, methods to increase graft viability are needed. Here, we report the results of a triple-blind, placebo-controlled trial to compare the survival ...... of fat grafts enriched with autologous adipose-derived stem cells (ASCs) versus non-enriched fat grafts....

  7. Autologous fat grafting: use of closed syringe microcannula system for enhanced autologous structural grafting

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    Alexander RW

    2013-04-01

    Full Text Available Robert W Alexander,1 David Harrell2 1Department of Surgery, School of Medicine and Dentistry, University of Washington, Seattle, WA, USA; 2Harvest-Terumo Inc, Plymouth, MA, USA Objectives: Provide background for use of acquiring autologous adipose tissue as a tissue graft and source of adult progenitor cells for use in cosmetic plastic surgery. Discuss the background and mechanisms of action of closed syringe vacuum lipoaspiration, with emphasis on accessing adipose-derived mesenchymal/stromal cells and the stromal vascular fraction (SVF for use in aesthetic, structural reconstruction and regenerative applications. Explain a proven protocol for acquiring high-quality autologous fat grafts (AFG with use of disposable, microcannula systems. Design: Explain the components and advantage of use of the patented super luer-lock and microcannulas system for use with the closed-syringe system. A sequential explanation of equipment selection for minimally traumatic lipoaspiration in small volumes is presented, including use of blunt injection cannulas to reduce risk of embolism. Results: Thousands of AFG have proven safe and efficacious for lipoaspiration techniques for large and small structural fat grafting procedures. The importance and advantages of gentle harvesting of the adipose tissue complex has become very clear in the past 5 years. The closed-syringe system offers a minimally invasive, gentle system with which to mobilize subdermal fat tissues in a suspension form. Resulting total nuclear counting of undifferentiated cells of the adipose-derived -SVF suggests that the yield achieved is better than use of always-on, constant mechanical pump applied vacuum systems. Conclusion: Use of a closed-syringe lipoaspiration system featuring disposable microcannulas offers a safe and effective means of harvesting small volumes of nonmanipulated adipose tissues and its accompanying progenitor cells within the SVF. Closed syringes and microcannulas are

  8. Ultrasound Diagnosis and Treatment of Breast Lumps after Breast Augmentation with Autologous Fat Grafting

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    Masaaki Shida, MD, PhD

    2017-12-01

    Conclusions:. The appropriate treatment for breast lumps after breast augmentation with autologous fat grafting must be selected according to the nature of the lumps. Ultrasound is essential for diagnosing the breast lump type and determining the best treatment.

  9. Importance of mesenchymal stem cells in autologous fat grafting

    DEFF Research Database (Denmark)

    Trojahn Kølle, Stig-Frederik; Oliveri, Roberto S; Glovinski, Peter Viktor

    2012-01-01

    the fat graft with adipose tissue-derived mesenchymal stem cells (ASC) before transplantation. We have reviewed original studies published on fat transplantation enriched with ASC. We found four murine and three human studies that investigated the subject after a sensitive search of publications....... In the human studies, so-called cell assisted lipotransfer (CAL) increased the ASC concentration 2-5 times compared with non-manipulated fat grafts, which caused a questionable improvement in survival of fat grafts, compared with that of traditional lipofilling. In contrast, in two of the murine studies ASC...

  10. Predictors of Autologous Free Fat Graft Retention in the Management of Craniofacial Contour Deformities.

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    Denadai, Rafael; Raposo-Amaral, Cesar Augusto; Pinho, Andre Silveira; Lameiro, Thais Miguel; Buzzo, Celso Luiz; Raposo-Amaral, Cassio Eduardo

    2017-07-01

    Autologous free fat graft outcomes are not always predictable, and variables that can potentially influence fat graft retention are still not well understood or investigated. The purposes of this study were to assess fat graft retention in the management of craniofacial contour deformities and to identify possible predictive factors of this retention. A prospective analysis was conducted using consecutive patients with unilateral craniofacial contour deformities who underwent autologous free fat grafting between 2012 and 2015. Standardized ultrasonographic craniofacial soft-tissue thickness measurements were adopted to determine the fat graft retention. Bivariate and multivariate analyses were performed to identify independent predictors of 12-month postoperative fat graft retention. One hundred forty-two patients were enrolled. There was significant (all p 0.05) from 3 to 12 months postoperatively, with a 12-month fat graft retention rate of 67.7 percent. Age, Parry-Romberg syndrome, previous craniofacial bone surgery, grafted volume, and forehead unit were independently negative (all p < 0.05) predictors of fat graft retention, whereas cheek unit was an independently positive (all p < 0.05) predictor of retention. Craniofacial fat graft retention is achievable but remains somewhat unpredictable, with age, Parry-Romberg syndrome, previous bone surgical intervention, grafted volume, and recipient sites affecting retention. Risk, III.

  11. Characterization of adipose tissue for autologous fat grafting.

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    Suszynski, Thomas M; Sieber, David A; Van Beek, Allen L; Cunningham, Bruce L

    2015-02-01

    Fat grafting is a common procedure in aesthetic and reconstructive plastic surgery, but variable graft retention limits its utility. Unpredictable clinical outcomes with fat grafting can be explained in part by the lack of standardized protocols for harvesting, processing, and transplanting adipose tissue (AT). Historically, plastic surgeons have relied on trial and error and their clinical experience to develop fat grafting protocols. Optimization of fat grafting protocols requires systematic assessment of the impact that key variables have on the quality of the AT preparation at each step of the procedure. In this article, we review recent findings regarding the composition and quality of AT prepared for fat grafting and the strengths and limitations of existing AT characterization assays. We discuss the need for an assessment of the viability of intact AT (ie, conventionally harvested AT that has not been disrupted further) by means of an operator-independent, quantitative assay that can be performed in real time and generates reproducible data. Promising assays for the characterization of cell product quality have been developed for other therapeutic applications, such as transplantation of pancreatic islet cells. The development or adaptation of a gold-standard assay to determine the quality of an AT preparation may help to standardize fat grafting protocols and improve clinical outcomes. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  12. Evidences of autologous fat grafting for the treatment of keloids and hypertrophic scars

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    VINÍCIUS ZOLEZI DA SILVA

    Full Text Available SUMMARY Introduction Since the 1980s, the use of autologous fat grafting has been growing in plastic surgery. Recently, this procedure has come to be used as a treatment for keloids and hypertrophic scars mainly due to the lack of satisfactory results with other techniques. So far, however, it lacks more consistent scientific evidence to recommend its use. The aim of this study was to review the current state of autologous fat grafting for the treatment of keloids and hypertrophic scars, their benefits and scientific evidences in the literature. Method A review in the Pubmed database was performed using the keywords “fat grafting and scar”, “fat grafting and keloid scar” and “fat grafting and hypertrophic scar.” Inclusion criteria were articles written in English and published in the last 10 years, resulting in 15 studies. Results These articles indicate that autologous fat grafting carried out at sites with pathological scars leads to a reduction of the fibrosis and pain, an increased range of movement in areas of scar contraction, an increase in their flexibility, resulting in a better quality of scars. Conclusion So far, evidences suggest that autologous fat grafting for the treatment of keloids and hypertrophic scars is associated with a better quality of scars, leading to esthetic and functional benefits. However, this review has limitations and these findings should be treated with reservations, since they mostly came from studies with low levels of evidence.

  13. Autologous fat grafting for cosmetic enhancement of the perioral region.

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    Glasgold, Mark; Lam, Samuel M; Glasgold, Robert

    2007-11-01

    The role of volume loss in the progression of facial aging is widely accepted as an important cause. The aging appearance of the perioral region and lower face is significantly affected by this volume loss, which contributes to the development of labiomental folds, the loss of definition of the jawline, and worsening of skin texture, among other manifestations. Autologous fat transfer can effectively replace this lost volume and contribute to any facial rejuvenation plan. Fat can replace larger volumes than off-the-shelf fillers and provides a potentially permanent solution.

  14. Autologous Fat Grafting as a Novel Approach to Parastomal Soft-tissue Volume Deficiencies

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    Robert C. Wu, MD

    2014-03-01

    Full Text Available Summary: The aim of this study is to describe a novel approach to revise maladaptive soft-tissue contour around an ileostomy. A patient with permanent ileostomy suffered from significant defects in soft-tissue contour due to scarring and wound contraction. He underwent autologous fat grafting to achieve sealing of his stoma appliance and improve cosmesis. Due to numerous surgeries, the stoma appliance would not seal and required daily appliance changes. The patient received autologous fat grafting to augment the contour around stoma. A complete fitting of stoma was achieved. The patient is satisfied with stoma sealing and is changing his stoma appliance every 5–7 days without skin excoriation. Autologous fat transfer is an effective approach to treat a subset of stoma patients with complex subcutaneous defects.

  15. Preliminary results with non-centrifuged autologous fat graft and percutaneous aponeurotomy for treating Dupuytren's disease.

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    Tuncel, U; Kurt, A; Gumus, M; Aydogdu, O; Güzel, N; Demir, O

    2017-10-01

    The aim of this study was to describe our experience with treating Dupuytren's disease using needle aponeurotomy and non-centrifuged autologous fat grafting. The study included 17 patients (18 hands). Patients were treated with needle aponeurotomy and non-centrifuged autologous fat graft under general anesthesia. The fat grafts were injected into the surgical area so as to stay in contact with the operated site. An extension splint was used for 1 week postoperatively and the patients received hand therapy for 3 weeks. Before the treatment, the contracture in the proximal interphalangeal and metacarpophalangeal joints was a mean of 45.06 ± 13.44 degrees and 36.56 ± 13.09 degrees, respectively. It was 1.61 ± 1.65 and -0.56 ± 3.78 degrees at 3 months, respectively. The difference between these measurements was statistically significant. The mean follow-up period was 12 months. The results were satisfactory and no complications were observed during the follow-up period. Based on the results of the study, percutaneous aponeurotomy with non-centrifuged autologous fat grafting was found to have significantly beneficial effects in the treatment of Dupuytren's disease. Copyright © 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.

  16. Autologous Fat Grafting in the Treatment of Painful Postsurgical Scar of the Oral Mucosa

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    Andrea Lisa

    2015-01-01

    Full Text Available Background. Persistent pain as a consequence of surgical treatment has been reported for several common surgical procedures and represents a clinical problem of great magnitude. Material and Methods. We describe the case of a 47-year-old female who presented a retractile scar that adhered to deep planes at the upper right of the vestibule due to surgical removal of maxillary exostosis, which determined important pain symptoms extending till the right shoulder during both chewing and rest. We subsequently treated her with autologous fat grafting according to Coleman’s technique. Results. Clinical assessments were performed at 5 and 14 days, 1, 3, and 6 months, and 1 year after surgical procedure. We observed a progressive release of scar retraction together with an important improvement of pain symptoms. Conclusion. The case described widens the possible application of autologous fat grafting on a new anatomical site as buccal vestibule and in one specific clinical setting confirming its promising biological effects.

  17. Autologous fat graft and bone marrow-derived mesenchymal stem cells assisted fat graft for treatment of Parry-Romberg syndrome.

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    Jianhui, Zhao; Chenggang, Yi; Binglun, Lu; Yan, Han; Li, Yang; Xianjie, Ma; Yingjun, Su; Shuzhong, Guo

    2014-09-01

    Progressive facial hemiatrophy, also called Parry-Romberg syndrome (PRS), is characterized by slowly progressive atrophy of one side of the face and primarily involves the subcutaneous tissue and fat. The restoration of facial contour and symmetry in patients affected by PRS still remains a challenge clinically. Fat graft is a promising treatment but has some shortcomings, such as unpredictability and low rate of graft survival due to partial necrosis. To obviate these disadvantages, fat graft assisted by bone marrow-derived mesenchymal stem cells (BMSCs) was used to treat PRS patients and the outcome was evaluated in comparison with the conventional treatment by autologous fat graft. Autologous fat graft was harvested by tumescent liposuction. Bone marrow-derived mesenchymal stem cells were then isolated by human Lymphocytes Separation Medium through density gradient centrifugation. Twenty-six patients were treated with autologous fat graft only (group A), whereas 10 other patients were treated with BMSC-assisted fat graft (group B). The Coleman technique was applied in all fat graft injections. The follow-up period was 6 to 12 months in this study, In group A, satisfactory outcome judged by symmetrical appearances was obtained with 1 injection in 12 patients, 2 injections in 8 patients, and 3 injections in 4 patients. However, the result of 1 patient was not satisfactory and 1 patient was overcorrected. In group B, 10 patients obtained satisfactory outcomes and almost reached symmetry by 1 injection. No complications (infection, hematoma, or subcutaneous mass) were observed. The results suggest that BMSC-assisted fat graft is effective and safe for soft tissue augmentation and may be superior to conventional lipoinjection. Additional study is necessary to further evaluate the efficacy of this technique.

  18. Autologous Free Fat Grafting for Management of the Facial Contour Asymmetry.

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    Denadai, Rafael; Raposo-Amaral, Cesar Augusto; Buzzo, Celso Luiz; Raposo-Amaral, Cassio Eduardo

    2018-02-23

    The purposes of this study were to report autologous free fat grafting as the workhorse procedure to augment the facial soft-tissue envelope and restore facial contour symmetry of patients with asymmetric facial malformations; to detail the SOBRAPAR Hospital algorithm for soft-tissue reconstruction of patients with facial contour asymmetry; and to assess facial symmetry after fat grafting. A retrospective analysis of consecutive patients (n = 178) who underwent fat grafting to restore the facial contour symmetry according to the SOBRAPAR Hospital algorithm between 2009 and 2016 was conducted. Computerized photogrammetric quantitative and qualitative facial symmetry analyses were performed. There were significant (all P < 0.05) postoperative quantitative facial symmetry enhancement and an overall qualitative facial symmetry enhancement, with a mean fat graft procedures per patient of 1.6 ± 0.7, ranging of 1 to 3. A significant improvement of facial contour symmetry was obtained in a subset of patients using fat grafting according to the SOBRAPAR Hospital algorithm.

  19. Immediate reconstruction with autologous fat grafting: influence in breast cancerregional recurrence

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    CAMILE CESA STUMPF

    Full Text Available ABSTRACT Objective: to evaluate local and systemic recurrence of breast cancer in patients submitted to autologous fat grafting in the immediate reconstruction after conservative surgery for breast cancer. Methods: this is a historical cohort study comparing 167 patients submitted to conservative surgery without reconstruction (conservative surgery group with 27 patients submitted to conservative treatment with immediate graft reconstruction, following the Coleman's technique (lipofilling group. All patients had invasive carcinoma and were operated by a single surgeon from 2004 to 2011. The postoperative follow-up time was 36 months. Results: the overall incidence of local recurrence was 2.4%. No patient in the lipofilling group had local recurrence during the study period. For systemic recurrence, the rates obtained were 3.7% (one patient for the fat grafting group and 1.8% (three patients for the conservative surgery group without reconstruction. Conclusion: there was no significant difference for local or systemic recurrence in the groups studied. Immediate autologous fat grafting appears to be a safe procedure.

  20. A Simple, Reliable, and Inexpensive Intraoperative External Expansion System for Enhanced Autologous Structural Fat Grafting.

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    Oranges, Carlo M; Tremp, Mathias; Ling, Barbara; Wettstein, Reto; Largo, René D; Schaefer, Dirk J

    2016-09-01

    External volume expansion of the recipient site by suction has been proposed as a way of improving fat graft survival. The objective of this study was to present an innovative and simple intraoperative external expansion system to enhance small-volume autologous fat grafting (40-80 mL) and to discuss its background and its mechanism of action. In this system, expansion is performed using a complete vacuum delivery system known as the Kiwi VAC-6000M with a PalmPump (Clinical Innovations). The recipient site is rapidly expanded intraoperatively 10 times for 30 seconds each with a negative pressure of up to 550 mm Hg before autologous fat injection. During this repetitive stimulation, the tissues become grossly expanded, developing macroscopic swelling that regresses slowly over the course of hours following the cessation of the stimulus. The system sets various mechanisms in motion, including scar release, mechanical stimulation, edema, ischemia, and inflammation, which provide an environment conducive for cell proliferation and angiogenesis. In order to maintain the graft construct in its expansive state, all patients are encouraged postoperatively to use the Kiwi three times daily for one minute per session over the course of three days. The handling of this system is simple for both the patients and the surgeon. Satisfactory clinical outcomes have been achieved without significant complications.

  1. Isolated Autologous Free Fat Grafting for Management of Facial Contour Asymmetry in a Subset of Growing Patients With Craniofacial Microsomia.

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    Denadai, Rafael; Raposo-Amaral, Cesar Augusto; Buzzo, Celso Luiz; Raposo-Amaral, Cassio Eduardo

    2016-03-01

    To report autologous free fat grafting as an isolated procedure to manage facial contour asymmetry of a subset of growing patients with craniofacial microsomia (CFM). A retrospective analysis of CFM patients (n = 11) with low socioeconomic and intellectual status, poor oral hygiene, living far from our center, Pruzansky-Kaban I/II mandibles, without functional concerns, and with no craniofacial skeletal surgery who underwent isolated free fat grafting between 2012 and 2013 was conducted. Surgeon and parent/patient satisfaction were elicited. Computerized photogrammetric quantitative and qualitative facial symmetry analyses were performed. All patients underwent isolated autologous free fat grafting to restore the facial contour symmetry. Surgeon and patient/parent were mostly satisfied. There were significant (all P < 0.05) postoperative quantitative facial symmetry enhancement and an overall qualitative facial symmetry enhancement. A significant improvement of facial symmetry was obtained in this subset of growing CFM patients using only isolated free fat grafting.

  2. Platelet-rich plasma-enriched autologous fat graft in regenerative and aesthetic facial surgery: Technical note.

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    Picard, F; Hersant, B; La Padula, S; Meningaud, J-P

    2017-09-01

    The goal of adding platelet-rich plasma (PRP) to autologous fat graft is to increase the survival rate of the graft. After their activation, platelets release some important growth factors. As a result, PRP may increase the proliferation and differentiation of Adipose-derived stem cells (ASCs) into adipocytes, improve fat graft vascularisation, and may block the apoptosis of grafted adipocytes. The other benefit expected from the addition of PRP to fat graft is the improvement of cutaneous trophicity above the grafted areas. An exhaustive review of the literature retrieved 11 clinical studies on humans and 7 on animals. A statistically significant increase of the survival rate of fat grafts has been found in 9 comparative studies. Our synthesis allowed us to set up the following protocol: addition of 20% of PRP activated with calcium hydrochloride to fat grafts. It may enhance the results of autologous facial fat graft in regenerative and aesthetic facial surgery. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. The Use of Autologous Fat Grafting for Treatment of Scar Tissue and Scar-Related Conditions: A Systematic Review.

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    Negenborn, Vera L; Groen, Jan-Willem; Smit, Jan Maerten; Niessen, Frank B; Mullender, Margriet G

    2016-01-01

    Scar tissue can cause cosmetic impairments, functional limitations, pain, and itch. It may also cause emotional, social, and behavioral problems, especially when it is located in exposed areas. To date, no gold standard exists for the treatment of scar tissue. Autologous fat grafting has been introduced as a promising treatment option for scar tissue-related symptoms. However, the scientific evidence for its effectiveness remains unclear. This systematic review aims to evaluate the available evidence regarding the effectiveness of autologous fat grafting for the treatment of scar tissue and scar-related conditions. A systematic literature review was performed using MEDLINE, Cochrane Library, EMBASE, and Web of Science. No language restrictions were imposed. Twenty-six clinical articles were included, reporting on 905 patients in total. Meta-analysis was not performed because of the heterogeneous methodology demonstrated among the articles. Main outcome measures were scar appearance and skin characteristics, restoration of volume and/or (three-dimensional) contour, itch, and pain. All publications report a beneficial effect of autologous fat grafting on scar tissue. There is statistical significant improvement of the scar appearance, skin characteristics, and pain. Itch and restoration of volume and three-dimensional contour also improved. Autologous fat grafting is used to improve a variety of symptoms related to scar tissue. This systematic review suggests that autologous fat grafting provides beneficial effects with limited side effects. However, the level of evidence and methodological quality are quite low. Future randomized controlled trials with a methodologically strong design are necessary to confirm the effects of autologous fat grafting on scar tissue and scar-related conditions.

  4. Autologous Fat Grafting Reduces Pain in Irradiated Breast: A Review of Our Experience

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    Fabio Caviggioli

    2016-01-01

    Full Text Available Introduction. Pain syndromes affect women after conservative and radical breast oncological procedures. Radiation therapy influences their development. We report autologous fat grafting therapeutical role in treating chronic pain in irradiated patients. Materials and Methods. From February 2006 to November 2014, we collect a total of 209 patients who meet the definition of “Postmastectomy Pain Syndrome” (PMPS and had undergone mastectomy with axillary dissection (113 patients or quadrantectomy (96 patients. Both procedures were followed by radiotherapy. We performed fat grafting following Coleman’s procedure. Mean amount of adipose tissue injected was 52 cc (±8.9 cc per breast. Seventy-eight in 209 patients were not treated surgically and were considered as control group. Data were gathered through preoperative and postoperative VAS questionnaires; analgesic drug intake was recorded. Results. The follow-up was at 12 months (range 11.7–13.5 months. In 120 treated patients we detected pain decrease (mean ± SD point reduction, 3.19 ± 2.86. Forty-eight in 59 patients stopped their analgesic drug therapy. Controls reported a mean ± SD decrease of pain of 1.14 ± 2.72. Results showed that pain decreased significantly in patients treated (p<0.005, Wilcoxon rank-sum test. Conclusion. Our 8-year experience confirms fat grafting effectiveness in decreasing neuropathic pain.

  5. An Animal Model of Local Breast Cancer Recurrence in the Setting of Autologous Fat Grafting for Breast Reconstruction.

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    Tsuji, Wakako; Valentin, Jolene E; Marra, Kacey G; Donnenberg, Albert D; Donnenberg, Vera S; Rubin, J Peter

    2018-01-01

    Autologous fat grafting after breast cancer surgery is commonly performed, but concerns about oncologic risk remain. To model the interaction between fat grafting and breast cancer cells, two approaches were employed. In the first approach, graded numbers of viable MDA-MB-231 or BT-474 cells were admixed directly into human fat grafts and injected subcutaneously into immune-deficient mice to determine if the healing graft is a supportive environment for the tumor. In the second approach, graded doses of MDA-MB-231 cells were suspended in Matrigel and injected into the mammary fat pads of mice. Two weeks after the tumor cells engrafted, 100 μL of human adipose tissue was grafted into the same site. Histologically, MDA-MB-231 cells seeded within fat grafts were observed and stained positive for human-specific pan-cytokeratin and Ki67. The BT-474 cells failed to survive when seeded within fat grafts at any dose. In the second approach, MDA-MB-231 cells had a strong trend toward lower Ki67 staining at all doses. Regression analysis on all groups with fat grafts and MDA-MB-231 revealed fat tissue was associated with lower cancer cell Ki67 staining. Healing fat grafts do not support the epithelial BT-474 cell growth, and support the mesenchymal MDA-MB-231 cell growth only at doses ten times greater than in Matrigel controls. Moreover, fat grafts in association with MDA-MB-231 cancer cells already present in the wound resulted in decreased tumor proliferation and increased fibrosis. These findings suggest that clinical fat grafting does not induce breast cancer cell growth, and may even have a suppressive effect. Stem Cells Translational Medicine 2018;7:125-134. © 2017 The Authors Stem Cells Translational Medicine published by Wiley Periodicals, Inc. on behalf of AlphaMed Press.

  6. [Consensus of the Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC) on Autologous Fat Grafting].

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    Giunta, R E; Horch, R E; Prantl, L; Baur, E M; Herold, C; Kamolz, L; Lehnhardt, M; Noah, E M; Rennekampff, O; Richter, D; Schaefer, D J; Ueberreiter, K

    2016-12-01

    On occasion of the Munich Plastic Symposium in Munich the board of the Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC) together with a group of experts who were also involved in the preparation of the recently published S2K guideline "Autologous Fat Grafting", prepared a consensus statement from a plastic-surgical point of view so to evaluate current spects and taking into account the current legal framework: 1. Autologous Fat Grafting is a long established treatment in plastic surgery and does not differ from other tissue grafts. 2. Mechanical processing of autologous fat does not provide any substantial change tot he tissue. 3. If other treatment methods to enrich progenitor cells of autolous fat i. e. by an enzymatic process have evidence that autologous adipose tissue or cells were substantially changed, classification as a drug could come in question under current german law (application of AMG/ATMP). © Georg Thieme Verlag KG Stuttgart · New York.

  7. Autologous Fat Grafting as a Last Resort for Unsustainable Pain in a Woman with Multiple Osteochondromas

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    Vera Lidwina Negenborn

    2017-03-01

    Full Text Available Multiple osteochondromas (MO is characterized by the formation of osteochondromas throughout the entire body. Although the evidence regarding its pathogenesis is well understood, no curative treatment for the disorder is available. Patients can be treated symptomatically by surgical removal of painful osteochondromas. Unfortunately, some patients still suffer from severe pain, even after surgery. We report on a case concerning a 48-year-old woman with a history of MO who presented with persistent pain after surgical removal of a symptomatic osteochondroma of the left scapula and multiple symptomatic osteochondromas of the left foot and trochanteric region. Several interventions to reduce the pain did not have any lasting effect. Subsequently, she was treated with autologous fat grafting (AFG. After each session she was pain-free for at least one year and reported only partial recurrence of the pain. This is the first case report describing AFG for the treatment of pain after both surgical removal of an osteochondroma and symptomatic osteochondromas in a patient suffering MO with promising results. The treatment is more effective and clearly continues to remain active longer than injection therapy or pain medication. Future studies are necessary to confirm our results.

  8. Use of autologous fat grafting for reconstruction postmastectomy and breast conserving surgery: a systematic review protocol.

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    Agha, Riaz A; Goodacre, Tim; Orgill, Dennis P

    2013-10-22

    There is growing interest in the potential use of autologous fat grafting (AFG) for the purposes of breast reconstruction. However, concerns have been raised regarding the technique's clinical effectiveness, safety and interference with screening mammography. The objective of this systematic review was to determine the oncological, clinical, aesthetic and functional, patient reported, process and radiological outcomes for AFG. All original studies, including randomised controlled trials, cohorts studies, case-control studies, case series and case reports involving women undergoing breast reconstruction. All AFG techniques performed for the purposes of reconstruction in the postmastectomy or breast conserving surgery setting will be considered. Outcomes are defined within this protocol along; oncological, clinical, aesthetic and functional, patient reported, process and radiological domains. The search strategy has been devised to find papers about 'fat grafting and breast reconstruction' and is outlined within the body of this protocol. The full search strategy is outlined within the body of the protocol. The following electronic databases will be searched from 1 January 1986 to 6 June 2013: PubMed, MEDLINE, EMBASE, SCOPUS, CINAHL, PsycINFO, SciELO, The Cochrane Library, including the Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effect (DARE), the Cochrane Methodology Register, Health Technology Assessment Database, the NHS Economic Evaluation Databases and Cochrane Groups, ClinicalTrials.gov, Current Controlled Trials Database, the World Health Organisation (WHO) International Clinical Trials Registry Platform, UpToDate.com, NHS Evidence and the York Centre for Reviews and Dissemination. Grey literature searches will also be conducted as detailed in our review protocol. Eligibility assessment occurred in two stages, title and abstract screening and then full text

  9. Augmentation Phalloplasty With Autologous Dermal Fat Graft in the Treatment of "Small Penis".

    Science.gov (United States)

    Xu, Lisi; Zhao, Muxin; Chen, Wen; Li, Yangqun; Yang, Zhe; Ma, Ning; Wang, Weixin; Feng, Jun; Liu, Qiyu; Ma, Tong

    2016-02-01

    Our objective is to report on the efficacy and safety of dermal fat graft in augmentation phalloplasty performed on patients who presented complaining of "small penis," and evaluate the cosmetic and psychological outcomes of it. From April 2010 and January 2015, 23 Chinese adult patients aged 18 to 33 years (average, 23 years) with subjective perception of small penis were included; all who requested an increase in the penile dimension underwent penile elongation (suprapubic skin advancement-ligamentolysis) and girth enhancement by dermal fat graft. Besides objective measurement, Male Genital Image Scale was used to facilitate selection of patients and evaluate the outcome, respectively. The change and shrinkage of the dermal fat strips was evaluated by ultrasound examination and computed tomography. No major complications or erection deficiencies occurred during the postoperative follow-up period. After 6 months, the mean flaccid length was increased by 2.27 ± 0.54 cm, whereas the mean flaccid circumference gain was 1.67 ± 0.46 cm. Significant improvement of genital satisfaction was reported during the follow-up. The shrinkage of dermal fat strips was inconspicuous, and no curvature was observed due to fibrosis. With strict patient selection, this procedure is proved to be a plausible and reasonable option for patients with penile dysmorphophobia. Also, it provides a potential alternative procedure to current dominant methods and promotes the aesthetic results with penile lengthening.

  10. Evaluation of a laminin-alginate biomaterial, adipocytes, and adipocyte-derived stem cells interaction in animal autologous fat grafting model using 7-Tesla magnetic resonance imaging.

    Science.gov (United States)

    Chen, Yo-Shen; Hsueh, Yu-Sheng; Chen, Yen-Yu; Lo, Cheng-Yu; Tai, Hao-Chih; Lin, Feng-Huei

    2017-01-01

    Biomaterials are often added to autologous fat grafts both as supporting matrices for the grafted adipocytes and as cell carrier for adipose-derived stem cells (ADSCs). This in vivo study used an autologous fat graft model to test a lamininalginate biomaterial, adipocytes, and ADSCs in immune-competent rats. We transplanted different combinations of shredded autologous adipose tissue [designated "A" for adipose tissue]), laminin-alginate beads [designated "B" for bead], and ADSCs [designated "C" for cell]) into the backs of 15 Sprague-Dawley rats. Group A received only adipocytes, Group B received only laminin-alginate beads, Group AB received adipocytes mixed with laminin-alginate beads, Group BC received laminin-alginate beads encapsulating ADSCs, and Group ABC received adipocytes and laminin-alginate beads containing ADSCs. Seven-tesla magnetic resonance imaging was used to evaluate the rats at the 1st, 6th, and 12th weeks after transplantation. At the 12th week, the rats were sacrificed and the implanted materials were retrieved for gross examination and histological evaluation. The results based on MRI, gross evaluation, and histological data all showed that implants in Group ABC had better resorption of the biomaterial, improved survival of the grafted adipocytes, and adipogenic differentiation of ADSCs. Volume retention of grafts in Group ABC (89%) was also significantly greater than those in Group A (58%) (p < 0.01). Our findings support that the combination of shredded adipose tissue with ADSCs in laminin-alginate beads provided the best overall outcome.

  11. Preoperative color duplex echographical venous mapping before autologous fat graft for calf augmentation: a case report of superficial vein thrombosis and prevalence of intersaphenic anastomosis.

    Science.gov (United States)

    Fraccalvieri, Marco; Contessa, Luigi; Salomone, Marco; Zingarelli, Enrico Maria; Bruschi, Stefano

    2014-08-01

    Autologous fat grafting for calf augmentation is considered an easy and safe technique. Only few cases of potential complications have been described in literature; among them, vein thrombosis was never reported. We report a case of superficial vein thrombosis of the intersaphenic anastomosis after fat graft for calf symmetrization in club-foot syndrome. A color duplex echographical study showed that such intersaphenic anastomoses are present in all patients, but they have an ectatic diameter in 70% of patients with great saphenous vein insufficiency and in 50% of patients without insufficiency. The plastic surgeon should be aware of the presence and topography of such anatomical variations before performing the procedure. Moreover, a preoperative color duplex echographical venous mapping may help the surgeon in avoiding the trauma on vein variants and subsequent complications.

  12. Facial fat necrosis following autologous fat transfer and its management

    Directory of Open Access Journals (Sweden)

    Sweta Rai

    2014-01-01

    Full Text Available Autologous fat transfer (AFT is an increasingly popular cosmetic procedure practiced by dermatologic surgeons worldwide. As this is an office based procedure performed under local or tumescent anaesthesia with fat transferred within the same individual and limited associated down time its is considered relatively safe and risk free in the cosmetic surgery arena. We describe a case of AFT related fat necrosis causing significant facial dysmorphia and psychosocial distress. We also discuss the benefits and risks of AFT highlighting common causes of fat graft failure.

  13. One stage rescue procedure after capsular contracture of breast implants with autologous fat grafts collected by water assisted liposuction (“BEAULI Method”

    Directory of Open Access Journals (Sweden)

    Ueberreiter, Klaus

    2013-01-01

    Full Text Available With increasing number of patients with silicone implants for breast augmentation or reconstruction we are confronted with more and more cases of capsular contracture. Not every case is resolved by resection of the capsule and exchange of implants. Many patients rather bear the consequences of severe fibrosis than to have their implants removed. The one stage procedure of implant removal and lipofilling proved to be highly efficient with good to excellent results and high patient satisfaction. Between January 2008 and October 2012 a total of 64 patients (124 breasts with capsular fibrosis Baker III to IV were treated with autologous fat grafts collected with the body-jet by water-assisted liposuction (“BEAULI Method”. Magnetic resonance imaging (MRI of the breasts was performed in 5 patients preoperatively and 6 month postoperatively, a clinical examination and photo documentation of all patients was done on day 1 and after 4 weeks, 12 weeks and 6 months postoperatively. The procedure included implant removal and lipofilling of the subcutaneous and intramuscular space in a single procedure by means of the BEAULI Method. The average gross amount of grafted fat was 260 ml. The average drainage time was one day. The shape of the breast changed to a more natural and ptotic form. Negative side effects like oily cysts or infections were not observed. The time of the overall procedure including liposuction was 70±15 min. Reoccurring capsular contracture is one of the hazards in plastic surgery. Until now the treatment of choice after more than two failed implant changes combined with resection of the capsule is usually the final removal of implants with or without possible additional autologous tissue transfer (microvascular flaps. We could add a relatively simple and efficient procedure to resolve and improve those cases by autologous fat transfer using water-assisted liposuction and the BEAULI Method.

  14. Human breast adipose-derived stem cells transfected with the stromal cell-derived factor-1 receptor CXCR4 exhibit enhanced viability in human autologous free fat grafts.

    Science.gov (United States)

    Xu, Fang-tian; Li, Hong-mian; Yin, Qing-Shui; Liu, Da-lie; Nan, Hua; Zhao, Pei-ran; Liang, Shuang-wu

    2014-01-01

    The main complication of autologous free fat tissue transplantation is fat resorption and calcification due to the ischemic necrosis of fat. The promotion of transplant neovascularization soon after autologous free fat grafts may reduce these outcomes. In adulthood, stromal cell-derived factor-1 (SDF-1) and its membrane receptor C-X-C chemokine receptor type 4 (CXCR4) are involved in the homing and migration of multiple stem cell types, neovascularization, and cell proliferation. We hypothesized that CXCR4 may improve the long-term survival of free fat tissue transplants by recruiting endothelial progenitor cells (EPCs) and may therefore improve graft revascularization. In this study, we aimed to determine the effect of human breast adipose-derived stem cells (HBASCs) transfected with the CXCR4 gene on the survival rate of human autologous free fat transplants in nude mice. Human breast adipose-derived stem cells (HBASCs) were expanded ex vivo for 3 passages, labeled with green fluorescent protein (GFP) and transfected with CXCR4 or left untransfected. Autologous fat tissues were mixed with the GFP-labeled, CXCR4-transfected HBASCs (group A), GFP-labeled HBASCs (group B), the known vascularization-promoting agent VEGF (group C), or medium (group D) and then injected subcutaneously into 32 nude mice at 4 spots in a random fashion. Six months later, the transplanted tissue volume and histology were evaluated, and neo-vascularization was quantified by counting the capillaries. CXCR4 and SDF-1α mRNA expression in the transplants was determined using real-time quantitative PCR analysis (qPCR). The data revealed that the control (group D) transplant volume survival was 28.3 ± 4.5%. Mixing CXCR4-transfected (group A) and untransfected (group B) HBASCs significantly increased transplant volume survival (79.5 ± 8.3% and 67.2 ± 5.9%, respectively), whereas VEGF-transfected HBASCs (group C) were less effective (41.2 ± 5.1%). Histological analysis revealed that both types

  15. Autologous Fat Injection for Augmented Mammoplasty

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Eul Sik; Seo, Bo Kyoung; Yi, Ann; Cho, Kyu Ran [Korea University Ansan Hospital, Ansan (Korea, Republic of)

    2008-12-15

    Autologous fat injection is one of the methods utilized for augmented mammoplasty methods. In this surgical procedure, the fat for transfer is obtained from the donor site of the patient's own body by liposuction and the fat is then injected into the breast. We report here cases of three patients who underwent autologous fat injection. Two of the patients had palpable masses that were present after surgery. The serial imaging findings and surgical method of autologous fat transfer are demonstrated

  16. Autologous Fat Grafting in Cosmetic Breast Augmentation: A Systematic Review on Radiological Safety, Complications, Volume Retention, and Patient/Surgeon Satisfaction.

    Science.gov (United States)

    Groen, Jan-Willem; Negenborn, Vera L; Twisk, Jos W R; Ket, Johannes C F; Mullender, Margriet G; Smit, Jan Maerten

    2016-10-01

    Autologous fat grafting (AFG) is increasingly used in cosmetic surgery. However, its efficacy and safety are still ambiguous. Both a comprehensive overview and recapitulation of the relevant literature provide current evidence on the efficacy and outcomes of AFG in cosmetic breast surgery. This review provides an up-to-date overview of the literature on AFG in cosmetic breast augmentation. A systematic review of the literature on AFG used for cosmetic breast augmentation was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. This study included selected studies that were published between January 1996 and February 2016 and reported on 10 patients or more who had a minimal mean follow-up period of 1 year. In this study, 22 articles that reported on 3565 patients with follow-up periods ranging from 12 to 136 months were included. A complication rate of 17.2% (95% CI 15.9-18.5) was seen. Indurations were the most frequent complication (33.3%, 95% CI 20.4-46.3), followed by persistent pain (25%, 95% CI 0.5-49.5), and hematoma (16.4%, 95% CI 14.5-18.4). Mammograms revealed micro-calcifications (9.0%, 95% CI 6.4-11.5) and macro-calcifications (7.0%, 95% CI 3.8-10.2). The mean volume retention was 62.4% (range, 44.7-82.6%), with a satisfaction rate of 92% in patients and 89% in surgeons. AFG is a promising method in achieving autologous cosmetic breast augmentation with satisfactory volume retention and satisfaction rates in eight and six studies, respectively. Complications and radiological findings are comparable to those after implant augmentation. Future studies should focus on cancer occurrence and detection to further substantiate AFG safety. In addition, grafting methods and the use of auxiliary procedures to identify factors leading to better outcomes in terms of volume retention should be investigated. Finally, objective questionnaires are needed to represent patient satisfaction. 3 Therapeutic.

  17. Periorbital fat grafting.

    Science.gov (United States)

    Massry, Guy G; Azizzadeh, Babak

    2013-02-01

    Periorbital aging is a multifactorial process involving volume loss (bone and soft tissue), tissue decent, and cutaneous degenerative changes. Traditional approaches to surgery on this area of the face have been subtractive in nature, focusing on excision of skin, muscle, and fat. This has frequently led to a gaunt or hollowed postoperative appearance. Contemporary aesthetic eyelid and periorbital rejuvenation has undergone a paradigm shift from an excisionally based surgical approach to one that prioritizes volume preservation and/or augmentation. The development of fat grafting to the eyelids and periorbita has given the eyelid surgeon a viable surgical alternative to prevent postoperative volume depletion, maintain the smooth transition of the lower eyelid to the cheek, and aid in restoring the youthful appearance desired after surgery. This article will focus of periorbital fat grafting and touch upon fat preservation techniques as primary restorative procedures or as surgical adjuncts. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  18. Transabdominal sacrocolpopexy with autologous rectus fascia graft.

    Science.gov (United States)

    Abraham, Nitya; Quirouet, Adrienne; Goldman, Howard B

    2016-08-01

    Extrusion and infection are potential postoperative complications when using synthetic mesh for abdominal sacrocolpopexy. Long-term follow-up in the Colpopexy and Urinary Reduction Efforts (CARE) trial revealed an estimated 9.9 % risk of mesh extrusion. There are 26 reports of spondylodiscitis after sacrocolpopexy with synthetic mesh. These surgical risks may be decreased by using autologous fascia. To date, there have been no reports of extrusion or spondylodiscitis after using autologous fascia for sacrocolpopexy. This video demonstrates transabdominal sacrocolpopexy with an autologous rectus fascia graft. A 76-year-old woman with symptomatic stage 3 prolapse also had a history of diverticulitis and sigmoid abscess requiring sigmoid colectomy with end colostomy and incidental left ureteral transection with subsequent left nephrostomy tube placement. She presented for colostomy reversal, ureteral reimplantation, and prolapse repair. Given the need for concomitant colon and ureteral reconstruction, the risk of infection was potentially higher if synthetic mesh were used. The patient therefore underwent transabdominal sacrocolpopexy with autologous rectus fascia graft. At 4 months' follow-up the patient reported resolution of her symptoms and on examination she had no pelvic organ prolapse. Transabdominal sacrocolpopexy using autologous rectus fascia graft is a feasible option, especially in cases in which infection and synthetic mesh extrusion risks are potentially higher.

  19. Hemifacial atrophy treated with autologous fat transplantation

    Directory of Open Access Journals (Sweden)

    Gandhi Vijay

    2005-01-01

    Full Text Available A 23-year-old male developed right hemifacial atrophy following marphea profunda. Facial asymmetry due to residual atrophy was treated with autologous fat harvested from buttocks with marked cosmetic improvement.

  20. Autologous fat transplantation for labia majora reconstruction.

    Science.gov (United States)

    Vogt, P M; Herold, C; Rennekampff, H O

    2011-10-01

    A case of autologous fat transplantation for labia majora augmentation after ablative surgery is presented. The patient reported pain and deformity of the left labium majus after resection for Bowen's disease. The symptoms had not been solved by classic plastic surgical reconstructions including a pudendal thigh fasciocutaneous flap. Use of autologous fat transplantation facilitated an improved aesthetic result while preserving residual sensation to the external genitalia and improving symptoms of mucosal exposure and dryness.

  1. Sites of Autologous Bone Grafts in Orthopaedic Traumatology ...

    African Journals Online (AJOL)

    Background: The use of autologous bone graft in orthopaedic traumatology is not uncommon. But little work, from West African subregion, has been devoted to sites used as sources of autologous bone grafts. Objective: The purpose of this study was to evaluate the evolution of these different sampling sites of autologous ...

  2. Autologous Bone Grafts Use in Orthopaedic Practice in Abuja ...

    African Journals Online (AJOL)

    Background: There is widespread use of autologous bone grafts in orthopaedic practice in Nigeria but detailed indications, donor sites and complications following use have not been reported in different regions. Objective: This is to highlight the indications, sources and complications of autologous bone grafts use in Abuja, ...

  3. Platlet Rich Plasma (PRP) Improves Fat Grafting Outcomes.

    Science.gov (United States)

    Modarressi, Ali

    2013-01-01

    Autologous fat transfer offers many qualities of a ideal soft tissue filler. Main advantages of fat grafting ensue from the fact that the lipoaspirate tissue is an abundant source of regenerative pluripotential cells. However, the reported rates of fat cell survival vary greatly in the medical literature (10-90%). Different techniques of harvesting, processing, and reinjecting the fat cells are so claimed to be responsible for these differences, without any agreement concerning the best way to process. To address this important disadvantage, we propose the addition of autologous platelet rich plasma (PRP) which is known as a natural reservoir of growth factors stimulating tissue repair and regeneration. This approach is completely autologous and immediately employed without any type of preconditioning. Platelets rich plasma (PRP) preparation included bleeding of 8 ml of blood from patient's peripheral vein in Regen Lab© tubes containing sodium citrate anticoagulant. The whole blood was centrifugated at 1500 g during 3 min. As Regen-tubes contained a special gel separator, 99 % of red blood cells were discarded from the plasma at the bottom of the gel, and >90% of platelets were harvested in 4 ml of plasma on the top of the gel, called the platelet-rich plasma (PRP). The purified fat prepared by Coleman technique was mixed with different amount of PRP for in vitro, in vivo (mice) and clinical experiments: >50% of PRP for skin rejuvenation, superficial scars correction, infraorbital region, ..., and for 20% of PRP with 80% of purified fat for deep filler indication (nasolabial folds, lips, or soft tissue defect). In vitro studies demonstrated that PRP increased fat cells survival rate and stem cells differentiation. Animal models showed that fat graft survival rate was significantly increased by addition of PRP. Several clinical cases confirmed the improvement of wound healing and fat grafting survival in facial reconstruction and aesthetic cases by association of

  4. The Influence of Barrier Membranes on Autologous Bone Grafts

    NARCIS (Netherlands)

    Gielkens, P. F. M.; Schortinghuis, J.; de Jong, J. R.; Paans, A. M. J.; Ruben, J. L.; Raghoebar, G. M.; Stegenga, B.; Bos, R. R. M.

    2008-01-01

    In implant dentistry, there is continuing debate regarding whether a barrier membrane should be applied to cover autologous bone grafts in jaw augmentation. A membrane would prevent graft remodeling with resorption and enhance graft incorporation. We hypothesized that membrane coverage does not

  5. Latissimus Dorsi and Immediate Fat Transfer (LIFT for Complete Autologous Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    James M. Economides, MD

    2018-01-01

    Conclusion:. Autologous augmentation of the LD flap with lipotransfer has been used to avoid placement of an implant. We improve the technique by performing lipotransfer during index reconstruction. Furthermore, we perform lipotransfer prior to disorigination of the LD muscle to minimize trauma to the flap and increase the efficiency of fat grafting. Our experience demonstrates that this technique is a viable autologous alternative to microsurgical breast reconstruction.

  6. MR imaging of osteochondral grafts and autologous chondrocyte implantation

    Energy Technology Data Exchange (ETDEWEB)

    Trattnig, S. [Medical University of Vienna, MR Centre of Excellence, Department of Radiology, Vienna (Austria); University Hospital of Vienna, MR-Center, Department of Radiology, Vienna (Austria); Millington, S.A. [Medical University of Vienna, MR Centre of Excellence, Department of Radiology, Vienna (Austria); Medical University of Vienna, Department of Trauma Surgery, Center for Joints and Cartilage, Vienna (Austria); Szomolanyi, P. [Medical University of Vienna, MR Centre of Excellence, Department of Radiology, Vienna (Austria); Marlovits, S. [Medical University of Vienna, Department of Trauma Surgery, Center for Joints and Cartilage, Vienna (Austria)

    2007-01-15

    Surgical articular cartilage repair therapies for cartilage defects such as osteochondral autograft transfer, autologous chondrocyte implantation (ACI) or matrix associated autologous chondrocyte transplantation (MACT) are becoming more common. MRI has become the method of choice for non-invasive follow-up of patients after cartilage repair surgery. It should be performed with cartilage sensitive sequences, including fat-suppressed proton density-weighted T2 fast spin-echo (PD/T2-FSE) and three-dimensional gradient-echo (3D GRE) sequences, which provide good signal-to-noise and contrast-to-noise ratios. A thorough magnetic resonance (MR)-based assessment of cartilage repair tissue includes evaluations of defect filling, the surface and structure of repair tissue, the signal intensity of repair tissue and the subchondral bone status. Furthermore, in osteochondral autografts surface congruity, osseous incorporation and the donor site should be assessed. High spatial resolution is mandatory and can be achieved either by using a surface coil with a 1.5-T scanner or with a knee coil at 3 T; it is particularly important for assessing graft morphology and integration. Moreover, MR imaging facilitates assessment of complications including periosteal hypertrophy, delamination, adhesions, surface incongruence and reactive changes such as effusions and synovitis. Ongoing developments include isotropic 3D sequences, for improved morphological analysis, and in vivo biochemical imaging such as dGEMRIC, T2 mapping and diffusion-weighted imaging, which make functional analysis of cartilage possible. (orig.)

  7. Resorbable screws for fixation of autologous bone grafts

    NARCIS (Netherlands)

    Raghoebar, GM; Liem, RSB; Bos, RRM; van der Wal, JE; Vissink, A

    The aim of this study was to evaluate the suitability of resorbable screws made of poly (D,L-lactide) acid (PDLLA) for fixation of autologous bone grafts related to graft regeneration and osseointegration of dental implants. In eight edentulous patients suffering from insufficient retention of their

  8. Supplementing fat grafts with adipose stromal cells for cosmetic facial contouring.

    Science.gov (United States)

    Li, Jie; Gao, Jianhua; Cha, Pengfei; Chang, Qiang; Liao, Yunjun; Liu, Chao; Li, Kecheng; Lu, Feng

    2013-03-01

    Numerous methods have been proposed to enhance the survival of fat grafts, but no definitive treatment is available. Stromal vascular fraction (SVF)-assisted cell therapy offers new perspectives for improving fat graft survival. To determine whether SVF supplementation could improve graft retention in patients undergoing autologous fat grafting for cosmetic improvement of facial contour. We retrospectively analyzed data from 38 women who underwent fat transplantation with SVF (n = 26) or fat grafting alone (n = 12) between October 2010 and January 2012. Each patient underwent computed tomography, and photographs were taken before and 6 months after surgery. The Philips Extended Brilliance Workspace was used for analysis of volume augmentation. All patients showed cosmetic improvements, but the degree varied. No complications were evidenced during follow-up. Fat survival was higher with SVF (64.8 ± 10.2%) than fat grafting alone (46.4 ± 9.3%) (p cosmetic facial contouring can improve the survival of fat grafts over fat grafting alone and provides satisfactory outcomes without major complications. Autologous fat grafting has been used for various cosmetic treatments and difficult reconstructive indications such as temporal depression, wrinkles of nasolabial folds, and hemifacial atrophy, with no incisional scar or complications associated with foreign materials, although problems such as a low rate of graft survival because of early resorption remain. (Aesthet Plast Surg, 14, 1990 and 127) Despite many innovations to overcome these problems, (Dermatol Surg, 26, 2000 and 1159); (Ann Plast Surg, 60, 2008 and 594); (Dermatol Surg, 27, 2001 and 819); (Dermatol Surg, 28, 2002 and 987) we lack a definitive method of fat processing that ensures maximal graft take and viability. (Plast Reconstr Surg, 115, 2005 and 197); (Dermatol Surg, 37, 2011 and 619). © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  9. Radiographic analysis of pasteurized autologous bone graft

    International Nuclear Information System (INIS)

    Ahmed, Adel Refaat; Manabe, Jun; Kawaguchi, Noriyoshi; Matsumoto, Seiichi; Matsushita, Yasushi

    2003-01-01

    Local malignant bone tumor excision followed by pasteurization and subsequent reimplantation is a unique technique for reconstruction after resection of primary bone sarcomas. The purpose of this investigation was to assess the normal and abnormal long-term radiographic findings of intercalary and osteo-chondral pasteurized bone graft/implant composite. The long-term radiographic findings of pasteurized bone grafts used in reconstruction after resection of bone and soft tissue sarcomas in relation to patients' clinical data were reviewed retrospectively. Thirty-one patients (18 females, 13 males; age range 7-77 years, mean 30 years) who underwent surgery between April 1990 and January 1997 at the authors' institute constituted the material of this study. They were followed up for at least 3 years or until the patient's death (mean 69 months). The International Society of Limb Salvage graft evaluation method that assesses the fusion, resorption, fracture, graft shortening, fixation, subluxation, joint narrowing and subchondral bone was used for evaluation of the radiographs. Twenty-one patients (68%) showed complete incorporation of graft and eight patients (26%) had partial incorporation. The overall radiographic evaluation rate was 81%. Fracture (10%) and infection (16%) were the main complications. No local recurrence was detected. These results indicate that pasteurization of bone is a useful option for reconstruction after resection of malignant bone tumors. (orig.)

  10. Radiographic analysis of pasteurized autologous bone graft.

    Science.gov (United States)

    Ahmed, Adel Refaat; Manabe, Jun; Kawaguchi, Noriyoshi; Matsumoto, Seiichi; Matsushita, Yasushi

    2003-08-01

    Local malignant bone tumor excision followed by pasteurization and subsequent reimplantation is a unique technique for reconstruction after resection of primary bone sarcomas. The purpose of this investigation was to assess the normal and abnormal long-term radiographic findings of intercalary and osteo-chondral pasteurized bone graft/implant composite. The long-term radiographic findings of pasteurized bone grafts used in reconstruction after resection of bone and soft tissue sarcomas in relation to patients' clinical data were reviewed retrospectively. Thirty-one patients (18 females, 13 males; age range 7-77 years, mean 30 years) who underwent surgery between April 1990 and January 1997 at the authors' institute constituted the material of this study. They were followed up for at least 3 years or until the patient's death (mean 69 months). The International Society of Limb Salvage graft evaluation method that assesses the fusion, resorption, fracture, graft shortening, fixation, subluxation, joint narrowing and subchondral bone was used for evaluation of the radiographs. Twenty-one patients (68%) showed complete incorporation of graft and eight patients (26%) had partial incorporation. The overall radiographic evaluation rate was 81%. Fracture (10%) and infection (16%) were the main complications. No local recurrence was detected. These results indicate that pasteurization of bone is a useful option for reconstruction after resection of malignant bone tumors.

  11. Radiographic analysis of pasteurized autologous bone graft

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Adel Refaat [Department of Orthopedic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Kamiikebukuro 1-37-1, Toshima-ku, 170-0012, Tokyo (Japan); Department of Orthopedic Surgery, Alexandria University, Alexandria (Egypt); Manabe, Jun; Kawaguchi, Noriyoshi; Matsumoto, Seiichi; Matsushita, Yasushi [Department of Orthopedic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Kamiikebukuro 1-37-1, Toshima-ku, 170-0012, Tokyo (Japan)

    2003-08-01

    Local malignant bone tumor excision followed by pasteurization and subsequent reimplantation is a unique technique for reconstruction after resection of primary bone sarcomas. The purpose of this investigation was to assess the normal and abnormal long-term radiographic findings of intercalary and osteo-chondral pasteurized bone graft/implant composite. The long-term radiographic findings of pasteurized bone grafts used in reconstruction after resection of bone and soft tissue sarcomas in relation to patients' clinical data were reviewed retrospectively. Thirty-one patients (18 females, 13 males; age range 7-77 years, mean 30 years) who underwent surgery between April 1990 and January 1997 at the authors' institute constituted the material of this study. They were followed up for at least 3 years or until the patient's death (mean 69 months). The International Society of Limb Salvage graft evaluation method that assesses the fusion, resorption, fracture, graft shortening, fixation, subluxation, joint narrowing and subchondral bone was used for evaluation of the radiographs. Twenty-one patients (68%) showed complete incorporation of graft and eight patients (26%) had partial incorporation. The overall radiographic evaluation rate was 81%. Fracture (10%) and infection (16%) were the main complications. No local recurrence was detected. These results indicate that pasteurization of bone is a useful option for reconstruction after resection of malignant bone tumors. (orig.)

  12. Role of adipose-derived stem cells in fat grafting and reconstructive surgery

    Directory of Open Access Journals (Sweden)

    Shaun S Tan

    2016-01-01

    Full Text Available Autologous fat grafting is commonly utilised to reconstruct soft tissue defects caused by ageing, trauma, chronic wounds and cancer resection. The benefits of fat grafting are minimal donor site morbidity and ease of availability through liposuction or lipectomy. Nonetheless, survival and longevity of fat grafts remain poor post-engraftment. Various methods to enhance fat graft survival are currently under investigation and its stem cell constituents are of particular interest. Cell-assisted lipotransfer refers to the addition of adipose-derived stem cell (ASC rich component of stromal vascular fraction to lipoaspirate, the results of which have proven promising. This article aims to review the role of ASCs in fat grafting and reconstructive surgery.

  13. Tissue-engineered autologous grafts for facial bone reconstruction.

    Science.gov (United States)

    Bhumiratana, Sarindr; Bernhard, Jonathan C; Alfi, David M; Yeager, Keith; Eton, Ryan E; Bova, Jonathan; Shah, Forum; Gimble, Jeffrey M; Lopez, Mandi J; Eisig, Sidney B; Vunjak-Novakovic, Gordana

    2016-06-15

    Facial deformities require precise reconstruction of the appearance and function of the original tissue. The current standard of care-the use of bone harvested from another region in the body-has major limitations, including pain and comorbidities associated with surgery. We have engineered one of the most geometrically complex facial bones by using autologous stromal/stem cells, native bovine bone matrix, and a perfusion bioreactor for the growth and transport of living grafts, without bone morphogenetic proteins. The ramus-condyle unit, the most eminent load-bearing bone in the skull, was reconstructed using an image-guided personalized approach in skeletally mature Yucatán minipigs (human-scale preclinical model). We used clinically approved decellularized bovine trabecular bone as a scaffolding material and crafted it into an anatomically correct shape using image-guided micromilling to fit the defect. Autologous adipose-derived stromal/stem cells were seeded into the scaffold and cultured in perfusion for 3 weeks in a specialized bioreactor to form immature bone tissue. Six months after implantation, the engineered grafts maintained their anatomical structure, integrated with native tissues, and generated greater volume of new bone and greater vascular infiltration than either nonseeded anatomical scaffolds or untreated defects. This translational study demonstrates feasibility of facial bone reconstruction using autologous, anatomically shaped, living grafts formed in vitro, and presents a platform for personalized bone tissue engineering. Copyright © 2016, American Association for the Advancement of Science.

  14. A novel and innovative technique of using a disposable syringe and mesh for harvesting fat for structural fat grafting

    Directory of Open Access Journals (Sweden)

    B C Ashok

    2015-01-01

    Full Text Available Background: Successful restoration of structure and function using autologous free fat grafts has remained elusive. Review of literature shows that various harvesting and preparation techniques have been suggested. The goal of these techniques is to obtain greater adipocyte cell survival and consequently more reliable clinical results. Materials and Methods: In our technique, a piece of mesh is kept at one end of the lipoaspiration syringe, which is then connected to the Suction pump. As one syringe fills, it is replaced by another one until the required amount of fat is obtained. Results: By using a polypropylene mesh in our technique, we can separate the transfusate from the harvested fat graft during harvesting itself. The fat graft thus obtained is dense and concentrated, with fewer impurities. Conclusion: Hence, we recommend our technique as a reliable method for extracting sterile emulsified fat in an economical way.

  15. Autologous bone graft versus demineralized bone matrix in internal fixation of ununited long bones

    OpenAIRE

    Rubenbauer Bianka; Löffler Thomas; Zaspel Johannes; Wittmann Alexandra; Pieske Oliver; Trentzsch Heiko; Piltz Stefan

    2009-01-01

    Abstract Background Non-unions are severe complications in orthopaedic trauma care and occur in 10% of all fractures. The golden standard for the treatment of ununited fractures includes open reduction and internal fixation (ORIF) as well as augmentation with autologous-bone-grafting. However, there is morbidity associated with the bone-graft donor site and some patients offer limited quantity or quality of autologous-bone graft material. Since allogene bone-grafts are introduced on the marke...

  16. Fat grafting in immediate breast reconstruction. Avoiding breast sequelae.

    Science.gov (United States)

    Moltó García, Roberto; González Alonso, Virina; Villaverde Doménech, María Eloísa

    2016-01-01

    The remarkable increase that breast-conserving surgery has been experiencing throughout the last decades is as much undeniable as the imposition of the immediate reconstruction as the gold-standard treatment regarding breast reconstruction. Nevertheless, these trends conflict since we do not have a satisfactory immediate reconstruction method for breast-conserving surgery. This work shows the technique we have developed to solve this problem through autologous fat grafting ensuring the same oncological safety. We present the preliminary results of 37 immediate reconstructions of lumpectomies and quadrantectomies through autologous fat grafting of lumpectomies. Patients have been chosen by a multidisciplinary committee following special criteria based on their low-risk pathology, having undergone different diagnostic tests previous to the resection and 1 year postoperative monitoring by qualified observers. Also, a satisfaction survey has been performed. In all cases studied, with a year follow-up, we found excellent aesthetic outcomes with no presence of the feared scar retractions and deformities, even after radiotherapy. According to patient surveys, the satisfaction rate was also very high. No important complications, either acute or chronic, have been observed from the implementation of this technique. This is a useful, innovative technique, having good aesthetic results, decreasing the incidence of aesthetic sequelae, commonly seen in simple lumpectomies without reconstruction. The complication rate is low, and oncological safety is not compromised.

  17. Cell-assisted lipotransfer: Friend or foe in fat grafting? Systematic review and meta-analysis.

    Science.gov (United States)

    Laloze, J; Varin, A; Gilhodes, J; Bertheuil, N; Grolleau, J L; Brie, J; Usseglio, J; Sensebe, L; Filleron, T; Chaput, B

    2018-02-01

    Autologous fat grafting is a common procedure for soft-tissue reconstruction but is associated with a graft resorption rate ranging from 20% to 80%. To improve the fat graft survival rate, a new technique, called cell-assisted lipotransfer (CAL), was developed. With CAL, fat is injected along with adipose-derived stromal cells that are assumed to improve fat survival rate. We conducted an evidence-based meta-analysis to evaluate the efficacy and safety of CAL as compared with conventional autologous fat grafting (non-CAL). The databases MEDLINE (via PubMed), Cochrane Library, EBSCO, Web of Science, and EMBASE were searched for reports of clinical trials, case series, and cohorts available from 2008 to 2016. We conducted a meta-analysis of the efficacy of CAL with data analysis concerning fat survival rate. The incidence of complications and the need for multiple procedures were evaluated to determine the safety of CAL. We identified 25 studies (696 patients) that were included in the systematic review; 16 studies were included in the meta-analysis to evaluate the efficacy of CAL. The fat survival rate was significantly higher with CAL than non-CAL (64% vs. 44%, p < .0001) independent of injection site (breast and face). This benefit of CAL was significant for only injection volumes <100 ml (p = .03). The two groups did not differ in frequency of multiple procedures after fat grafting, but the incidence of complications was greater with CAL than non-CAL (8.4% vs. 1.5%, p = .0019). The CAL method is associated with better fat survival rate than with conventional fat grafting but only for small volumes of fat grafting (<100 ml). Nonetheless, the new technique is associated with more complications and did not reduce the number of surgical procedures needed after the first fat grafting. More prospective studies are required to draw clinical conclusions and to demonstrate the real benefit of CAL as compared with common autologous fat grafting. Copyright © 2017

  18. Repair of large segmental bone defects: BMP-2 gene activated muscle grafts vs. autologous bone grafting.

    Science.gov (United States)

    Betz, Oliver B; Betz, Volker M; Schröder, Christian; Penzkofer, Rainer; Göttlinger, Michael; Mayer-Wagner, Susanne; Augat, Peter; Jansson, Volkmar; Müller, Peter E

    2013-08-08

    Common cell based strategies for the treatment of osseous defects require the isolation and expansion of autologous cells. Since this makes such approaches time-consuming and expensive, we developed a novel expedited technology creating gene activated muscle grafts. We have previously shown that large segmental bone defects in rats can be regenerated by implantation of muscle tissue fragments activated by BMP-2 gene transfer. In the present study, we compared the bone healing capacities of such gene activated muscle grafts with bone isografts, mimicking autologous bone grafting, the clinical gold standard for treatment of bone defects in patients. Two of 14 male, syngeneic Fischer 344 rats used for this experiment served as donors for muscle and bone. Muscle tissue was harvested from both hind limbs and incubated with an adenoviral vector carrying the cDNA encoding BMP-2. Bone was harvested from the iliac crest and long bone epiphyses. Bone defects (5 mm) were created in the right femora of 12 rats and were filled with either BMP-2 activated muscle tissue or bone grafts. After eight weeks, femora were evaluated by radiographs, micro-computed tomography (μCT), and biomechanical testing. In the group receiving BMP-2 activated muscle grafts as well as in the bone-grafting group, 100% of the bone defects were healed, as documented by radiographs and μCT-imaging. Bone volume was similar in both groups and biomechanical stability of the two groups was statistically indistinguishable. This study demonstrates that treatment of large bone defects by implantation of BMP-2 gene activated muscle tissue leads to similar bone volume and stability as bone isografts, mimicking autologous bone grafting.

  19. The Safety and Efficacy of Cell-Assisted Fat Grafting to Traditional Fat Grafting in the Anterior Mid-Face: An Indirect Assessment by 3D Imaging.

    Science.gov (United States)

    Sasaki, Gordon H

    2015-12-01

    Numerous methodologies and algorithms have been suggested to enhance fat graft survival, including the usage of stromal vascular fraction (SVF) and platelet-rich plasma (PRP), but no long-term studies are available. This single-center prospective, case-controlled study investigated the safety and efficacy of combining a modified Baker-designed lateral SMASectomy or plication face lift with simultaneous anterior mid-face grafting into site-specific compartments by (1) conventional Coleman's technique or (2) Yoshimura's cell-assisted lipografting technique. On the voluntary principle, candidates selected one of four techniques for volumization of their mid-face: conventional fat grafting; PRP-assisted fat grafting; SVF-assisted fat grafting; and PRP/SVF- assisted fat grafting. For comparison data, comparable fat volumes, SVF volumes and nucleated cells, and PRP volumes and platelet concentrations were injected into each designated group. Indirect volume retentions were determined by standardized Vectra 3D analyses up to 1 year. PRP, SVF, and PRP/SVF cell supplementation of processed fat resulted in statistically significant percent mean graft retention over their baseline control at 12 months (p facial aesthetic surgery. With refinements in the entire grafting process and the potential benefits of autologous cell approaches with SVF and PRP, future evidence-based controlled studies under regulatory approval may improve graft survival in a safe and effective manner. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

  20. Autologous Fat Transfer in a Patient with Lupus Erythematosus Profundus

    Directory of Open Access Journals (Sweden)

    Jimi Yoon

    2012-10-01

    Full Text Available Lupus erythematosus profundus, a form of chronic cutaneous lupus erythematosus, is a rare inflammatory disease involving in the lower dermis and subcutaneous tissues. It primarily affects the head, proximal upper arms, trunk, thighs, and presents as firm nodules, 1 to 3 cm in diameter. The overlying skin often becomes attached to the subcutaneous nodules and is drawn inward to produce deep, saucerized depressions. We present a rare case of lupus erythematosus profundus treated with autologous fat transfer.

  1. Autologous miniature punch skin grafting in stable vitiligo

    Directory of Open Access Journals (Sweden)

    Savant S

    1992-01-01

    Full Text Available Autologous split thickness miniature punch skin grafting is one of the surgical modes of treatment of stable vitiligo. Out of 87 different sites, of stable vitiligo, occurring in 62 cases, (32 focal, 22 segmental and 8 generalised 75 sites showed total repigmentation with excellent cosmetic colour match. Out of the 62 cases, 46 cases who were treated postsurgically with PUVA therapy repigmented within 2 ½ to 3 months, 10 cases, who received no treatment postsurgically repigmented by 3 ½ to 6 months. In addition 6 cases in whom no treatment was given postsurgically had to be given PUVA therapy 3 months after surgery as there was poor repigmentation. The complications seen were graft rejection due to improper immobilization in 6 cases, graft rejection due to secondary infection in 1, contact allergic dermatitis to framycetin in 3, and reactivation of vitiligo in 2. Side effects seen were cobblestoning in 32, sinking pits in 12, variegated appearance in 4, and superficial scarring at donor site in all 62 cases.

  2. Long-term use and follow-up of autologous and homologous cartilage graft in rhinoplasty

    Directory of Open Access Journals (Sweden)

    Ghasemali Khorasani

    2016-05-01

    Full Text Available Background: Cartilage grafting is used in rhinoplasty and reconstructive surgeries. Autologous rib and nasal septum cartilage (auto graft is the preferred source of graft material in rhinoplasty, however, homologous cartilage (allograft has been extensively used to correct the nasal framework in nasal deformities. Autologous cartilage graft usage is restricted with complication of operation and limiting availability of tissue for extensive deformities. Alternatively, preserved costal cartilage allograft represents a readily available and easily contoured material. The current study was a formal systematic review of complications associated with autologous versus homologous cartilage grafting in rhinoplasty patients. Methods: In this cohort retrospective study, a total of 124 patients undergone primary or revision rhinoplasty using homologous or autologus grafts with postoperative follow-up ranging from 6 to 60 months were studied. The types of grafts and complications related to the grafts were evaluated. This included evaluation for warping, infection, resorption, mobility and fracture. Results: The total complications related to the cartilage grafts were 7 cases, which included 1 warped in auto graft group, three cases of graft displacement (two in allograft group and one in auto graft group and three fractures in allograft group. No infection and resorption was recorded. Complication rate (confidence interval 0.95 in autologous and homologous group were 1.25(0.4-3.88 and 2.08(0.78-5.55 in 1000 months follow up. There was no statistically significant difference between autologous and homologous group complications. Onset of complication in autologous and homologous group were 51.23(49.27-53.19 and 58.7(54.51-62.91 month respectively (P=0.81. Conclusion: The allograft cartilage has the advantage of avoiding donor-site scar. Moreover, it provides the same benefits as autologous costal cartilage with comparable complication rate. Therefore, it

  3. Application of adipose-derived stromal cells in fat grafting: Basic science and literature review.

    Science.gov (United States)

    Moustaki, Margarita; Papadopoulos, Othon; Verikokos, Christos; Karypidis, Dimitrios; Masud, Dhalia; Kostakis, Alkiviadis; Papastefanaki, Florentia; Roubelakis, Maria G; Perrea, Despoina

    2017-09-01

    Autologous fat is considered the ideal material for soft-tissue augmentation in plastic and reconstructive surgery. The primary drawback of autologous fat grafting is the high resorption rate. The isolation of mesenchymal stem cells from adipose tissue inevitably led to research focusing on the study of combined transplantation of autologous fat and adipose derived stem cells (ADSCs) and introduced the theory of 'cell-assisted lipotransfer'. Transplantation of ADSCs is a promising strategy, due to the high proliferative capacity of stem cells, their potential to induce paracrine signalling and ability to differentiate into adipocytes and vascular cells. The current study examined the literature for clinical and experimental studies on cell-assisted lipotransfer to assess the efficacy of this novel technique when compared with traditional fat grafting. A total of 30 studies were included in the present review. The current study demonstrates that cell-assisted lipotransfer has improved efficacy compared with conventional fat grafting. Despite relatively positive outcomes, further investigation is required to establish a consensus in cell-assisted lipotransfer.

  4. Use of autologous grafts in the treatment of acquired penile curvature: An experience of 33 cases

    Directory of Open Access Journals (Sweden)

    Abdul Rouf Khawaja

    2016-01-01

    Conclusion: Tunical lengthening procedures by autologous free grafts represents a safe and reproducible technique. A good preoperative erectile function is required for tunical lengthening procedure. Temporalis fascia graft is thin, tough membrane and effective graft for PD with good cosmetic and functional results.

  5. Hand Rejuvenation: A Comprehensive Review of Fat Grafting.

    Science.gov (United States)

    Hoang, Don; Orgel, Matthew I; Kulber, David A

    2016-05-01

    Dermal atrophy, bulging reticular veins, and prominent bones and tendons are characteristic of the aging hand. Demand for cosmetic procedures to restore a youthful appearance to the dorsum of the hand has risen in recent years. A review of the literature reveals that of the many options for hand restoration, autologous fat grafting stands out as the most promising choice compared with many available alternative options such as microdermabrasion, peeling agents, and dermal fillers. This article details the surgical technique and relevant anatomy necessary for successful hand rejuvenation. Future advancements may rely on further study into adipose-derived stem cells. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  6. Treatment of osteochondritis dissecans of the femoral condyle with autologous bone grafts and matrix-supported autologous chondrocytes

    Science.gov (United States)

    Bruns, Juergen; Deuretzbacher, Georg; Ruether, Wolfgang; Fuerst, Martin; Niggemeyer, Oliver

    2009-01-01

    The objective of this study was to determine the clinical outcome of combined bone grafting and matrix-supported autologous chondrocyte transplantation in patients with osteochondritis dissecans of the knee. Between January 2003 and March 2005, 21 patients (mean age 29.33 years) with symptomatic osteochondritis dissecans (OCD) of the medial or lateral condyle (grade III or IV) of the knee underwent reconstruction of the joint surface by autologous bone grafts and matrix-supported autologous chondrocyte transplantation. Patients were followed up at three, six, 12 and 36 months to determine outcomes by clinical evaluation based on Lysholm score, IKDC and ICRS score. Clinical results showed a significant improvement of Lysholm-score and IKDC score. With respect to clinical assessment, 18 of 21 patients showed good or excellent results 36 months postoperatively. Our study suggests that treatment of OCD with autologous bone grafts and matrix-supported autologous chondrocytes is a possible alternative to osteochondral cylinder transfer or conventional ACT. PMID:19626325

  7. Autologous Fat Transfer: An Aesthetic and Functional Refinement for Parotidectomy

    Directory of Open Access Journals (Sweden)

    Pierre G. Vico

    2014-01-01

    Full Text Available Parotidectomy is a surgical procedure associated to functional (Frey’s syndrome as well as aesthetic (facial asymmetry complications that can be very disturbing for the patient. Several procedures have been described to primarily avoid or secondarily reconstruct the facial defect and treat the neurological iatrogenic syndrome. Autologous fat transfer was primarily used in 10 cases to avoid such complications. It is an easy technique widely used in cosmetic and reconstructive surgery. This technique gives very satisfying long-term results on the cosmetic as well as on the physiological point of view.

  8. Treatment of severe osteochondral defects of the knee by combined autologous bone grafting and autologous chondrocyte implantation using fibrin gel

    NARCIS (Netherlands)

    Konst, Y.E.; Benink, R.J.; Veldstra, R.; van der Krieke, T.J.; Helder, M.N.; van Royen, B.J.

    2012-01-01

    Purpose: Severe symptomatic and unstable osteochondral defects of the knee are difficult to treat. A variety of surgical techniques have been developed. However, the optimal surgical technique is still controversial. We present a novel technique in which autologous bone grafting is combined with

  9. Use of dermal fat graft for augmentation of the labia majora.

    Science.gov (United States)

    Salgado, Christopher J; Tang, Jennifer C; Desrosiers, Arthur E

    2012-02-01

    Dermal fat grafts have been utilized in plastic surgery for both reconstructive and aesthetic purposes of the face, breast, and body. There are multiple reports in the literature on the male phallus augmentation with the use of dermal fat grafts. Few reports describe female genitalia aesthetic surgery, in particular rejuvenation of the labia majora. In this report we describe an indication and use of autologous dermal fat graft for labia majora augmentation in a patient with loss of tone and volume in the labia majora. We found that this procedure is an option for labia majora augmentation and provides a stable result in volume-restoration. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. Is there evidence that barrier membranes prevent bone resorption in autologous bone grafts during the healing period? A systematic review

    NARCIS (Netherlands)

    Gielkens, Pepijn F. M.; Bos, Ruud R. M.; Raghoebar, Gerry M.; Stegenga, Boudewijn

    2007-01-01

    Introduction: Autologous bone is considered the "reference standard" for bone-grafting procedures. A barrier membrane covering an autologous bone graft (guided bone regeneration [GBR]) is expected to prevent graft resorption. Good clinical results have been reported for GBR, although potential

  11. Three-Dimensional Volumetric Analysis of 3 Fat-Processing Techniques for Facial Fat Grafting: A Randomized Clinical Trial.

    Science.gov (United States)

    Wu, Rongwei; Yang, Xiaonan; Jin, Xiaolei; Lu, Haibin; Jia, Zhenhua; Li, Binghang; Jiang, Haiyue; Qi, Zuoliang

    2018-01-11

    Autologous fat grafting has revolutionized the field of facial soft-tissue augmentation, despite a lack of standardization. Objective data are needed to arrive at consensus regarding the best technique for optimal volume retention. To compare 3 fat-processing techniques with 3-dimensional (3-D) technology to explore the optimal fat-processing technique for improving the volume retention of grafted fat. From September 2015 to December 2016, patients with facial asymmetry were treated by initial facial fat grafting at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Sixty-three patients (21 per group) were randomized to 1 of 3 fat-processing techniques: sedimentation, centrifugation, and cotton pad filtration. Patients underwent 3-D scanning preoperatively and at 1, 3, 6, and 12 months postoperatively. Patients who did not complete preoperative or postoperative follow-up and 3-D imaging were excluded from the analysis. Autologous fat grafting to correct facial asymmetry. The percentage volume maintenance of each fat-processing technique was measured with 3-D software and analyzed with variance analysis. Of the 63 randomized patients, 30 (7 men, 23 women; mean [SD] age at surgery, 22.2 [8.0] years) completed follow-up. The mean (SD) percentage volume maintenance of the 3 groups at 1, 3, 6, and 12 months postoperatively was, respectively, 49% (4%), 45% (3%), 43% (3%), and 41% (3%) for the cotton pad filtration group; 41% (3%), 38% (4%), 36% (4%), and 34% (3%) for the centrifugation group; and 37% (4%), 34% (4%), 31% (3%), and 31% (3%) for sedimentation group. The variance analysis showed that the cotton pad filtration group demonstrated a statistically significant higher percentage volume maintenance in comparison with the centrifugation and sedimentation groups. The use of 3-D technology provides an objective and accurate way to evaluate different fat-processing techniques. Autologous fat processed by cotton pad

  12. Sublabial Autologous Ear Cartilage Grafting for Increasing the Nasolabial Angle

    Directory of Open Access Journals (Sweden)

    Rajko Toncic

    2016-01-01

    Full Text Available BackgroundThe loss of nasal tip support is caused by many factors and eventually results in the collapse and eventual dropping of the nasal tip. This reduces the nasolabial (NL angle and negatively affects respiratory functions and one's appearance.MethodsThe aim of this retrospective study, which was conducted on 52 patients, was to present and popularize a simple and effective method for the reconstruction of a weakened columella by inserting an autologous ear cartilage graft using a sublabial approach.ResultsOf all the patients, three patients experienced transplant rejection. The period of follow-up observation was one to five years (mean, 27 months. The results were objectively evaluated by measuring the NL angle in standardized photos before and after the procedure at different time intervals over the follow-up period. We observed a significant increase of the NL angle (mean, 20°, and found these results to be durable over the long term. Of the 52 patients included in this study observed patients, three were dissatisfied (due to immediate infection and shifting of the strut, 28 were satisfied, and 21 were very satisfied.ConclusionsThe surgical method described here is simple and can be learned quickly. It has very good results with few complications, and is our method of choice for complex and serious cases seen in everyday rhinosurgical practice.

  13. Quantifying Long-term Retention of Excised Fat Grafts

    DEFF Research Database (Denmark)

    Herly, Mikkel; Ørholt, Mathias; Glovinski, Peter V.

    2017-01-01

    Background: Predicting the degree of fat graft retention is essential whenplanning reconstruction or augmentation with free fat grafting. Most surgeonsobserve volume loss over time after fat grafting; however, the portion lost toresorption after surgery is still poorly defined, and the time...... to reach steadystate is unknown. Methods: The authors compiled a retrospective, longitudinal cohort of patientswith vestibular schwannoma who had undergone ablative surgery and reconstructionwith excised fat between the years 2006 and 2015. Fat volume retentionwas quantified by computed tomography....... The average baseline graft volumewas 18.1 ± 4.8 ml. The average time to reach steady state was 806 days aftertransplantation. By this time, the average fat graft retention was 50.6 percent(95 percent CI, 46.4 to 54.7 percent). No statistically significant association wasfound between baseline graft volume...

  14. Micro-Autologous Fat Transplantation for Treating a Gummy Smile.

    Science.gov (United States)

    Huang, Shu-Hung; Huang, Yu-Hao; Lin, Yun-Nan; Lee, Su-Shin; Chou, Chih-Kang; Lin, Tsung-Ying; Takahashi, Hidenobu; Kuo, Yur-Ren; Lai, Chung-Sheng; Lin, Sin-Daw; Lin, Tsai-Ming

    2018-03-16

    A gummy smile is treated using a number of techniques, including botulinum toxin injection and various surgical interventions. Micro-autologous fat transplantation (MAFT) is a potentially advantageous alternative approach that has not been previously evaluated. This study sought to determine the long-term results of MAFT in patients with a gummy smile. Seven patients with gummy smiles were evaluated for MAFT treatment between October 2015 and April 2017. Centrifuged purified fat was micro-transplanted into the nasolabial groove, ergotrid, and upper lip areas using the MAFT-GUN while the patients were under total intravenous anesthesia. The mean age of the 7 patients was 31 years (range, 23-40 years). The mean operating time for MAFT was 52 minutes (range, 40-72 minutes), and the mean volume of fat delivered to the nasolabial groove, ergotrid, and upper lip was 16.1 mL. The mean decreases of gingival display in the right canine incisor, left canine incisor, right canine, and left canine teeth were 4.9, 4.6, 3.8, and 4.4 mm, respectively. The smiles of the 7 patients showed significant improvement at an average follow-up time of 12.9 months. Gummy smile treatment using MAFT is an effective, reliable, and relatively simple method, with high patient satisfaction and minimal risk of complications.

  15. Do Stem Cells Have an Effect When We Fat Graft?

    Science.gov (United States)

    Rinker, Brian D; Vyas, Krishna S

    2016-06-01

    Fat grafting has become a widely accepted modality of soft tissue restoration and has found applications in many areas of aesthetic and reconstructive plastic surgery. Numerous claims have been made regarding the regenerative effects of fat grafting on the recipient bed. The purpose of this paper is to survey the available literature to answer the question of whether fat grafting has a positive effect on the surrounding tissues. It has been convincingly demonstrated that fat grafts contain viable adipose-derived stem cells (ASCs). The fate of these cells is determined by the microenvironment of the recipient bed, but animal studies have shown that a large fraction of ASCs survive engraftment. Numerous clinical studies have demonstrated the positive effects of fat grafting on recipient tissues. Improvement in validated scar scores as well as scar stiffness measurements have been documented after fat grafting of burn scars. Fat grafting has also been convincingly demonstrated to improve the quality of irradiated tissues, as measured by validated clinical scales and staged histology. It is ultimately unclear whether ASCs are responsible for these effects, but the circumstantial evidence is weighty. Fat grafting is effective for volumizing and improving skin quality in the setting of radiation, burns, and other scars. The observed effects are likely due to ASCs, but the evidence does not support the routine use of ASC-enriched fat grafts.

  16. Micro-autologous Fat Transplantation (MAFT) for Forehead Volumizing and Contouring.

    Science.gov (United States)

    Chou, C K; Lee, S S; Lin, T Y; Huang, Y H; Takahashi, H; Lai, C S; Lin, S D; Lin, T M

    2017-08-01

    Frontal fullness in Asians is often considered to indicate one's public popularity and leadership skills. Numerous materials and techniques have been applied clinically to recontour or volumize the frontal area, with variable results. The micro-autologous fat transplantation (MAFT) technique proposed by Lin et al. (2nd academic congress of Taiwan Cosmetic Association Taipei, Taiwan) in 2007 has demonstrated its feasibility in facial rejuvenation. In the present study, we used an innovative instrument to apply the MAFT technique to frontal augmentation with fat grafting and reported the results. MAFT was performed on 178 patients (167 female, 11 male) during a 5-year period starting in January 2010. Fat was harvested by liposuction, processed and refined by centrifugation at 1200×g for 3 min. The purified fat was micro-transplanted for frontal contouring with the assistance of an instrument, the MAFT-GUN. The patients were followed up regularly, and photographs were taken for comparison. On average, the MAFT procedure took 52 min to complete. The average amount of delivered fat was 10.2 mL. The follow-up period was 34 months on average. No complications, including neurovascular injury, skin necrosis, abscess, nodulation, calcification or irregularity, were noted. A patient-rated satisfaction 5-point Likert scale demonstrated that 83.1% of all patients had favorable results (48.3% were satisfied, and 34.8% were very satisfied). The concept and technique of MAFT has changed fat grafting from an operation with unpredictable clinical results to an easy, reliable and consistent procedure. Furthermore, the use of a precisely controlled instrument enabled surgeons to perform highly accurate micro-fat grafting. In comparison with other strategies for volume restoration, the MAFT procedure demonstrated high patient satisfaction with the long-term results. Therefore, the use of MAFT as an alternative approach to forehead contouring and volumizing was addressed. This

  17. Comparison of three different fat graft preparation methods: gravity separation, centrifugation, and simultaneous washing with filtration in a closed system.

    Science.gov (United States)

    Zhu, Min; Cohen, Steven R; Hicok, Kevin C; Shanahan, Rob K; Strem, Brian M; Yu, Johnson C; Arm, Douglas M; Fraser, John K

    2013-04-01

    Successful long-term volume retention of an autologous fat graft is problematic. The presence of contaminating cells, tumescent fluid, and free lipid in the graft contributes to disparate outcomes. Better preparation methods for the fat graft before transplantation may significantly improve results. Subcutaneous fat from 22 donors was divided and processed using various graft preparation methods: (1) no manipulation control, (2) gravity separation, (3) Coleman centrifugation, and (4) simultaneous washing with filtration using a commercially available system (Puregraft; Cytori Therapeutics, Inc., San Diego, Calif.). Fat grafts from various preparation methods were examined for free lipid, aqueous liquid, viable tissue, and blood cell content. Adipose tissue viability was determined by measuring glycerol release after agonist induction of lipolysis. All test graft preparation methods exhibited significantly less aqueous fluid and blood cell content compared with the control. Grafts prepared by washing with filtration exhibited significantly reduced blood cell and free lipid content, with significantly greater adipose tissue viability than other methods. Washing with filtration within a closed system produces a fat graft with higher tissue viability and lower presence of contaminants compared with grafts prepared by alternate methods.

  18. Effects of the Diabetic Condition on Grafted Fat Survival: An Experimental Study Using Streptozotocin-Induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Jae A Jung

    2014-05-01

    Full Text Available Background Autologous fat grafts have been widely used for cosmetic purposes and for soft tissue contour reconstruction. Because diabetes mellitus is one of the major chronic diseases in nearly every country, the requirement for fat grafts in diabetes patients is expected to increase continuously. However, the circulation complications of diabetes are serious and have been shown to involve microvascular problems, impairing ischemia-driven neovascularization in particular. After injection, revascularization is vital to the survival of the grafted fat. In this study, the authors attempted to determine whether the diabetic condition inhibits the survival of injected fat due to impaired neovascularization. Methods The rat scalp was used for testing fat graft survival. Forty-four seven-week-old male Sprague-Dawley rats were allocated to a diabetic group or a control group. 1.0 mL of processed fat was injected subcutaneously into the scalp of each rat. The effect of diabetes was evaluated by calculating the volume and the weight of the grafted fat and by histologically analyzing the fat sections. Results The surviving fat graft volume and weight were considerably smaller in the diabetic group than in the control group (P<0.05, and histological evaluations showed less vascularity, and more cysts, vacuoles, and fibrosis in the diabetic group (P<0.05. Cellular integrity and inflammation were not considerably different in the two groups. Conclusions As the final outcome, we found that the presence of diabetes might impair the survival and the quality of fat grafts, as evidenced by lower fat graft weights and volumes and poor histologic graft quality.

  19. Heat-Shock Protein 70 Overexpression in Adipose-Derived Stem Cells Enhances Fat Graft Survival.

    Science.gov (United States)

    Feng, Hao; Qiu, Lihong; Zhang, Teng; Yu, Houyou; Ma, Xianjie; Su, Yingjun; Zheng, Hui; Wang, Yong; Yi, Chenggang

    2017-04-01

    Autologous fat grafting is a prevalent technique used for soft-tissue augmentation; however, the poor survival rate of the grafted tissue remains a drawback of this method. Although adipose-derived stem cells (ASCs) are an attractive candidate for enhancing graft retention, the poor posttransplantation viability of these cells limits their application. Here we investigated whether overexpression of the antiapoptotic protein heat-shock protein 70 (Hsp70) could enhance ASCs' therapeutic potential for fat transplant survival. Recombinant adenoviral vectors were used to overexpress Hsp70 in ASCs isolated from a healthy woman. The Hsp70 expression was assessed by quantitative real-time polymerase chain reaction and Western blot analyses. The adipose tissue granules aspirated from another woman were mixed with ASCs expressing green fluorescent protein (GFP)-tagged Hsp70 (group A) or GFP alone (group B), untreated ASCs (group C), and phosphate-buffered saline (group D). Fat mixtures were then injected subcutaneously into the backs of nude mice, and graft survival was compared after 3 months. Adipose-derived stem cells transduced with recombinant adenoviral vectors exhibited significantly increased Hsp70 expression in vitro. Meanwhile, weight retention analyses demonstrated that fat grafts using the group A cell population exhibited significantly higher survival rates than the other treatment groups in vivo. Moreover, histological analyses revealed that fat grafts containing GFP-Hsp70-expressing ASCs yielded significantly lower levels of tissue fibrosis and fat cysts/vacuoles, higher capillary densities, and increased numbers of viable adipocytes than the control groups. Our data indicate that Hsp70 overexpression enhances the efficacy of ASC therapy by improving the survival and quality of the transplanted fat tissues.

  20. Allogeneic adipose-derived stem cells promote survival of fat grafts in immunocompetent diabetic rats.

    Science.gov (United States)

    Zhang, Jun; Bai, Xiaozhi; Zhao, Bin; Wang, Yunchuan; Su, Linlin; Chang, Peng; Wang, Xujie; Han, Shichao; Gao, Jianxin; Hu, Xiaolong; Hu, Dahai; Liu, Xiaoyan

    2016-05-01

    Autologous adipose-derived stem cells (ADSCs) can protect fat grafts in cell-assisted lipotransfer (CAL). However, diabetes alters the intrinsic properties of ADSCs and impairs their function so that they lack these protective effects. We investigate whether allogeneic ADSCs from healthy donors could protect fat grafts in immunocompetent diabetic rats. Syngeniec adipose tissues and ADSCs were derived from diabetic Lewis (LEW) rats, whereas allogeneic ADSCs were from healthy brown-Norway rats. A grafted mixture containing 0.7 ml granule fat and 0.3 ml 6 × 10(6) allogeneic/syngeneic ADSCs was injected subcutaneously on the skulls of diabetic LEW rats. Fat samples were harvested to evaluate the levels of injury and vascularization as shown by perilipin A, CD34 and VEGF at 14 days. The immune response was evaluated with a lymphocytotoxicity test and the CD4/CD8 ratio in peripheral blood at 14 days. The volume retention of fat grafts was measured at 3 months. Healthy allogeneic ADSCs increased the expression levels of perilipin A, CD34 and VEGF at 14 days. The volume retention of fat grafts was improved by allogeneic ADSCs at 3 months. ADSCs were demonstrated to have low immunogenicity by the lymphocyte proliferation test and immunophenotype including MHC and co-stimulatory markers. The lymphocytotoxicity test and CD4/CD8 ratio indicated no obvious immune response elicited by allogeneic ADSCs. Thus, healthy allogeneic ADSCs can promote the survival of fat grafts in this immunocompetent diabetic rat model, with little or no obvious immune rejection.

  1. A classification of clinical fat grafting: different problems, different solutions.

    Science.gov (United States)

    Del Vecchio, Daniel; Rohrich, Rod J

    2012-09-01

    Fat grafting has reemerged from a highly variable procedure to a technique with vast reconstructive and cosmetic potential. Largely because of a more disciplined and scientific approach to fat grafting as a transplantation event, early adopters of fat transplantation have begun to approach fat grafting as a process, using sound surgical transplantation principles: recipient preparation, controlled donor harvest, time-efficient transplantation, and proper postoperative care. Despite these principles, different fat grafting techniques yield impressive clinical outcomes. The essential variables of four types of fat grafting cases were identified and compared: harvesting, methods of cell processing, methods of transplantation, and management of the recipient site. Each case differed for most of the variables analyzed. The two clinical drivers that most impacted these differences were the volume demands of the recipient site and whether the recipient site was healthy tissue or pathologic tissue. After these two drivers, a matrix classification of small-volume versus large-volume and regenerative versus nonregenerative cases yields four distinct categories. Not all fat grafting is the same. Fat grafting, once thought to be a simple technique with variable results, is a much more complex procedure with at least four definable subtypes. By defining the essential differences in the recipient site, the key driver in fat transplantation, the proper selection of technique can be best chosen. In fat transplantation, different problems require different solutions.

  2. Facial rejuvenation: Serial fat graft transfer | Saad Ibrahiem ...

    African Journals Online (AJOL)

    Autologous fat transfer is a century-old method for both aesthetic and reconstructive purposes. It is considered by many plastic surgeons the ideal body filler. The only disadvantage is its variable degree of resorption, which ranged from 45% to 80%. Various groups have studied the effects of cryo-preservation for fat storage, ...

  3. The composite of bone marrow concentrate and PRP as an alternative to autologous bone grafting.

    Directory of Open Access Journals (Sweden)

    Mohssen Hakimi

    Full Text Available One possible alternative to the application of autologous bone grafts represents the use of autologous bone marrow concentrate (BMC. The purpose of our study was to evaluate the potency of autologous platelet-rich plasma (PRP in combination with BMC. In 32 mini-pigs a metaphyseal critical-size defect was surgically created at the proximal tibia. The animals were allocated to four treatment groups of eight animals each (1. BMC+CPG group, 2. BMC+CPG+PRP group, 3. autograft group, 4. CPG group. In the BMC+CPG group the defect was filled with autologous BMC in combination with calcium phosphate granules (CPG, whereas in the BMC+CPG+PRP group the defect was filled with the composite of autologous BMC, CPG and autologous PRP. In the autograft group the defect was filled with autologous cancellous graft, whereas in the CPG group the defect was filled with CPG solely. After 6 weeks radiological and histomorphometrical analysis showed significantly more new bone formation in the BMC+CPG+PRP group compared to the BMC+CPG group and the CPG group. There were no significant differences between the BMC+CPG+PRP group and the autograft group. In the PRP platelets were enriched significantly about 4.7-fold compared to native blood. In BMC the count of mononuclear cells increased significantly (3.5-fold compared to the bone marrow aspirate. This study demonstrates that the composite of BMC+CPG+PRP leads to a significantly higher bone regeneration of critical-size defects at the proximal tibia in mini-pigs than the use of BMC+CPG without PRP. Furthermore, within the limits of the present study the composite BMC+CPG+PRP represents a comparable alternative to autologous bone grafting.

  4. The composite of bone marrow concentrate and PRP as an alternative to autologous bone grafting.

    Science.gov (United States)

    Hakimi, Mohssen; Grassmann, Jan-Peter; Betsch, Marcel; Schneppendahl, Johannes; Gehrmann, Sebastian; Hakimi, Ahmad-Reza; Kröpil, Patric; Sager, Martin; Herten, Monika; Wild, Michael; Windolf, Joachim; Jungbluth, Pascal

    2014-01-01

    One possible alternative to the application of autologous bone grafts represents the use of autologous bone marrow concentrate (BMC). The purpose of our study was to evaluate the potency of autologous platelet-rich plasma (PRP) in combination with BMC. In 32 mini-pigs a metaphyseal critical-size defect was surgically created at the proximal tibia. The animals were allocated to four treatment groups of eight animals each (1. BMC+CPG group, 2. BMC+CPG+PRP group, 3. autograft group, 4. CPG group). In the BMC+CPG group the defect was filled with autologous BMC in combination with calcium phosphate granules (CPG), whereas in the BMC+CPG+PRP group the defect was filled with the composite of autologous BMC, CPG and autologous PRP. In the autograft group the defect was filled with autologous cancellous graft, whereas in the CPG group the defect was filled with CPG solely. After 6 weeks radiological and histomorphometrical analysis showed significantly more new bone formation in the BMC+CPG+PRP group compared to the BMC+CPG group and the CPG group. There were no significant differences between the BMC+CPG+PRP group and the autograft group. In the PRP platelets were enriched significantly about 4.7-fold compared to native blood. In BMC the count of mononuclear cells increased significantly (3.5-fold) compared to the bone marrow aspirate. This study demonstrates that the composite of BMC+CPG+PRP leads to a significantly higher bone regeneration of critical-size defects at the proximal tibia in mini-pigs than the use of BMC+CPG without PRP. Furthermore, within the limits of the present study the composite BMC+CPG+PRP represents a comparable alternative to autologous bone grafting.

  5. Chronologic changes of free fat graft in rabbit using CT

    International Nuclear Information System (INIS)

    Kondo, Norihiro; Kurita, Kenichi; Yajima, Tetsuya; Izumi, Masahiro

    2008-01-01

    Free fat grafts are now used for preventing osteal readhesion, filling dead space, and protecting grafted nerves and vessels. However, it is reported that grafted fat tissue is unstable resulting in high risk of cicatrization and infection. We grafted free fat to a rabbit's back and observed the chronologic change using CT. Ten adult male Japanese white rabbits (3.5 kg) were used. In five rabbits, fat tissue was obtained from the back under general anaesthesia, and transplanted into the back about 50 mm posterior from the donor site. CT was taken in the fixed scan condition five times (preoperation, immediate postoperation, postoperative 1-month, 2-month, and 3-month). In the remaining five rabbits, only CT scan was taken three times as a control. It was observed that we compared preoperative fat volume with the postoperative volume using RealINTAGE. Grafted fat tissue decreased postoperatively at 1-month and completely disappeared at 3-months. We were able to prove that CT scan is effective to observe the chronologic change of grafted fat tissue. Techniques of tissue engineering are necessary for survival of grafted fat tissue. (author)

  6. Use of autologous grafts in the treatment of acquired penile curvature: An experience of 33 cases.

    Science.gov (United States)

    Khawaja, Abdul Rouf; Dar, Tanveer Iqbal; Zahur, Suhael; Tariq, Sheikh; Hamid, Arf; Wani, M S; Wazir, B S; Iqbal, Arsheed

    2016-01-01

    The objective was to compare the use of autologous dermal and temporalis fascia grafts in the treatment of acquired penile curvatures. It was a prospective observational study of 33 cases, conducted in Sher-i-Kashmir Institute of Medical Sciences, Srinagar from March 2007 to September 2013. All the patients had stable Peyronies disease (PD). Dorsal, dorsolateral and vental curvatures with good preoperative erections were included. PD index with visual analog scales for curvature was used preoperatively. An informed written consent was taken from all the patients with main emphasis on erectile dysfunction. After an average follow up of 2 years, complete straightening of penis was observed in all patients with satisfactory sexual intercourse in 30 patients (90%). Three patients (10%) required frequent use of type 5 phosphodiesterase inhibitors for adequate erections. Overall 91% of patients and partners were satisfied with the procedure and cosmetically donor site was better in temporalis fascia graft site. No rejection of any graft was noted and glans hypoesthesia was noticed in 4 patients (12%). None of the patients required penile prosthesis. Total operative time for harvesting and application of the graft was more in dermal grafts (>3 hrs) than for temporalis fascia graft (2 hrs). Tunical lengthening procedures by autologous free grafts represents a safe and reproducible technique. A good preoperative erectile function is required for tunical lengthening procedure. Temporalis fascia graft is thin, tough membrane and effective graft for PD with good cosmetic and functional results.

  7. Stability of simultaneously placed dental implants with autologous bone grafts harvested from the iliac crest or intraoral jaw bone.

    Science.gov (United States)

    Kang, Young-Hoon; Kim, Hyun-Min; Byun, June-Ho; Kim, Uk-Kyu; Sung, Iel-Yong; Cho, Yeong-Cheol; Park, Bong-Wook

    2015-12-30

    Jaw bone and iliac bone are the most frequently used autologous bone sources for dental implant placement in patients with atrophic alveolar ridges. However, the comparative long-term stability of these two autologous bone grafts have not yet been investigated. The aim of this study was to compare the stability of simultaneously placed dental implants with autologous bone grafts harvested from either the iliac crest or the intraoral jaw bone for severely atrophic alveolar ridges. In total, 36 patients (21 men and 15 women) were selected and a retrospective medical record review was performed. We compared the residual increased bone height of the grafted bone, peri-implantitis incidence, radiological density in newly generated bones (HU values), and implant stability using resonance frequency analysis (ISQ values) between the two autologous bone graft groups. Both autologous bone graft groups (iliac bone and jaw bone) showed favorable clinical results, with similar long-term implant stability and overall implant survival rates. However, the grafted iliac bone exhibited more prompt vertical loss than the jaw bone, in particular, the largest vertical bone reduction was observed within 6 months after the bone graft. In contrast, the jaw bone graft group exhibited a slower vertical bone resorption rate and a lower incidence of peri-implantitis during long-term follow-up than the iliac bone graft group. These findings demonstrate that simultaneous dental implantation with the autologous intraoral jaw bone graft method may be reliable for the reconstruction of edentulous atrophic alveolar ridges.

  8. Use of autologous bone graft in anterior cervical decompression: morbidity & quality of life analysis.

    LENUS (Irish Health Repository)

    Heneghan, Helen M

    2009-01-01

    BACKGROUND: Autologous iliac crest graft has long been the gold standard graft material used in cervical fusion. However its harvest has significant associated morbidity, including protracted postoperative pain scores at the harvest site. Thus its continued practice warrants scrutiny, particularly now that alternatives are available. Our aims were to assess incidence and nature of complications associated with iliac crest harvest when performed in the setting of Anterior Cervical Decompression (ACD). Also, to perform a comparative analysis of patient satisfaction and quality of life scores after ACD surgeries, when performed with and without iliac graft harvest. METHODS: All patients who underwent consecutive ACD procedures, with and without the use of autologous iliac crest graft, over a 48 month period were included (n = 53). Patients were assessed clinically at a minimum of 12 months postoperatively and administered 2 validated quality of life questionnaires: the SF-36 and Cervical Spine Outcomes Questionnaires (Response rate 96%). Primary composite endpoints included incidence of bone graft donor site morbidity, pain scores, operative duration, and quality of life scores. RESULTS: Patients who underwent iliac graft harvest experienced significant peri-operative donor site specific morbidity, including a high incidence of pain at the iliac crest (90%), iliac wound infection (7%), a jejunal perforation, and longer operative duration (285 minutes vs. 238 minutes, p = 0.026). Longer term follow-up demonstrated protracted postoperative pain at the harvest site and significantly lower mental health scores on both quality of life instruments, for those patients who underwent autologous graft harvest CONCLUSION: ACD with iliac crest graft harvest is associated with significant iliac crest donor site morbidity and lower quality of life at greater than 12 months post operatively. This is now avoidable by using alternatives to autologous bone without compromising clinical

  9. Socket grafting with the use of autologous bone: an experimental study in the dog.

    Science.gov (United States)

    Araújo, Mauricio G; Lindhe, Jan

    2011-01-01

    studies in humans and animals have shown that following tooth removal (loss), the alveolar ridge becomes markedly reduced. Attempts made to counteract such ridge diminution by installing implants in the fresh extraction sockets were not successful, while socket grafting with anorganic bovine bone mineral prevented ridge contraction. to examine whether grafting of the alveolar socket with the use of chips of autologous bone may allow ridge preservation following tooth extraction. in five beagle dogs, the distal roots of the third and fourth mandibular premolars were removed. The sockets in the right or the left jaw quadrant were grafted with either anorganic bovine bone or with chips of autologous bone harvested from the buccal bone plate. After 3 months of healing, biopsies of the experimental sites were sampled, prepared for buccal-lingual ground sections and examined with respect to size and composition. it was observed that the majority of the autologous bone chips during healing had been resorbed and that the graft apparently did not interfere with socket healing or processes that resulted in ridge resorption. autologous bone chips placed in the fresh extraction socket will (i) neither stimulate nor retard new bone formation and (ii) not prevent ridge resorption that occurs during healing following tooth extraction.

  10. Autologous graft-versus-host disease induction in advanced breast cancer: role of peripheral bloodprogenitor cells

    NARCIS (Netherlands)

    Wall, E. van der; Horn, T.; Bright, E.; Passos-Coehlo, J-L.; Bond, S.; Clarke, B.; Altomonte, V.; McIntyre, K.; Vogelsang, G.; Noga, S.J.; Davis, J.M.; Thomassen, J.; Ohly, K.V.; Lee, S.M.; Fetting, J.; Armstrong, D.K.; Davidson, N.E.; Hess, A.D.; Kennedy, M.J.

    2000-01-01

    The purpose of the present study was to investigate the impact of the use of peripheral blood progenitor cells (PBPCs) on the induction of autologous graft-versus-host disease (GVHD) in patients with advanced breast cancer. 14 women with stage IIIB and 36 women with stage IV breast cancer received

  11. Treatment of midshaft clavicular nonunion with plate fixation and autologous bone grafting

    DEFF Research Database (Denmark)

    Olsen, Bo Sanderhoff; Vaesel, M T; Søjbjerg, Jens Ole

    1995-01-01

    , and one had a failure. Thirteen of 16 patients were satisfied with the cosmetic outcome, assessing their cosmetic result as either good or excellent. Rigid plate fixation and restoration of clavicular length with autologous cancellous bone graft is recommended for the treatment of symptomatic clavicular...

  12. Biodegradable p(DLLA-epsilon-CL) nerve guides versus autologous nerve grafts : Electromyographic and video analysis

    NARCIS (Netherlands)

    Meek, MF; Nicolai, JPA; Gramsbergen, A; van der Werf, J.F.A.

    The aim of this study was to evaluate the functional effects of bridging a gap in the sciatic nerve of the rat with either a biodegradable copolymer of (DL)-lactide and epsilon -caprolactone [p(DLLA-epsilon -CL)] nerve guide or an autologous nerve graft. Electromyograms (EMGs) of the gastrocnemius

  13. Poly(DL-lactide-epsilon-caprolactone) nerve guides perform better than autologous nerve grafts

    NARCIS (Netherlands)

    DenDunnen, WFA; VanderLei, B; Schakenraad, JM; Stokroos, [No Value; Blaauw, E; Pennings, AJ; Robinson, PH; Bartels, H.

    1996-01-01

    The aim of this study was to compare the speed and quality of nerve regeneration after reconstruction using a biodegradable nerve guide or an autologous nerve graft. We evaluated nerve regeneration using light microscopy, transmission electron microscopy and morphometric analysis. Nerve regeneration

  14. A novel noninvasive three-dimensional volumetric analysis for fat-graft survival in facial recontouring using the 3L and 3M technique.

    Science.gov (United States)

    Zhu, Ming; Xie, Yun; Zhu, Yijia; Chai, Gang; Li, Qingfeng

    2016-02-01

    Autologous fat grafting for volume augmentation in soft tissue has grown in popularity in the plastic surgery. The aim of this study is to provide a new three-dimensional (3D) modeling and analyzing technique for evaluating long-term outcomes of autologous fat graft. A retrospective study was conducted using the medical records of 22 patients who underwent autologous fat grafting by using our "3L and 3M" technique. The average follow-up period was 12 months. Every patient received 3D scanning before and 3, 6, and 12 months after the operation. The 3D facial models were analyzed with corresponding analyzing software to quantify the volume discrepancy at different periods. The retention rate of fat was calculated by comparing both postoperative and preoperative images. In the objective evaluation, the average injected fat volume was 18 ± 12.68 ml, while the average survival fat volume was 11.61 ± 7.58 ml at 3 months, 9.05 ± 5.59 ml at 6 months, and 7.97 ± 4.57 ml at the last follow-up, respectively. Therefore, the amount of fat graft remaining in the recipient sites was 28.94-56.25% (average 44.53 ± 6.32%) at 12 months after operation. In this study, we have demonstrated the ability to use the novel noninvasive 3D volumetric analysis for the survival of fat graft. We consider that the "3L and 3M" technique is an effective and long-lasting treatment of fat grafting for correcting congenital or acquired defects compared with the outcomes of fat grafting reported by other researchers. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Substitutes of structural and non-structural autologous bone grafts in hindfoot arthrodeses and osteotomies: a systematic review.

    Science.gov (United States)

    Müller, Marc Andreas; Frank, Alexander; Briel, Matthias; Valderrabano, Victor; Vavken, Patrick; Entezari, Vahid; Mehrkens, Arne

    2013-02-07

    Structural and non-structural substitutes of autologous bone grafts are frequently used in hindfoot arthrodeses and osteotomies. However, their efficacy is unclear.The primary goal of this systematic review was to compare autologous bone grafts with structural and non-structural substitutes regarding the odds of union in hindfoot arthrodeses and osteotomies. The Medline and EMBASE and Cochrane databases were searched for relevant randomized and non-randomized prospective studies as well as retrospective comparative chart reviews. 10 studies which comprised 928 hindfoot arthrodeses and osteotomies met the inclusion criteria for this systematic review. The quality of the retrieved studies was low due to small samples sizes and confounding variables. The pooled random effect odds for union were 12.8 (95% CI 12.7 to 12.9) for structural allografts, 5.7 (95% CI 5.5 to 6.0) for cortical autologous grafts, 7.3 (95% CI 6.0 to 8.6) for cancellous allografts and 6.0 (95% CI 5.7 to 6.4) for cancellous autologous grafts. In individual studies, the odds of union in hindfoot arthrodeses achieved with cancellous autologous grafts was similar to those achieved with demineralised bone matrix or platelet derived growth factor augmented ceramic granules. Our results suggest an equivalent incorporation of structural allografts as compared to autologous grafts in hindfoot arthrodeses and osteotomies. There is a need for prospective randomized trials to further clarify the role of substitutes of autologous bone grafts in hindfoot surgery.

  16. Comparison of Puddu osteotomy with or without autologous bone grafting: a prospective clinical trial

    Directory of Open Access Journals (Sweden)

    Marcus Ceregatti Passarelli

    Full Text Available ABSTRACT Objectives: To test the hypothesis that autologous iliac bone grafts do not enhance clinical results and do not decrease complication rates in patients undergoing medial opening-wedge high tibial , osteotomy. Methods: Forty patients allocated in a randomized, two-armed, double-blinded clinical trial were evaluated between 2007 and 2010. One group received bone graft, and the other group was left without filling the osteotomy defect. The primary outcome was the Knee Society Score. , Radiographic measurement of the frontal anatomical femoral-tibial angle and the progression of osteoarthritis according to the modified Ahlback classification were used as secondary outcomes., Results: There was no difference in KSS scale between the graft group (64.4 ± 21.8 and the graftless group (61.6 ± 17.3; p= 0.309. There was no difference of angle between the femur and tibia in the frontal plane between the groups (graft, = 184 ± 4.6 degrees, graftless = 183.4 ± 5.1 degrees; p= 1.0, indicating that there is no loss of correction due to the lack of the graft. There was significant aggravation of osteoarthritis in a greater number of patients in a graft group (p= 0.005 . Conclusion: Autologous iliac bone graft does not improve clinical outcomes in medium and long-term follow-up of medial opening-wedge high tibial osteotomy fixed with a first generation Puddu plate in the conditions of this study.

  17. The Effect of Smoking on Facial Fat Grafting Surgery.

    Science.gov (United States)

    Özalp, Burhan; Çakmakoğlu, Çağri

    2017-03-01

    Facial fat grafting has been increasingly performed to create a more youthful face. Cigarette smoking might have potential harmful effects on fat graft survival. The aim of this study was to evaluate the effects of cigarette smoking on facial lipofilling.Eighteen smoker patients (13 females and 5 males) with a mean age of 37.4 years (range: 21-53 years) who underwent facial lipofilling were enrolled in this retrospective study. The patients were followed up for an average of 19.3 months (range: 14-32 months). The fat-graft survival rate, degree of skin improvement, and presence and severity of surgical complications (fat necrosis, oil cysts, and infection) were evaluated. A 10-point Likert scale was used to assess patient satisfaction with facial fat grafting surgery.The mean injected fat volume was 42 mL (range: 30-80 mL). Clinical and photographic evaluation by the surgical team led to an estimation of 40% for the mean fat survival rate. Four instances of fat necrosis, 2 oil cysts, and 1 infection were diagnosed and treated conservatively. Five patients underwent a second fat grafting surgical procedure; 3 of these had a third fat grafting surgery to obtain the desired facial fullness. Improvement of skin quality was better during the first months after surgery, but not long standing. Overall patient satisfaction in terms of aesthetic appearance, facial fullness, and rejuvenation was 74%.Although cigarette smoking causes low fat survival rates and impairs the improvement of skin quality, successful results can be obtained with facial lipofilling in the smokers.

  18. Scarless abdominal fat graft harvest for neurosurgical procedures: technical note.

    Science.gov (United States)

    Trinh, Victoria T; Duckworth, Edward A M

    2015-02-01

    Background Abdominal fat grafts are often harvested for use in skull base reconstruction and cerebrospinal fluid (CSF) leak repairs, and for operations traversing the nasal sinuses or mastoid bone. Although the endoscopic transnasal surgery has gained significant popularity, in part because it is considered "scarless," a common adjunct, the abdominal fat graft, can result in a disfiguring scar across the abdomen. Objective This is the first report of a scarless abdominal fat graft technique for skull base reconstruction. Methods Ten patients with a median age of 56.5 years (range: 45-73 years) underwent endoscopic transsphenoidal tumor resection with intraumbilical fat graft harvest. Careful circumferential fat dissection at the umbilicus, with progressive retraction of the graft, was crucial to ensure maximal visualization and to prevent injury to the subcutaneous vessels and rectus fascia. Results Following reconstruction of the sellar skull base, all patients did well postoperatively with no evidence of CSF leak. At 12-week follow-up for all patients, there was no evidence of scar, intracavity hematoma, or wound infection. Conclusions Fat graft harvest through an intraumbilical incision results in a scar-free abdominal harvest, and is a useful procedural adjunct to complement "scarless" brain surgery.

  19. Rejuvenation of the periorbital complex with autologous fat transfer: current therapy.

    Science.gov (United States)

    Ciuci, Paul M; Obagi, Suzan

    2008-08-01

    This article examines the pathophysiology of periorbital aging and details a technique, autologous fat transfer, to restore a youthful appearance to the periorbital complex. The use of photographs taken of patients in their late teens or early 20s shows that the main changes of periorbital aging are consistent with volume loss more so than gravitational changes. This article reflects on the shortcomings of currently accepted surgical approaches to the rejuvenation of the periorbital region. After a detailed clinical evaluation of the periorbital region including overall facial aging, brow position, and eyelid laxity, patients underwent autologous fat transfer to the periorbital region. The technique consists of autologous fat harvesting using the senior author's modification of the Coleman technique to the upper brow and lower eyelid region. Detailed clinical evaluations of each subject, and comparisons to a preoperative youthful photograph of each, were made at 1 week, 6 weeks, and 6 months postoperatively. These evaluations included subjective clinical estimations of overall brow fullness, brow position, and upper and lower eyelid laxity; a judgment of the appearance of the supraorbital and infraorbital rim; appearance of a short lower eyelid length, and an assessment of the subject's convex facial profile. While maintaining a natural, "nonsurgical" appearance with this approach and this technique, the patient achieved a more youthful look after autologous fat transfer. Although there are still indications for brow lift and blepharoplasty in certain patients, neither procedure restores a youthful, rejuvenated appearance to the periorbital complex as well as autologous fat transfer.

  20. Second-degree burns with six etiologies treated with autologous noncultured cell-spray grafting.

    Science.gov (United States)

    Esteban-Vives, Roger; Choi, Myung S; Young, Matthew T; Over, Patrick; Ziembicki, Jenny; Corcos, Alain; Gerlach, Jörg C

    2016-11-01

    Partial and deep partial-thickness burn wounds present a difficult diagnosis and prognosis that makes the planning for a conservative treatment versus mesh grafting problematic. A non-invasive treatment strategy avoiding mesh grafting is often chosen by practitioners based on their clinical and empirical evidence. However, a delayed re-epithelialization after conservative treatment may extend the patient's hospitalization period, increase the risk of infection, and lead to poor functional and aesthetic outcome. Early spray grafting, using non-cultured autologous cells, is under discussion for partial and deep partial-thickness wounds to accelerate the re-epithelialization process, reducing the healing time in the hospital, and minimizing complications. To address planning for future clinical studies on this technology, suitable indications will be interesting. We present case information on severe second-degree injuries after gas, chemical, electrical, gasoline, hot water, and tar scalding burns showing one patient per indication. The treatment results with autologous non-cultured cells, support rapid, uncomplicated re-epithelialization with aesthetically and functionally satisfying outcomes. Hospital stays averaged 7.6±1.6 days. Early autologous cell-spray grafting does not preclude or prevent simultaneous or subsequent traditional mesh autografting when indicated on defined areas of full-thickness injury. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  1. Fatal Fat Embolism After Penis Enlargement by Autologous Fat Transfer: A Case Report and Review of the Literature.

    Science.gov (United States)

    Zilg, Brita; Råsten-Almqvist, Petra

    2017-09-01

    Fat embolism is an incidental finding in cases of long bone fractures or other trauma, but it is also associated with liposuction and autologous fat transfer, a procedure where fat from liposuction is injected back into the same patient's face, breast, buttocks or penis. We here present a case of sudden death by fat embolism in a healthy young male, caused by a simple penis enlargement procedure, in which fat was injected into the penis shaft. We suggest that the risk of fat embolization might be higher when pretraumatized tissue is subjected to fat injection, like in this case, where a penis elongation was performed before the fat injection. © 2017 American Academy of Forensic Sciences.

  2. Utility of indium-111 labelled autologous platelets in the diagnosis of renal graft rejection

    International Nuclear Information System (INIS)

    Martin-Comin, J.; Roca, M.; Grino, J.M.; Paradell, C.; Caralps, A.

    1982-01-01

    The usefulness of In-111 labelled autologous platelets in the diagnosis of renal graft rejection was studied. The method is based on imaging of the graft area at 4, 24, 48 and 72 hours after the injection of the labelled cells. The study was done in 21 renal cadaveric transplant recipients: control group: four patients without evidence of rejection. No platelet uptake was observed in any of them. Study group: in 13 patients with acute rejection and 1 with chronic rejection graft tracer uptake was seen. In the 3 others with a non-immunological sudden impairment of renal function, no activity was detected in graft area. Changes in renal platelet trapping correlated with response to antirejection therapy

  3. In-111 oxine autologous labeled platelets in the diagnosis of kidney graft rejection

    International Nuclear Information System (INIS)

    Martin-Comin, J.; Roca, M.; Grino, J.M.; Paradell, C.; Caralps, C.

    1983-01-01

    The usefulness of In-111 oxine labeled autologous platelets in the diagnosis of renal graft rejection was studied. The method is based on imaging of the graft area at 4, 24, 48, and 72 hours after the injection of the labeled cells. The study was done in 31 renal transplant recipients. The control group included four patients with normal renal function without evidence of rejection. No platelet uptake was observed in any of them. The study group included 22 patients with acute rejection which was confirmed histologically in 13. One case of chronic vascular type rejection of the graft tracer uptake was seen. There was a false-positive result due to a perirenal hematoma. In three patients with a non-immunological sudden impairment of renal function, no activity was detected in the graft area. We also evaluated the changes in platelet trapping throughout the study and they seemed to correlate with the response to the antirejection therapy

  4. Autologous bone graft versus demineralized bone matrix in internal fixation of ununited long bones.

    Science.gov (United States)

    Pieske, Oliver; Wittmann, Alexandra; Zaspel, Johannes; Löffler, Thomas; Rubenbauer, Bianka; Trentzsch, Heiko; Piltz, Stefan

    2009-12-15

    Non-unions are severe complications in orthopaedic trauma care and occur in 10% of all fractures. The golden standard for the treatment of ununited fractures includes open reduction and internal fixation (ORIF) as well as augmentation with autologous-bone-grafting. However, there is morbidity associated with the bone-graft donor site and some patients offer limited quantity or quality of autologous-bone graft material. Since allogene bone-grafts are introduced on the market, this comparative study aims to evaluate healing characteristics of ununited bones treated with ORIF combined with either iliac-crest-autologous-bone-grafting (ICABG) or demineralized-bone-matrix (DBM). From 2000 to 2006 out of sixty-two consecutive patients with non-unions presenting at our Level I Trauma Center, twenty patients had ununited diaphyseal fractures of long bones and were treated by ORIF combined either by ICABG- (n = 10) or DBM-augmentation (n = 10). At the time of index-operation, patients of the DBM-group had a higher level of comorbidity (ASA-value: p = 0.014). Mean duration of follow-up was 56.6 months (ICABG-group) and 41.2 months (DBM-group). All patients were clinically and radiographically assessed and adverse effects related to bone grafting were documented. The results showed that two non-unions augmented with ICABG failed osseous healing (20%) whereas all non-unions grafted by DBM showed successful consolidation during the first year after the index operation (p = 0.146). No early complications were documented in both groups but two patients of the ICABG-group suffered long-term problems at the donor site (20%) (p = 0.146). Pain intensity were comparable in both groups (p = 0.326). However, patients treated with DBM were more satisfied with the surgical procedure (p = 0.031). With the use of DBM, the costs for augmentation of the non-union-site are more expensive compared to ICABG (calculated difference: 160 euro/case). Nevertheless, this study demonstrated that the

  5. Treatment of perforated cornea with an autologous lamellar scleral graft: histologic findings.

    Science.gov (United States)

    Jovanovic, Vesna; Jankov, Mirko; Nikolic, Ljubisa

    2018-01-01

    We report a case of central corneal perforation treated with an autologous lamellar scleral graft and histologic findings obtained after a subsequent penetrating keratoplasty. A corneal perforation within a large Pseudomonas ulcer in a 55-year-old male rigid gas permeable contact lens wearer was sealed by a lamellar scleral graft from the same eye, followed by an uneventful penetrating keratoplasty 6 months later. Histology of the excised button revealed that the well-apposed graft, which maintained the irregular arrangement of the scleral collagen fibers, was embedded in the corneal stroma over the deep blood vessels and a rupture in Descemet's membrane. The clinical and histologic findings showed that autologous lamellar scleral grafts can be successfully used for the emergency treatment of corneal perforation when a corneal transplant is not available. The distinctive scleral structure revealed by histology and the inadequate graft transparency indicate that visual rehabilitation of eyes with a central corneal perforation can be achieved only by a subsequent optic penetrating keratoplasty.

  6. Autologous mini punch grafting: an experience of using motorized power punch in 10 patients.

    Science.gov (United States)

    Chandrashekar, Bs; Madura, C; Varsha, Dv

    2014-01-01

    Autologous mini punch grafting (MPG) is a safe, effective and easy technique that can be performed on any site with minimal side effects and good cosmetic results. Large areas of stable generalised vitiligo require more grafts and are time consuming. Hence multiple sessions of surgery need to be scheduled. We share our experience of using motorised power punches to increase the speed of surgery in large areas of stable vitiligo in 10 patients. Ten patients in the age group of 12-55 years were treated with miniature punch grafting using power punches in single session on various sites. The power punches of 1-1.5 mm diameter were used to score donor and recipient sites, either of same or less than 0.2-0.3 mm size punches. The harvested grafts from donor site were then secured in the recipient beds and dressed. The average number of grafts harvested per session was 125-185, the duration of surgery ranged from 45 to 90 minutes. Perigraft pigment spread was seen at 3 weeks. Complete repigmentation was observed in 3-4 months in eight patients. Cobble stoning was observed in one patient, and all donor sites healed well with superficial scarring. We conclude that autologous MPG with motorised power punches for stable vitiligo, especially on large areas including difficult sites can be performed with ease in comparatively lesser time in a single session, greatly benefiting the patients.

  7. Autologous mini punch grafting: An experience of using motorized power punch in 10 patients

    Directory of Open Access Journals (Sweden)

    B S Chandrashekar

    2014-01-01

    Full Text Available Background: Autologous mini punch grafting (MPG is a safe, effective and easy technique that can be performed on any site with minimal side effects and good cosmetic results. Large areas of stable generalised vitiligo require more grafts and are time consuming. Hence multiple sessions of surgery need to be scheduled. We share our experience of using motorised power punches to increase the speed of surgery in large areas of stable vitiligo in 10 patients. Materials and Methods: Ten patients in the age group of 12-55 years were treated with miniature punch grafting using power punches in single session on various sites. The power punches of 1-1.5 mm diameter were used to score donor and recipient sites, either of same or less than 0.2-0.3 mm size punches. The harvested grafts from donor site were then secured in the recipient beds and dressed. Results: The average number of grafts harvested per session was 125-185, the duration of surgery ranged from 45 to 90 minutes. Perigraft pigment spread was seen at 3 weeks. Complete repigmentation was observed in 3-4 months in eight patients. Cobble stoning was observed in one patient, and all donor sites healed well with superficial scarring. Conclusion: We conclude that autologous MPG with motorised power punches for stable vitiligo, especially on large areas including difficult sites can be performed with ease in comparatively lesser time in a single session, greatly benefiting the patients.

  8. Autologous fat transplantation: volumetric tools for estimation of volume survival. A systematic review.

    Science.gov (United States)

    Herold, Christian; Ueberreiter, Klaus; Busche, Marc N; Vogt, Peter M

    2013-04-01

    Autologous fat transplantation has gained great recognition in aesthetic and reconstructive surgery. Two main aspects are of predominant importance for progress control after autologous fat transplantation to the breast: quantitative information about the rate of fat survival in terms of effective volume persistence and qualitative information about the breast tissue to exclude potential complications of autologous fat transplantation. There are several tools available for use in evaluating the rate of volume survival. They are extensively compared in this review. The anthropometric method, thermoplastic casts, and Archimedes' principle of water displacement are not up to date anymore because of major drawbacks, first and foremost being reduced reproducibility and exactness. They have been replaced by more exact and reproducible tools such as MRI volumetry or 3D body surface scans. For qualitative and quantitative progress control, MRI volumetry offers all the necessary information: evaluation of fat survival and diagnostically valuable imaging to exclude possible complications of autologous fat transplantation. For frequent follow-up, e.g., monthly volume analysis, repeated MRI exams would not be good for the patient and are not cost effective. In these cases, 3D surface imaging is a good tool and especially helpful in a private practice setting where fast data acquisition is needed. This tool also offers the possibility of simulating the results of autologous fat transplantation. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  9. Scintigraphic follow up of autologous splenic grafts: An experimental and clinical study

    International Nuclear Information System (INIS)

    Reilmann, H.; Creutzig, H.; Pabst, R.; Kamran, D.

    1984-01-01

    The risk of overwhelming sepsis in splenectomized patients is well known and autotransplantation of splenic tissue might be considered as a prophylactic approach. Little is known, however, of the success of grafting in man. In six patients with autologous grafts after emergency splenectomy the ''trapping function'' (TF) was measured by sequential scintigraphy with heat damaged red cells every third month. To correlate TF with blood flow and histology, different experiments were done in pigs: ligation of the splenic artery or partial splenectomy or total splenectomy with grafting of fragments either subfascially or in the greater momentum. TF, blood flow with Rb-86 and immune response was measured at different times after surgery. Remnants left at the main vessels did not grow, while splenic tissue left at smaller vessels increased in size. There were great differences in blood flow per gram splenic tissue, but a significant correlation between TF and blood flow. All experimental grafts showed a normal function both of the white and the red pulp. In patients there was a growth of grafts in four, while in two no TF could be measured. TF is an indicator of relative blood flow to splenic grafts and therefore useful in the follow up of grafted patients

  10. Stroma-supported progenitor production as a prognostic tool for graft failure following autologous stem cell transplantation

    NARCIS (Netherlands)

    van Hennik, P. B.; Breems, D. A.; Kusadasi, N.; Slaper-Cortenbach, I. C.; van den Berg, H.; van der Lelie, H. J.; Schipperus, M. R.; Cornelissen, J. J.; Ploemacher, R. E.

    2000-01-01

    To analyse the involvement of a possible numerical or qualitative stem cell defect in the development of sustained graft failure after autologous transplantation, we have determined the graft content of CD34+ nucleated cells, colony-forming cells and cobblestone area-forming cell subsets, as well as

  11. Effects of Autologous Fat and ASCs on Swine Hypertrophic Burn Scars: A Multimodal Quantitative Analysis

    Directory of Open Access Journals (Sweden)

    Scott J. Rapp, MD

    2017-11-01

    Conclusion:. Early results suggest that autologous fat and/or ASCs may improve healing of hypertrophic scarring by altering the cellular and structural components during wound remodeling up to 20 weeks after injury. This may have beneficial applications in early treatment of large or cosmetically sensitive immature burn scars.

  12. Feasibility of arthroscopic placement of autologous matrix-induced chondrogenesis grafts in the cadaver hip joint

    Directory of Open Access Journals (Sweden)

    Fritz Thorey

    2013-09-01

    Full Text Available An assortment of clinical trials have been done presenting the effectiveness of autologous matrix-induced chondrogenesis (AMIC for the regeneration of chondral leasions. The purpose of the study was to underline the accessability of the acetabulum and the femoral head through the known portals and prove i the feasibility of placing the AMIC in the different zones of the hip joint and ii check for dislocation after joint movement. Six human cadavers underwent hip arthroscopy on both hips. Two chondral lesions were set on each femoral head and two in the acetabulum to evaluate a total of 48 defects. After microfracturing an autologous matrix-induced chondrogenesis graft was placed on these lesions arthroscopically. After repeated joint movement the dislocation of the graft was checked. It was possible to place the AMIC graft in all 48 chondral lesions. The time needed for placing the graft was 8±2.9 minutes. A trend of time reduction could be detected throughout this study as the surgeon gained more experience. For the femoral head, after twenty cycles of joint movement 18/24 spots showed no displacement, 4/24 showed minor displacement (<3 mm and 2/24 showed major displacement (>3 mm. None showed total displacement. For the acetabulum 22/24 spots showed no displacement and 2/24 showed minor displacement. A combined microfracturing and placing of an AMIC graft of focal chondral lesions of the hip joint can be done arthroscopically. Prospective randomized in vivo studies should compare the results of arthroscopilally placed AMIC grafts with microfracturing and microfracturing alone.

  13. The use of matriderm and autologous skin graft in the treatment of full thickness skin defects.

    Science.gov (United States)

    Min, Jang Hwan; Yun, In Sik; Lew, Dae Hyun; Roh, Tai Suk; Lee, Won Jai

    2014-07-01

    For patients with full thickness skin defects, autologous Split-thickness skin grafts (STSG) are generally regarded as the mainstay of treatment. However, skin grafts have some limitations, including undesirable outcomes resulting from scars, poor elasticity, and limitations in joint movement due to contractures. In this study, we present outcomes of Matriderm grafts used for various skin tissue defects whether it improves on these drawbacks. From January 2010 to March 2012, a retrospective review of patients who had undergone autologous STSG with Matriderm was performed. We assessed graft survival to evaluate the effectiveness of Matriderm. We also evaluated skin quality using a Cutometer, Corneometer, Tewameter, or Mexameter, approximately 12 months after surgery. A total of 31 patients underwent STSG with Matriderm during the study period. The success rate of skin grafting was 96.7%. The elasticity value of the portion on which Matriderm was applied was 0.765 (range, 0.635-0.800), the value of the trans-epidermal water loss (TEWL) was 10.0 (range, 8.15-11.00) g/hr/m(2), and the humidification value was 24.0 (range, 15.5-30.0). The levels of erythema and melanin were 352.0 arbitrary unit (AU) (range, 299.25-402.75 AU) and 211.0 AU (range, 158.25-297.00 AU), respectively. When comparing the values of elasticity and TEWL of the skin treated with Matriderm to the values of the surrounding skin, there was no statistically significant difference between the groups. The results of this study demonstrate that a dermal substitute (Matriderm) with STSG was adopted stably and with minimal complications. Furthermore, comparing Matriderm grafted skin to normal skin using Cutometer, Matriderm proved valuable in restoring skin elasticity and the skin barrier.

  14. The Use of Matriderm and Autologous Skin Graft in the Treatment of Full Thickness Skin Defects

    Directory of Open Access Journals (Sweden)

    Jang Hwan Min

    2014-07-01

    Full Text Available Background For patients with full thickness skin defects, autologous Split-thickness skin grafts (STSG are generally regarded as the mainstay of treatment. However, skin grafts have some limitations, including undesirable outcomes resulting from scars, poor elasticity, and limitations in joint movement due to contractures. In this study, we present outcomes of Matriderm grafts used for various skin tissue defects whether it improves on these drawbacks. Methods From January 2010 to March 2012, a retrospective review of patients who had undergone autologous STSG with Matriderm was performed. We assessed graft survival to evaluate the effectiveness of Matriderm. We also evaluated skin quality using a Cutometer, Corneometer, Tewameter, or Mexameter, approximately 12 months after surgery. Results A total of 31 patients underwent STSG with Matriderm during the study period. The success rate of skin grafting was 96.7%. The elasticity value of the portion on which Matriderm was applied was 0.765 (range, 0.635-0.800, the value of the trans-epidermal water loss (TEWL was 10.0 (range, 8.15-11.00 g/hr/m2, and the humidification value was 24.0 (range, 15.5-30.0. The levels of erythema and melanin were 352.0 arbitrary unit (AU (range, 299.25-402.75 AU and 211.0 AU (range, 158.25-297.00 AU, respectively. When comparing the values of elasticity and TEWL of the skin treated with Matriderm to the values of the surrounding skin, there was no statistically significant difference between the groups. Conclusions The results of this study demonstrate that a dermal substitute (Matriderm with STSG was adopted stably and with minimal complications. Furthermore, comparing Matriderm grafted skin to normal skin using Cutometer, Matriderm proved valuable in restoring skin elasticity and the skin barrier.

  15. Sinus lift tissue engineering using autologous pulp micro-grafts: A case report of bone density evaluation

    OpenAIRE

    Brunelli, Giorgio; Motroni, Alessandro; Graziano, Antonio; D?Aquino, Riccardo; Zollino, Ilaria; Carinci, Francesco

    2013-01-01

    Background: Although autografts are the standard procedure for bone grafting, the use of bone regeneration by means of dental pulp stem cell is an alternative that opens a new era in this field. Rigenera Protocol is a new technique able to provide the surgeon autologous pulp micro-grafts. Materials and Methods: At the Department of Oral Surgery, Don Orione Hospital, Bergamo, Italy, one patient underwent sinus lift elevation with pulp stem micro-grafts gentle poured onto collagen sponge. A CT ...

  16. History of fat grafting: from ram fat to stem cells.

    Science.gov (United States)

    Mazzola, Riccardo F; Mazzola, Isabella C

    2015-04-01

    Fat injection empirically started 100 years ago to correct contour deformities mainly on the face and breast. The German surgeon Eugene Hollaender (1867-1932) proposed a cocktail of human and ram fat, to avoid reabsorption. Nowadays, fat injection has evolved, and it ranks among the most popular procedures, for it provides the physician with a range of aesthetic and reconstructive clinical applications with regenerative effects on the surrounding tissues. New research from all over the world has demonstrated the role of adipose-derived stem cells, present in the adipose tissue, in the repair of damaged or missing tissues. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Supervivencia a largo plazo de los injertos grasos Long-term survival with fat grafting

    Directory of Open Access Journals (Sweden)

    J. Planas

    2006-03-01

    Full Text Available Presentamos varios casos de pérdida de volumen de diferentes etiologías y en distintas regiones corporales y faciales tratadas mediante injertos de tejido graso autólogo según la técnica de lipoestructura. En ningún caso se realizó sobrecorrección del defecto en ningún caso. La evolución con un seguimiento máximo de 7 años y mínimo de 1 año no mostró disminución del volumen obtenido en el acto quirúrgico en la gran mayoría de los casos. Debido a los resultados obtenidos creemos que el injerto de grasa autólogo es el método de elección para restaurar volúmenes con fines estéticos o reconstructivos.Volume loss in several facial and body areas was treated by means of autologous fatty tissue grafts with lipostructure technique. There were no cases of overcorrection. The patients’ course, with a maximum follow-up of 7 years and a minimum of 1 year did not evidence any loss of the surgically restored tissue volume in the majority of cases. The above results suggest that autologous fat grafts are the method of choice to restore volume for both cosmetic and reconstructive purposes.

  18. Harvey Cushing's repair of a dural defect after a traumatic brain injury: novel use of a fat graft.

    Science.gov (United States)

    Zaidi, Hasan A; Pendleton, Courtney; Cohen-Gadol, Aaron A; Quinones-Hinojosa, Alfredo

    2011-01-01

    A review of Harvey Cushing's surgical cases at Johns Hopkins Hospital revealed new information about his early work with the use of fat grafts to close dural defects. The Johns Hopkins Hospital surgical records from 1896 to 1912 were reviewed. A single case in which Cushing used an autologous fat graft to repair a dural defect in 1912 after a traumatic brain injury was selected for further study. An 18-year-old white female patient presented with recurring seizures in her sleep approximately 12 years after a traumatic brain injury. A depressed skull fracture as a result of this injury was explored by Cushing, and a dural defect was found. Fat was harvested from the thigh of the patient and was sutured in layers to cover the defect. Cushing noted that this was the first of its kind of operation and "probably of very little use." The patient was discharged within 2 weeks after the operation despite recurrence of her seizure episodes. Despite its questionable functional success, we report herein a previously unpublished operative case by Harvey Cushing's in which an autologous fat graft was used to close a traumatic wound resulting in a dural defect. This report predates currently known published reports of the use of fat to seal dural defects. Cushing recognized that a factor found in fat tissue may aid in wound healing. Contemporary studies indicate the presence of mesenchymal stem cells in fat tissue may be responsible for the accelerated healing and reduced incidence of cerebral spinal fluid leaks after cranial surgery. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Facial autologous soft-tissue contouring by adjunction of tissue cocktail injection (micrograft and minigraft mixture of dermis, fascia, and fat).

    Science.gov (United States)

    Erol, O O

    2000-11-01

    Facial aging is both a physiologic and anatomic process characterized by changes in the skin and supporting tissues. The aging process produces an outer envelope that gradually expands while its contents gradually involute and the underlying structure weakens. This process results in an excess of skin that tends to create folds, grooves, and deepening furrows. Contour augmentation and filling depressions with autologous tissue or heterogeneous materials are widely used in face rejuvenation as an adjunctive procedure. There is unanimous agreement on the advantages of autogenous tissue grafts over alloplastic materials and heterogeneous transplants. It is also well known that the revascularization of a small graft (fat, dermis, and/or composite graft) is better than a large graft. For this reason, fat injections consisting of small particles have recently become popular. According to different authors, a graft take may vary from 30 to 50 percent. Nevertheless, it has been thoroughly documented that a graft consisting of dermis or fascia is superior to a fat graft in both the graft take rate and quality of the tissue. Strips of dermal graft have been used successfully for several years to fill lip contour and nasolabial folds. However, the main disadvantage of this technique is that utilization is restricted only to certain areas where there is a need for a small incision. To overcome this obstacle, the author developed a simple technique to obtain an injectable mass from a mixture of dermis, muscle strips, fat tissue, and fascia to use in body contouring (especially in the facial region) in large areas. The author describes the use of the technique in 450 patients. Follow-up in these patients from 6 months to 10 years showed that the application of the "tissue cocktail" procedure in select patients improved the author's results and created a marked increase in the number of satisfied patients with no complaints. The take and durability of this kind of graft were

  20. Reengineering autologous bone grafts with the stem cell activator WNT3A.

    Science.gov (United States)

    Jing, Wei; Smith, Andrew A; Liu, Bo; Li, Jingtao; Hunter, Daniel J; Dhamdhere, Girija; Salmon, Benjamin; Jiang, Jie; Cheng, Du; Johnson, Chelsey A; Chen, Serafine; Lee, Katherine; Singh, Gurpreet; Helms, Jill A

    2015-04-01

    Autologous bone grafting represents the standard of care for treating bone defects but this biomaterial is unreliable in older patients. The efficacy of an autograft can be traced back to multipotent stem cells residing within the bone graft. Aging attenuates the viability and function of these stem cells, leading to inconsistent rates of bony union. We show that age-related changes in autograft efficacy are caused by a loss in endogenous Wnt signaling. Blocking this endogenous Wnt signal using Dkk1 abrogates autograft efficacy whereas providing a Wnt signal in the form of liposome-reconstituted WNT3A protein (L-WNT3A) restores bone forming potential to autografts from aged animals. The bioengineered autograft exhibits significantly better survival in the hosting site. Mesenchymal and skeletal stem cell populations in the autograft are activated by L-WNT3A and mitotic activity and osteogenic differentiation are significantly enhanced. In a spinal fusion model, aged autografts treated with L-WNT3A demonstrate superior bone forming capacity compared to the standard of care. Thus, a brief incubation in L-WNT3A reliably improves autologous bone grafting efficacy, which has the potential to significantly improve patient care in the elderly. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Fat Grafting: A Citation Analysis of the Seminal Articles

    Directory of Open Access Journals (Sweden)

    Cormac W. Joyce, MB, BCh

    2015-01-01

    Conclusions: The scientific relevance of a published work is reflected in the number of citations from peers that it receives. Therefore, the 100 most-cited papers in fat grafting have been the most influential articles on this field, and they are likely to be the ones that are remembered most.

  2. Treatment of lower extremity long bone nonunion with expandable intramedullary nailing and autologous bone grafting.

    Science.gov (United States)

    Niu, Yunfei; Bai, Yushu; Xu, Shuogui; Liu, Xinwei; Wang, Panfeng; Wu, Dajiang; Zhang, Chuncai; Li, Ming

    2011-07-01

    Nonunion of long bones in lower limbs is a common complication of orthopedic trauma that can be extremely debilitating. This retrospective study describes our experience using expandable intramedullary nails and autologous bone grafting in treating lower limb long bone nonunion with bone defects. Nineteen patients (mean age 38.9 years, range 18-61) with lower limb long bone nonunion and defects caused by femoral or tibial fracture types were as follows: A2 (3 femoral, 1 tibial), A3 (1 femoral, 2 tibial), B2 (3 femoral, 4 tibial), and B3 (1 femoral, 4 tibial). Expandable intramedullary nailing and autologous bone (iliac and/or fibular) grafting were used for the treatment. Postoperative bone healing as determined by analysis of standard anteroposterior and lateral X-ray films every 4 weeks. Complications were noted. The average number of previous surgeries was 1.9 (range 1-4). The mean duration from original injury to treatment was 17.6 months (range 9-40 months). Femoral shaft nonunion healed on average of 26.5 weeks (range 16-60 weeks) after surgery, while tibial shaft nonunion healed on average of 23.6 weeks (range 12-40 weeks) after surgery. Class I healing occurred in all but two patients who experienced chronic postoperative osteomyelitis and delayed wound healing, respectively. Two patients complained of postoperative donor site pain. The use of expandable intramedullary nails and autologous bone grafts was an effective method for repair of nonunion of lower limb fractures combining with bone defects with minimal complications.

  3. Achieving Ideal Lower Face Aesthetic Contours: Combination of Tridimensional Fat Grafting to the Chin with Masseter Botulinum Toxin Injection.

    Science.gov (United States)

    Chang, Chun-Shin; Kang, Gavin Chun-Wui

    2016-11-01

    Lower face aesthetic contouring is in high demand among Asians with wide and short faces desiring a slim lower face. For this purpose invasive mandible angle reduction and genioplasty are complex procedures with significant risks and downtime. Non-invasive botulinum toxin A injection into bilateral masseters - while popular for lower face contouring - does not address facial length deficiency in wide and short faces. Autologous chin fat grafting is a simple minimally-invasive technique for facial lengthening. We present our experience pairing chin fat grafting and masseteric botulinum toxin injection for effective lower face contouring. Thirteen consecutive patients with relatively wide and short faces underwent chin fat grafting and 1 to 3 serial masseteric botulinum toxin A injections. Mean follow up after final intervention was 20 months (range, 6 months to 3 years). The postoperative mean ratio of bigonial distance to total facial height improved from 0.599 to 0.569 (P tridimensional chin fat grafting and botulinum toxin masseteric injection is an effective, simple, fast, inexpensive, safe, and minimally-invasive strategy for aesthetic lower face contouring of short and wide faces, with short downtime, long-lasting results, and high patient satisfaction. 4 Therapeutic. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  4. Facial rejuvenation: Serial fat graft transfer

    African Journals Online (AJOL)

    Saad Mohamed Saad Ibrahiem

    2016-02-01

    Feb 1, 2016 ... lipoaspirate is great loss that makes preservation of the excess fat as a strong desire of both the plastic surgeon and the patient for future application. It is our hypothesis that lipoaspirate obtained from conventional liposuction could be preserved and stored at low temperature (below À18 °C), and then serial ...

  5. Studies in Fat Grafting: Part II. Effects of Injection Mechanics on Material Properties of Fat

    Science.gov (United States)

    Atashroo, David; Raphel, Jordan; Chung, Michael T.; Paik, Kevin J.; Parisi-Amon, Andreina; McArdle, Adrian; Senarath-Yapa, Kshemendra; Zielins, Elizabeth R.; Tevlin, Ruth; Duldulao, Chris; Walmsley, Graham G.; Hu, Michael S.; Momeni, Arash; Domecus, Brian; Rimsa, Joe R.; Greenberg, Lauren; Gurtner, Geoffrey C.; Longaker, Michael T.; Wan, Derrick C.

    2014-01-01

    Background While fat grafting can address many soft tissue deficits, results remain inconsistent. In this study, we compared physical properties of fat following injection using an automated, low shear device or the modified Coleman technique. Methods Lipoaspirate was obtained from nine patients and processed for injection using either a modified Coleman technique or with an automated, low shear device. Fat was passed through a 2 mm cannula and compared to minimally processed fat. A rheometer was used to measure the storage modulus and shear rate at which tissues began to lose their solid-like properties. Viscosity was also measured and gross properties of treatment groups were qualitatively evaluated with a glass slide test. Results Fat injected through an automated, low shear device closely matched physical properties of minimally processed fat. The storage modulus (G′) of fat for the device group was greater than the modified Coleman group and the onset of breakdown was delayed. Similarly, viscosity measurement of fat from the automated device closely matched minimally processed fat and was greater than the modified Coleman group. Conclusions The physical properties of lipoaspirate processed using an automated, low shear device with a 2 mm cannula preserved the intactness of fat more than the modified Coleman technique. Our rheological data demonstrate less damage using an automated device compared to modified Coleman technique and potentially support its use for improved fat graft integrity. PMID:25028817

  6. Repair of an Autologous Saphenous Vein Graft Aneurysm Ten Years after Renal Artery Reconstruction during Live Donor Renal Transplantation.

    Science.gov (United States)

    Oelschlaeger, Markus; Sokolakis, Ioannis; Kalogirou, Charis; Frey, Lea; Riedmiller, Hubertus; Kübler, Hubert; Kellersmann, Richard; Vergho, Daniel

    2017-10-06

    Saphenous vein graft (SVG) aneurysms (SVGA) after renal transplantation represents a rare vascular complication with subsequent challenging multidisciplinary treatment. We present a case of a 30-year-old female who received a live donor kidney transplantation for end-stage renal disease that was caused due to the hemolytic uremic syndrome. Postoperatively, an insufficient graft perfusion due to an arterial kinking was noted and repaired using an autologous SVG interposition. Ten years later, a 3-cm aneurysm of the SVG at the anastomotic site with the common iliac artery was discovered. Multidisciplinary surgical exploration with excision of the aneurysm-carrying vein graft and interposition of a new autologous SVG was successfully carried out with preservation of renal allograft's function. Treatment of SVGA after rental transplantation with a new autologous SVG is challenging but feasible, requiring a multidisciplinary approach in order to guarantee successful rates and to prevent allograft loss. © 2017 S. Karger AG, Basel.

  7. In vivo bioimaging analysis of stromal vascular fraction-assisted fat grafting: the interaction and mutualism of cells and grafted fat.

    Science.gov (United States)

    Zhou, Shuang-Bai; Chiang, Cheng-An; Xie, Yun; Li, Hua; Liu, Kai; Kobayashi, Eiji; Li, Qing-Feng

    2014-11-27

    Unpredictable survival rate of transplanted fat is an obstacle in application of fat grafting. Although recent researches have suggested that adipose-derived stromal vascular fraction (SVF) could promote grafted fat survival, there has been seldom reports on tracing the dynamic change of grafted fat in vivo and on discussing interaction between transplanted SVFs and surrounding fat graft. Fat tissue and SVF separated from luciferase (Luc)-transgenic rats were applied for bioimaging analysis. The Luc-fat (0.2 mL) was subcutaneously injected into the back of nude mice with or without SVFs from 0.2 mL wild type rat fat, with bioimaging at 63 days. Immunohistochemical staining was performed to evaluate the structural integrity. Moreover, to evaluate the influence of surrounding fat tissue to transplanted SVFs, Luc-SVFs separated from 0.2 mL luciferase fat were transplanted to evaluate the influence of surrounding fat tissue to transplanted SVFs. The bioimaging results showed that fat tissues transplanted with SVFs had higher survival ratio than those transplanted without SVFs (49.99(5.38)% vs. 32.78(3.32)%; P fat grafts had more integral structure and less necrosis cysts. The results showed that, with the existence of grafted fat, transplanted SVF survived for a significantly longer time and could contribute to fat graft survival and regeneration by differentiating into structural cells. The results showed that SVF-assisted fat graft had significantly higher survival rate than that transplanted alone. Moreover, our research demonstrated that interaction between grafted fat and SVFs was important in SVF's long-term living and differentiation.

  8. Autologous fat injection combined with palatoplasty and pharyngoplasty for velopharyngeal insufficiency and cleft palate: preliminary experience.

    Science.gov (United States)

    Cao, Yimei; Ma, Tingting; Wu, Di; Yin, Ningbei; Zhao, Zhenmin

    2013-08-01

    The aim was to evaluate clinical application of autologous fat transplantation in the posterior pharynx to treat velopharyngeal incompetence and cleft palate. Case series with chart review. Cleft Lip and Palate Center of Plastic Surgery Hospital, an academic medical center. We studied 11 patients (age, 5-26 years) with a cleft palate and velopharyngeal insufficiency who underwent autologous fat injection. Patients were followed for 9 to 40 months. Pronunciation evaluation, visual appearance of the palatopharyngeal area, nasopharyngeal fibroscopy (NPF), palatopharyngeal lateral radiography, and magnetic resonance imaging (MRI) were undertaken before and after the operation. Speech intelligibility was markedly increased in all patients. Pronunciation was good to excellent compared with the preoperative level (P = .001). Mean velopharyngeal insufficiency rate was significantly reduced from 26.05% to 6.96% (P = .028) by NPF and from 26.42% to 7.11% (P = .017) by MRI (axial plane). Magnetic resonance imaging indicated significantly reduced mean minimum velopharyngeal distance, from 10.39 to 3.65 mm (P = .012) in the sagittal plane, and markedly increased thickness of transplanted fat in the posterior pharyngeal wall (sagittal, 5.43 mm; axial, 4.74 mm). There were few complications (sleep apnea, nasopharyngeal regurgitation). Autologous fat transplantation in the posterior pharyngeal wall was a good method for treating velopharyngeal incompetence. The safety profile was good in our sample, and we got a consistent result in the follow-up period. In addition, it also could be combined with routine surgery.

  9. Autologous Punch Grafting In Vitiligo : A Six Year Study (Preliminary Report

    Directory of Open Access Journals (Sweden)

    Gosh Sanjay

    1995-01-01

    Full Text Available A6-year study (1989-1995 on autologous punch grafting was performed in 410 different sites of 184 resistant, stable and localized vitiligo patients and Calcutta Skin institute. Grafting was undertaken by skin biopsy punch and curved scissors keeping a distance of 1-2 cm between adjoining grafts, the donor site graft being 0.5 mm to1mm larger than the recipient one. 12 cases were halo nevus, the central mole of which was excised and subsequently grafted. The grafts were well accepted in 385 (93.9% sites and rejected in 20 (4.9% sites due to secondary infection and in 5 (1.2% for poor care in immobilization by the patients. Spontaneous pigment- spread was seen in 77(18.8% sites, predominantly on face, neck and upper trunk. Post-surgical psoralen with seen at all in 13 (3.2% sites, mainly located on bony prominences (tibial surface and maleoli, fingers and feet. Perigraft hyper-pigmentation was seen in 29(7.1%sites, especially on sun-exposed area. Excellent pigment-spread was seen in 8(66.7% cases of halo nevus: 3 (25% showed sinking pits and 1(8.3% remnant of mole. Raised graft surface (cobble stoning was not uniform in 36 (8.8% sites. Keloidal growth at donor sites was seen in 12 (2.9% cases. This simple, unique, economic, outdoor-based, effective and cosmetically acceptable procedure may be a positive answer to many refractory vitiligo patients.

  10. Grafting Of Autologous Non-Cultured Melanocytes For The Treatment Of Vitiligo : A Pilot Study

    Directory of Open Access Journals (Sweden)

    kumar Sudhir

    2003-01-01

    Full Text Available Vitiligo is a common, often heritable, acquired disorder. Although vitiligo does not cause any physical problem but it surely is a psychosocial disaster. Depigmented patches resistant to medical treatment need to be managed surgically. Surgically. Surgical procedures usually performed lead to unsatisfactory results and that too at the cost of scarring of normal donor site. Here we describe our experience with grafting of non-cultured autologous melanocytes, which is not associated with any scarring. We tried this method in 16 lesions in 8 patients of stable vitiligo. Due to its advantages, like no scarring at recipient sites, ability to re-pigment large area with small piece of skin graft, simplicity and feasibility in Indian conditions, this is a good alternative in the treatment of vitiligo.

  11. Autologous Chondrocyte Implantation "Sandwich" Technique Compared With Autologous Bone Grafting for Deep Osteochondral Lesions in the Knee.

    Science.gov (United States)

    Minas, Tom; Ogura, Takahiro; Headrick, Jeff; Bryant, Tim

    2018-02-01

    Treating symptomatic osteochondral defects is challenging, especially in young adults with deep (>8-10 mm) empty defects after osteochondritis dissecans (OCD) or collapsed condyles secondary to avascular necrosis (AVN). For this population, osteoarthritis (OA) is inevitable if articular congruence is not restored. To describe the autologous chondrocyte implantation (ACI) "sandwich" technique with autologous bone grafting (ABG) and compare it with ABG alone for restoration of the osteochondral unit. The midterm to long-term outcomes in patients after the treatment for OCD and AVN will be reported and compared. Cohort study; Level of evidence, 3. The outcomes for a consecutive cohort of 24 patients who underwent combined ABG with the ACI sandwich technique between 2001 and 2013 (ACI sandwich group) was compared with a historical control group of 17 consecutive patients who underwent ABG alone between 1995 and 2002 (ABG group) by a single surgeon for symptomatic deep (>8 mm) osteochondral lesions. Patients who were followed up with a minimum of 2 years were included in this study. The modified Cincinnati Knee Rating System, the Western Ontario and McMaster Universities Osteoarthritis Index, a visual analog scale (VAS), the Short Form-36, and a patient satisfaction survey were used to evaluate clinical outcomes. Survival analysis was performed using the Kaplan-Meier method, with no clinical improvement, graft failure, or conversion to prosthetic arthroplasty as the endpoint (failure). Kellgren-Lawrence (K-L) grading to assess OA progression was also performed. In the ABG group, 13 of 17 patients (76%) were available with a mean follow-up of 15.7 years postoperatively (range, 5-21 years). In the ACI sandwich group, all 24 patients were available with a mean follow-up of 7.8 years postoperatively (range, 2-15 years). No significant differences were observed between the groups in terms of age, sex, side of the operated knee, body mass index, lesion type, lesion size

  12. Efficacy of Autologous Bone Marrow Concentrate for Knee Osteoarthritis with and without Adipose Graft

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    Christopher Centeno

    2014-01-01

    Full Text Available Introduction. We investigated the use of autologous bone marrow concentrate (BMC with and without an adipose graft, for treatment of knee osteoarthritis (OA. Methods. Treatment registry data for patients who underwent BMC procedures with and without an adipose graft were analyzed. Pre- and posttreatment outcomes of interest included the lower extremity functional scale (LEFS, the numerical pain scale (NPS, and a subjective percentage improvement rating. Multivariate analyses were performed to examine the effects of treatment type adjusting for potential confounding factors. The frequency and type of adverse events (AE were also examined. Results. 840 procedures were performed, 616 without and 224 with adipose graft. The mean LEFS score increased by 7.9 and 9.8 in the two groups (out of 80, respectively, and the mean NPS score decreased from 4 to 2.6 and from 4.3 to 3 in the two groups, respectively. AE rates were 6% and 8.9% in the two groups, respectively. Although pre- and posttreatment improvements were statistically significant, the differences between the groups were not. Conclusion. BMC injections for knee OA showed encouraging outcomes and a low rate of AEs. Addition of an adipose graft to the BMC did not provide a detectible benefit over BMC alone.

  13. Use of non-vascularized autologous fibula strut graft in the treatment of segmental bone loss.

    Science.gov (United States)

    Lawal, Y Z; Garba, E S; Ogirima, M O; Dahiru, I L; Maitama, M I; Abubakar, K; Ejagwulu, F S

    2011-01-01

    Fractures resulting in segmental bone loss challenge the orthopedic surgeon. Orthopedic surgeons in developed countries have the option of choosing vascularized bone transfers, bone transport, allogenic bone grafts, bone graft substitutes and several other means to treat such conditions. In developing countries where such facilities or expertise may not be readily available, the surgeon has to rely on other techniques of treatment. Non-vascularized fibula strut graft and cancellous bone grafting provides a reliable means of treating such conditions in developing countries. Over a period of six years all patients with segmental bone loss either from trauma or oncologic resection were included in the study. Data concerning the type of wound, size of gap and skin loss at tumor or fracture were obtained from clinical examination and radiographs. Ten patients satisfied the inclusion criteria for the study. The average length of the fibula strut is 7 cm, the longest being 15 cm and the shortest 3 cm long. The average defect length was 6.5 cm. Five patients had Gustillo III B open tibial fractures. One patient had recurrent giant cell tumor of the distal radius and another had a polyostotic bone cyst of the femur, which was later confirmed to be osteosarcoma. Another had non-union of distal tibial fracture with shortening. One other patient had gunshot injury to the femur and was initially managed by skeletal traction. The tenth patient had a comminuted femoral fracture. All trauma patients had measurement of missing segment, tissue envelope assessment, neurological examination, and debridement under general anesthesia with fracture stabilization with external fixators or casts. Graft incorporation was 80% in all treated patients. Autologous free, non-vascularized fibula and cancellous graft is a useful addition to the armamentarium of orthopedic surgeon in developing countries attempting to manage segmental bone loss, whether created by trauma or excision of tumors.

  14. Fast and simple fat grafting of the breast

    DEFF Research Database (Denmark)

    Kristensen, Rasmus Nygård; Gunnarsson, Gudjon L; Børsen-Koch, Mikkel

    2015-01-01

    and furthermore there are still questions about the oncologic safety in using adipose derived stem cells (ADSC). Simple fat harvesting using low vacuum and preparation by sedimentation is a fast and effective method to perform FG successfully for correction of shape and volume deficits of the breast following......Fat grafting (FG) is being used at an escalating rate for correction of shape and volume of all types of breast surgery in order to optimize the aesthetic result in spite of an ongoing debate of the oncologic safety. In this paper we demonstrate our simple and fast sedimentation based FG technique...

  15. Treatment of Early-Stage Pressure Ulcers by Using Autologous Adipose Tissue Grafts

    Directory of Open Access Journals (Sweden)

    Giovanni Francesco Marangi

    2014-01-01

    Full Text Available Assessing pressure ulcers (PUs in early stages allows patients to receive safer treatment. Up to now, in addition to clinical evaluation, ultrasonography seems to be the most suitable technique to achieve this goal. Several treatments are applied to prevent ulcer progression but none of them is totally effective. Furthermore, the in-depth knowledge of fat regenerative properties has led to a wide use of it. With this study the authors aim at introducing a new approach to cure and prevent the worsening of early-stage PUs by using fat grafts. The authors selected 42 patients who showed clinical and ultrasonographic evidence of early-stage PUs. Values of skin thickness, fascial integrity, and subcutaneous vascularity were recorded both on the PU area and the healthy trochanteric one, used as control region. Fat grafting was performed on all patients. At three months, abnormal ultrasonographic findings, such as reduction of cutaneous and subcutaneous thickness, discontinuous fascia, and decrease in subcutaneous vascularity, all were modified with respect to almost all the corresponding parameters of the control region. Results highlight that the use of fat grafts proved to be an effective treatment for early-stage PUs, especially in the care of neurological and chronic bedridden patients.

  16. Treatment of early-stage pressure ulcers by using autologous adipose tissue grafts.

    Science.gov (United States)

    Marangi, Giovanni Francesco; Pallara, Tiziano; Cagli, Barbara; Schena, Emiliano; Giurazza, Francesco; Faiella, Elio; Zobel, Bruno Beomonte; Persichetti, Paolo

    2014-01-01

    Assessing pressure ulcers (PUs) in early stages allows patients to receive safer treatment. Up to now, in addition to clinical evaluation, ultrasonography seems to be the most suitable technique to achieve this goal. Several treatments are applied to prevent ulcer progression but none of them is totally effective. Furthermore, the in-depth knowledge of fat regenerative properties has led to a wide use of it. With this study the authors aim at introducing a new approach to cure and prevent the worsening of early-stage PUs by using fat grafts. The authors selected 42 patients who showed clinical and ultrasonographic evidence of early-stage PUs. Values of skin thickness, fascial integrity, and subcutaneous vascularity were recorded both on the PU area and the healthy trochanteric one, used as control region. Fat grafting was performed on all patients. At three months, abnormal ultrasonographic findings, such as reduction of cutaneous and subcutaneous thickness, discontinuous fascia, and decrease in subcutaneous vascularity, all were modified with respect to almost all the corresponding parameters of the control region. Results highlight that the use of fat grafts proved to be an effective treatment for early-stage PUs, especially in the care of neurological and chronic bedridden patients.

  17. Outcomes of Autologous Fat Injection Laryngoplasty in Unilateral Vocal Cord Paralysis

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    Ehsan Khadivi

    2016-05-01

    Full Text Available Introduction: Unilateral vocal cord paralysis (UVCP is not an uncommon finding. Several procedures are available to manage glottal insufficiency. We conducted a clinical trial to evaluate the outcome of fat injection laryngoplasty.   Materials and Methods: Liposuctioned lower abdomen fat was injected for augmentation of paralyzed vocal cord in 20 patients with UVCP. Autologous fat was harvested with an 18G needle and a 20-ml disposable syringe using a liposuction technique. Clinical follow-up after the injection was carried out from 1 to 6–21 months   Results: Voice and glottal protective function were significantly improved after the surgery. Vocal elements were immediately improved after the surgery, and after 1 year of follow-up. Conclusion:  Fat injection laryngoplasty by liposuction is simple, safe, effective and has a low cost for patients with UVCP with aspiration and breathy voice dysphonia.

  18. The influence of rifamycin decontamination on incorporation of autologous onlay bone grafts in rats: A histometric and immunohistochemical evaluation.

    Science.gov (United States)

    Taşdemir, Ufuk; Özeç, İlker; Esen, Haci Hasan; Avunduk, M Cihat

    2015-05-01

    Although it has been shown that rifamycin is an effective agent for bone graft decontamination, no information exists on the effects of rifamycin decontamination on bone graft incorporation. The aim of this study was to evaluate the influence of rifamycin decontamination on the incorporation of autologous onlay bone grafts quantitatively. In 30 rats, a standardized 5.0-mm-diameter bone graft was harvested from the right mandibular angle, contaminated with saliva, decontaminated with rifamycin solution, and augmented to the left as an onlay graft. Ten animals were sacrificed at 7, 14, and 21 days after surgery. In the control group (10 rats), the onlay grafts were neither contaminated nor decontaminated, and the rats were sacrificed at 21 days after surgery. Histological slides were prepared from each grafted site for both immunohistochemistry analysis (bone morphogenetic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF) antibodies) and histometric analysis. Images obtained from the graft incorporation area with the light microscope were transferred to a PC, and they were evaluated using Clemex PE 3.5 image analysis software. The grafts were fully incorporated in all specimens. The results showed that rifamycin decontamination has no detrimental effect on graft incorporation and the findings revealed a tendency for earlier revascularization and osteogenesis in the decontamination group. Data were analyzed using variance analysis and Tukey's test. Rifamycin decontamination has no detrimental effect on autogenous graft incorporation, and it can be used for graft decontamination with confidence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Surgical management of diaphyseal humeral nonunion after intramedullary nailing: Wave-plate fixation and autologous bone grafting without nail removal

    NARCIS (Netherlands)

    Gerber, Ariane; Marti, René; Jupiter, Jesse

    2003-01-01

    Six patients with a nonunion of the humeral diaphysis after intramedullary nailing were treated with a wave plate and autologous bone graft but without removal of the intramedullary implant. The mean duration of the nonunion was 19 months (range, 6-36 months). At a mean follow-up of 12 months

  20. Does platelet-rich plasma promote remodeling of autologous bone grafts used for augmentation of the maxillary sinus floor?

    NARCIS (Netherlands)

    Raghoebar, GM; Schortinghuis, J; Liem, RSB; Ruben, JL; van der Wal, JE; Vissink, A

    The aim of this study was to evaluate the effect of platelet-rich plasma (PRP) on remodeling of autologous bone grafts used for augmentation of the floor of the maxillary sinus. In five edentulous patients suffering from insufficient retention of their upper denture related to a severely resorbed

  1. Functional assessment of sciatic nerve reconstruction : Biodegradable poly (DLLA-epsilon-CL) nerve guides versus autologous nerve grafts

    NARCIS (Netherlands)

    Meek, MF; Dijkstra, [No Value; Den Dunnen, WFA; Ijkema-Paassen, J; Schakenraad, JM; Gramsbergen, A; Robinson, PH

    1999-01-01

    The aim of this study was to compare functional nerve recovery after reconstruction with a biodegradable p(DLLA-epsilon-CL) nerve guide filled with modified denatured muscle tissue (MDMT), or an autologous nerve graft. We evaluated nerve recovery using walking track analysis (measurement of the

  2. Repair of refractory wounds through grafting of artificial dermis and autologous epidermis aided by vacuum-assisted closure.

    Science.gov (United States)

    Zhang, Chenwei; Liu, Dalie; Liang, Zhi; Liu, Fei; Lin, Haibo; Guo, Zhengdong

    2014-08-01

    This study aimed to investigate the clinical efficacy of vacuum-assisted closure (VAC) combined with grafting of artificial dermis and autologous epidermis in the repair of refractory wounds. Patients with refractory wounds underwent debridement. Then the VAC device was used to culture wound granulation tissue. After the wound granulation tissue began to grow, artificial dermis was grafted on the wounds with VAC treatment. Then autologous epidermis was grafted on the artificial dermis to repair the wounds after survival of the artificial epidermis. The study mainly observed length of the hospital stay, survival of the artificial dermis, time required for culture of the granulation tissue using VAC before grafting of the artificial dermis, survival time of the artificial dermis, survival conditions of the autologous epidermis, influence on functions of a healed wound at a functional part, healing conditions of donor sites, and recurrence conditions of the wounds. Healing was successful for 22 patients (95.7%), but treatment failed for 1 child. The 22 patients were followed up for 6 to 24 months. According to follow-up findings, the skin grafts had good color and a soft texture. They were wear resistant and posed no influence on function. The appearance of the final results was the same as that of the full-thickness skin graft. Mild or no pigmentation and no scar formation occurred at the donor sites, and the wounds did not recur. Vacuum-assisted closure combined with grafting of artificial dermis and autologous epidermis is an effective means for repairing refractory wounds and is worth clinical popularizing and application. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  3. Cellulite: a new treatment approach combining subdermal Nd: YAG laser lipolysis and autologous fat transplantation.

    Science.gov (United States)

    Goldman, Alberto; Gotkin, Robert H; Sarnoff, Deborah S; Prati, Clarissa; Rossato, Flávia

    2008-01-01

    Cellulite is an alteration of the topography of the skin that occurs in body areas where fat deposition seems to be under the influence of estrogen: mainly the hips, buttocks, thighs, and abdomen. The presence of cellulite is a significant source of patient dissatisfaction. There is currently no cure or consistently effective treatment for cellulite. The authors sought to show that the subdermal application of the neodymium-doped yttrium aluminium garnet (Nd:YAG) laser combined with autologous fat transplantation is a safe and effective treatment for cellulite. From January 2003 to December 2006, 52 female patients with Curri grade III to IV cellulite were treated with subdermal 1064-nm Nd:YAG laser lipolysis combined with autologous fat transplantation. Patient assessment was collected for data analysis. After the treatment, tissue samples were obtained in some subjects in order to ascertain the histologic effects of the laser treatment. This treatment resulted in significant clinical improvement in cellulite. The adverse effects were mild and temporary, and the postoperative period was well tolerated. A majority of patients (84.6%) rated the results of treatment as either good or excellent. The treatment of severe cases of cellulite (Curri grades III and IV) by a combination of 1064-nm Nd:YAG laser lipolysis and autologous fat transplantation proved to be both safe and effective. In addition, subdermal laser lipolysis has the advantage of inducing neocollagenesis and stimulating postoperative skin tightening. This represents a new treatment option for the ubiquitous cellulite disorder. Although this treatment has shown promising results in this pilot study, further studies are necessary in order to draw final conclusions.

  4. Effects of local irradiation of thymus, hypothalamys/hypophysis and gonad regions on repopulation of autologous and grafted thymus in mice

    International Nuclear Information System (INIS)

    Savina, N.P.; Yarilin, A.A.

    1995-01-01

    Mice were grafted with syngeneic thymus 1-3 days or 7.5-8 moths after local irradiation of thymus, hypothalamus/hypophysis and gonads. Thymus weight and thymocyte number were measured in autologous and grafted thymus 35-40 days after the transplantation. Thymus transplantation induces significant decrease in weight and cellularity of both autologous and grafted thymus. Irradiation of autologous and grafted thymus in doses of 1 and 10 Gy abrogates this effect. Irradiation of hypothalamus/hypophysis and gonades induces decrease of weight and cellularity of autologous and grafted thymus. Irradiation of gonads does not abrogate inhibitory effect of thymus transplantation. Local irradiation of all three regions decreases titre of serum thymic activity and influence concentrations of some hypophysis and adrenal hormones. 7 refs.; 3 figs.; 2 tabs

  5. Autologous nerve graft repair of different degrees of sciatic nerve defect: stress and displacement at the anastomosis in a three-dimensional fnite element simulation model

    Directory of Open Access Journals (Sweden)

    Cheng-dong Piao

    2015-01-01

    Full Text Available In the repair of peripheral nerve injury using autologous or synthetic nerve grafting, the magnitude of tensile forces at the anastomosis affects its response to physiological stress and the ultimate success of the treatment. One-dimensional stretching is commonly used to measure changes in tensile stress and strain however, the accuracy of this simple method is limited. Therefore, in the present study, we established three-dimensional finite element models of sciatic nerve defects repaired by autologous nerve grafts. Using PRO E 5.0 finite element simulation software, we calculated the maximum stress and displacement of an anastomosis under a 5 N load in 10-, 20-, 30-, 40-mm long autologous nerve grafts. We found that maximum displacement increased with graft length, consistent with specimen force. These findings indicate that three-dimensional finite element simulation is a feasible method for analyzing stress and displacement at the anastomosis after autologous nerve grafting.

  6. USE OF GENETICALLY MODIFIED MUSCLE AND FAT GRAFTS TO REPAIR DEFECTS IN BONE AND CARTILAGE

    Science.gov (United States)

    Evans, C.H.; Liu, F.-J.; Glatt, V.; Hoyland, J.A.; Kirker-Head, C.; Walsh, A.; Betz, O.; Wells, J.W.; Betz, V.; Porter, R.M.; Saad, F.A.; Gerstenfeld, L.C.; Einhorn, T.A.; Harris, M.B.; Vrahas, M.S.

    2015-01-01

    We report a novel technology for the rapid healing of large osseous and chondral defects, based upon the genetic modification of autologous skeletal muscle and fat grafts. These tissues were selected because they not only possess mesenchymal progenitor cells and scaffolding properties, but also can be biopsied, genetically modified and returned to the patient in a single operative session. First generation adenovirus vector carrying cDNA encoding human bone morphogenetic protein-2 (Ad.BMP-2) was used for gene transfer to biopsies of muscle and fat. To assess bone healing, the genetically modified (“gene activated”) tissues were implanted into 5mm-long critical size, mid-diaphyseal, stabilized defects in the femora of Fischer rats. Unlike control defects, those receiving gene-activated muscle underwent rapid healing, with evidence of radiologic bridging as early as 10 days after implantation and restoration of full mechanical strength by 8 weeks. Histologic analysis suggests that the grafts rapidly differentiated into cartilage, followed by efficient endochondral ossification. Fluorescence in situ hybridization detection of Y-chromosomes following the transfer of male donor muscle into female rats demonstrated that at least some of the osteoblasts of the healed bone were derived from donor muscle. Gene activated fat also healed critical sized defects, but less quickly than muscle and with more variability. Anti-adenovirus antibodies were not detected. Pilot studies in a rabbit osteochondral defect model demonstrated the promise of this technology for healing cartilage defects. Further development of these methods should provide ways to heal bone and cartilage more expeditiously, and at lower cost, than is presently possible. PMID:20073015

  7. The influence of three barrier membranes on modeling and incorporation of autologous onlay bone grafts in rats. An evaluation by transversal microradiography

    NARCIS (Netherlands)

    Gielkens, Pepijn F. M.; Hoogeveen, Eelke J.; Schortinghuis, Jurjen; Ruben, Jan L.; Huysmans, Marie-Charlotte D. N. J. M.; Stegenga, Boudewijn

    Objectives: To determine whether covering an autologous bone grafts with three different barrier membranes prevents graft resorption, and to compare these membranes to each other. Design: In 192 rats a standardised 4.0 mm diameter bone graft was harvested from the right mandibular angle and

  8. Lymphedema Fat Graft: An Ideal Filler for Facial Rejuvenation

    Directory of Open Access Journals (Sweden)

    Fabio Nicoli

    2014-09-01

    Full Text Available Lymphedema is a chronic disorder characterized by lymph stasis in the subcutaneous tissue. Lymphatic fluid contains several components including hyaluronic acid and has many important properties. Over the past few years, significant research has been performed to identify an ideal tissue to implant as a filler. Because of its unique composition, fat harvested from the lymphedema tissue is an interesting topic for investigation and has significant potential for application as a filler, particularly in facial rejuvenation. Over a 36-month period, we treated and assessed 8 patients with lymphedematous limbs who concurrently underwent facial rejuvenation with lymphedema fat (LF. We conducted a pre- and post-operative satisfaction questionnaire survey and a histological assessment of the harvested LF fat. The overall mean general appearance score at an average of 6 months after the procedure was 7.2±0.5, demonstrating great improvement. Patients reported significant improvement in their skin texture with a reading of 8.5±0.7 and an improvement in their self-esteem. This study demonstrates that LF as an ideal autologous injectable filler is clinically applicable and easily available in patients with lymphedema. We recommend the further study and clinical use of this tissue as it exhibits important properties and qualities for future applications and research.

  9. Correction of facial lipoatrophy using autologous fat transplants in HIV-infected adolescents.

    Science.gov (United States)

    Dollfus, C; Blanche, S; Trocme, N; Funck-Brentano, I; Bonnet, F; Levan, P

    2009-05-01

    Antiretroviral therapy has dramatically improved the survival of HIV-infected children. Nevertheless, side effects comparable to those found in adults have been encountered, such as facial lipoatrophy, which can have a negative impact on the self-esteem of otherwise healthy adolescents. Cosmetic surgical procedures in adolescents raise psychological issues which need to be specifically addressed and which have never been previously reported in this population. We evaluated the patient satisfaction, safety and cosmetic results of HIV-infected adolescents who experienced autologous fat transplants for the correction of facial lipoatrophy. We report the results of plastic surgery using autologous fat transplants (Coleman's Lipostructure) in six HIV-infected adolescents with facial lipoatrophy: three boys and three girls, aged 14-19 years. The quantity of reinjected fat on each side of the face varied from 5 to 12 mL within a single procedure. All the patients reported being satisfied or very satisfied with the cosmetic results and reported a positive impact on their daily life. With well-trained surgeons and carefully selected indications, corrective surgery of facial lipoatrophy in HIV-infected adolescents can provide immediate and long-lasting benefits in terms of physical appearance and psychological wellbeing, and should be considered as a component of comprehensive care.

  10. Delayed Union of a Sacral Fracture: Percutaneous Navigated Autologous Cancellous Bone Grafting and Screw Fixation

    International Nuclear Information System (INIS)

    Huegli, R. W.; Messmer, P.; Jacob, A. L.; Regazzoni, P.; Styger, S.; Gross, T.

    2003-01-01

    Delayed or non-union of a sacral fracture is a serious clinical condition that may include chronic pain, sitting discomfort, gait disturbances, neurological problems, and inability to work. It is also a difficult reconstruction problem. Late correction of the deformity is technically more demanding than the primary treatment of acute pelvic injuries. Open reduction, internal fixation (ORIF), excision of scar tissue, and bone grafting often in a multi-step approach are considered to be the treatment of choice in delayed unions of the pelvic ring. This procedure implies the risk of neurological and vascular injuries, infection, repeated failure of union, incomplete correction of the deformity, and incomplete pain relief as the most important complications. We report a new approach for minimally invasive treatment of a delayed union of the sacrum without vertical displacement. A patient who suffered a Malgaigne fracture (Tile C1.3) was initially treated with closed reduction and percutaneous screw fixation (CRPF) of the posterior pelvic ring under CT navigation and plating of the anterior pelvic ring. Three months after surgery he presented with increasing hip pain caused by a delayed union of the sacral fracture. The lesion was successfully treated percutaneously in a single step procedure using CT navigation for drilling of the delayed union, autologous bone grafting, and screw fixation

  11. Solitary haemangioma of the shaft of long bones: resection and reconstruction with autologous bone graft.

    Science.gov (United States)

    Li, Zhaoxu; Tang, Jicun; Ye, Zhaoming

    2013-04-01

    Bone haemangiomas are uncommon lesions, occurring in the skull or spine. A solitary haemangioma in the diaphysis of a long bone is rare. We retrospectively investigated six patients who presented with a solitary haemangioma in a long bone diaphysis. After segmental bone resection, the bone defect was replaced by a bone autograft. Patients were reviewed clinically and with radiographs. The mean follow-up was 6 years (range : 1-20 years). At the time of latest follow-up, no patient had a recurrence. Postoperative complications were one wound necrosis and one superficial wound infection. Union of the gap filling graft with the host bone was achieved in all patients at an average of 4 months (range: 3-8 months). The average Musculoskeletal Tumor Society functional score was 77% (range: 53%-90%) of normal at 6 months postoperatively, and 97% (range: 95%-99%) at the last follow-up evaluation. Segmental resection for solitary haemangioma and reconstruction with autologous bone graft can be considered as a suitable treatment option.

  12. Differential contributions of graft-derived and host-derived cells in tissue regeneration/remodeling after fat grafting.

    Science.gov (United States)

    Doi, Kentaro; Ogata, Fusa; Eto, Hitomi; Kato, Harunosuke; Kuno, Shinichiro; Kinoshita, Kahori; Kanayama, Koji; Feng, Jingwei; Manabe, Ichiro; Yoshimura, Kotaro

    2015-06-01

    Recent research indicates that the adipose tissue of nonvascularized grafts is completely remodeled within 3 months, although origins of next-generation cells are unclear. Inguinal fat pads of green fluorescent protein mice and wild-type mice were cross-transplanted beneath the scalp. At 1, 2, 4, and 12 weeks after transplantation, grafted fat was harvested, weighed, and analyzed through immunohistochemistry, whole-mount staining, and flow cytometry of cell isolates. Bone marrow of green fluorescent protein mice was transplanted to wild-type mice (after irradiation). Eight weeks later, these mice also received fat grafts, which were analyzed as well. The majority of host-derived cells detected during remodeling of grafted fat were macrophages (>90 percent at the early stage; 60 percent at 12 weeks). Cell origins were analyzed at 12 weeks (i.e., when completely regenerated). At this point, mature adipocytes were largely derived from adipose-derived stem/stromal cells of grafts. Although vascular wall constituents were chiefly graft derived, vascular endothelial cells originated equally from graft and host bone marrow. Adipose-derived stem/stromal cells of regenerated fat were an admixture of grafted, host nonbone marrow, and host bone marrow cells. The above findings underscore the importance of adipose stem/stromal cells in the grafted fat for adipocyte regeneration. Host bone marrow and local tissues contributed substantially to capillary networks and provided new adipose-derived stem/stromal cells. An appreciation of mechanisms that are operant in this setting stands to improve clinical outcomes of fat grafting and cell-based therapies.

  13. Effect, Feasibility, and Clinical Relevance of Cell Enrichment in Large Volume Fat Grafting

    DEFF Research Database (Denmark)

    Rasmussen, Bo Sonnich; Lykke Sørensen, Celine; Vester-Glowinski, Peter Viktor

    2017-01-01

    Large volume fat grafting is limited by unpredictable volume loss; therefore, methods of improving graft retention have been developed. Fat graft enrichment with either stromal vascular fraction (SVF) cells or adipose tissue-derived stem/stromal cells (ASCs) has been investigated in several animal...... and human studies, and significantly improved graft retention has been reported. Improvement of graft retention and the feasibility of these techniques are equally important in evaluating the clinical relevance of cell enrichment. We conducted a systematic search of PubMed to identify studies on fat graft...... enrichment that used either SVF cells or ASCs, and only studies reporting volume assessment were included. A total of 38 articles (15 human and 23 animal) were included to investigate the effects of cell enrichment on graft retention as well as the feasibility and clinical relevance of cell-enriched fat...

  14. Implantation of Autologous Adipose Tissue-Derived Mesenchymal Stem Cells in Foot Fat Pad in Rats.

    Science.gov (United States)

    Molligan, Jeremy; Mitchell, Reed; Bhasin, Priya; Lakhani, Aliya; Schon, Lew; Zhang, Zijun

    2015-11-01

    The foot fat pad (FFP) bears body weight and may become a source of foot pain during aging. This study investigated the regenerative effects of autologous adipose tissue-derived mesenchymal stem cells (AT-MSCs) in the FFP of rats. Fat tissue was harvested from a total of 30 male Sprague-Dawley rats for isolation of AT-MSCs. The cells were cultured, adipogenic differentiation was induced for 1 week, and the AT-MSCs were labeled with fluorescent dye before injection. AT-MSCs (5 × 10(4) in 50 µL of saline) were injected into the second infradigital pad in the right hindfoot of the rat of origin. Saline only (50 µL) was injected into the corresponding fat pad in the left hind paw of each rat. Rats (n = 10) were euthanized at 1, 2, and 3 weeks, and the second infradigital fat pads were dissected for histologic examination. The fluorescence-labeled AT-MSCs were present in the foot pads throughout the 3-week experimental period. On histologic testing, the area of fat pad units (FPUs) in the fat pads that received AT-MSC injections was greater than that in the control fat pads. Although the thickness of septae was not changed by AT-MSC injections, the density of elastic fibers in the septae was increased in the fat pads with implanted AT-MSCs. In this short-term study, the implanted AT-MSCs largely survived and might have stimulated the expansion of individual FPUs and increased the density of elastic fibers in the FFP in this rat model. These data support the development of stem cell therapies for age-associated degeneration in FFP in humans. © The Author(s) 2015.

  15. Evaluation of immediate breast reconstruction after breast-conserving therapy using autologous free dermal fat flap

    International Nuclear Information System (INIS)

    Kadoya, Takayuki; Nishisaka, Takashi; Mukai, Shoichiro; Saeki, Yoshihiro; Sakimoto, Hideto; Eto, Takaaki; Takahashi, Makoto

    2010-01-01

    We performed immediate breast reconstruction using autologous free dermal fat flap followed by irradiation to the breast in a total of 11 patients with breast cancer in whom breast-conserving therapy was difficult. Their postoperative courses were satisfactory and they had not experienced infection and necrosis of the flap Postoperative MRI examination confirmed that the blood flow had resumed only in the periphery of the flap, but no blood flow was seen in the center part of the flap and the size of the flap had become smaller than that when it had been collected. Core needle biopsy showed that fatty tissue of the flap had dropped while its tissue structure had been kept intact, of which histological features were compatible with those of coagulation and necrosis of the tissue due to decreased flap perfusion. The cosmetic evaluation of the reconstructed breast was rated as an average score of 10.0 according to the Sawai group's criteria of the Japanese Breast Cancer Society. The postoperative flap was felt hard in many cases, but good outcomes were gained in all cases in terms of the lowest hanging point of the breast, location of the nipple, and balance between the right and left breasts. Autologous free dermal fat flap is an easier and less invasive breast reconstruction method than myocutaneous flap and implant methods. It requires no positioning changes of the patient and can be performed not only by plastic surgeons but also by general surgeons. (author)

  16. Effect of BCNU combined with total body irradiation or cyclophosphamide on survival of dogs after autologous marrow grafts

    International Nuclear Information System (INIS)

    Paterson, A.H.G.; English, D.

    1979-01-01

    Dogs were treated with either: (1) 750 rad total body irradiation; (2) BCNU 2 or 4 mg/kg IV 48 hours prior to 750 rad total body irradiation; or (3) BCNU 4 mg/kg IV plus cyclophosphamide 30 mg/kg IV. Results showed that of 11 dogs who received 750 rad total body irradiation and did not receive cryopreserved autologous bone marrow cells, none survived, compared to an 88% survival (31 of 35 dogs) after 750 rad total body irradiation if the dogs received stored autologous bone marrow cells. However, when the dogs were treated with BCNU 2 or 4 mg/kg prior to 750 rad total body irradiation the survival rate, despite infusion of autologous bone marrow cells, dropped to 25% (3 of 12 dogs) for BCNU 2 mg/kg, and 17% (2 of 12 dogs) for BCNU 4 mg/kg. This effect did not seem to be due to direct serum inhibition of hemopoietic cell proliferation since serum obtained at various intervals after BCNU administrations failed to inhibit CFU growth in vitro. The dogs died from hemorrhage and infection; at autopsy there was hemorrhagic pneumonitis and intestinal ulcerations with petechial hemorrhages, suggesting that the combination of BCNU and total body irradiation may have synergistic toxicity on the canine gastro-intestinal tract. When BCNU was combined with cyclophosphamide, reversal of marrow toxicity occurred in 54% (6 of 11 dogs) with stored autologous bone marrow cells compared to no survival (0 of 8 dogs) with stored autologous bone marrow cells. Thus while autologous bone marrow grafts are useful for reversal of marrow toxicity due to many therapeutic protocols, such grafts alone may not provide protection against toxicity due to the combination of high dosage BCNU and total body irradiation

  17. Autologous Bone Grafting and Revision Plating in a Case of Persistent High Tibial Osteotomy Non-Union.

    Science.gov (United States)

    Ming, Tan Shi; Koon, Wong Merng

    2016-01-01

    Uni-compartmental knee arthritis may be treated with several surgical options including uni-compartmental knee arthroplasty, total knee arthroplasty and high tibial osteotomy. Non-union is a well-established and common complication that may arise from the latter option and few reports have shown successful treatment of persistent non-union of high tibial osteotomy. We present a case of persistent non-union after high tibial osteotomy treated with autologous iliac crest bone grafting and revision plating. At 1 year post-operative interval, successful union was achieved after revision internal fixation. In addition, a good functional outcome was achieved. In this patient with persistent non-union following high tibial osteotomy, the aim of revision was to restore alignment and effect bone healing while preserving adequate tibial bone stock. Revision plating with autologous bone grafting is a good surgical strategy in the treatment ofpersistent non-union with hardware failure.

  18. Future Economics of Liver Transplantation: A 20-Year Cost Modeling Forecast and the Prospect of Bioengineering Autologous Liver Grafts.

    Directory of Open Access Journals (Sweden)

    Dany Habka

    Full Text Available During the past 20 years liver transplantation has become the definitive treatment for most severe types of liver failure and hepatocellular carcinoma, in both children and adults. In the U.S., roughly 16,000 individuals are on the liver transplant waiting list. Only 38% of them will receive a transplant due to the organ shortage. This paper explores another option: bioengineering an autologous liver graft. We developed a 20-year model projecting future demand for liver transplants, along with costs based on current technology. We compared these cost projections against projected costs to bioengineer autologous liver grafts. The model was divided into: 1 the epidemiology model forecasting the number of wait-listed patients, operated patients and postoperative patients; and 2 the treatment model forecasting costs (pre-transplant-related costs; transplant (admission-related costs; and 10-year post-transplant-related costs during the simulation period. The patient population was categorized using the Model for End-Stage Liver Disease score. The number of patients on the waiting list was projected to increase 23% over 20 years while the weighted average treatment costs in the pre-liver transplantation phase were forecast to increase 83% in Year 20. Projected demand for livers will increase 10% in 10 years and 23% in 20 years. Total costs of liver transplantation are forecast to increase 33% in 10 years and 81% in 20 years. By comparison, the projected cost to bioengineer autologous liver grafts is $9.7M based on current catalog prices for iPS-derived liver cells. The model projects a persistent increase in need and cost of donor livers over the next 20 years that's constrained by a limited supply of donor livers. The number of patients who die while on the waiting list will reflect this ever-growing disparity. Currently, bioengineering autologous liver grafts is cost prohibitive. However, costs will decline rapidly with the introduction of new

  19. A prospective randomized study comparing centrifugation and sedimentation for fat grafting in breast reconstruction.

    Science.gov (United States)

    Sarfati, I; van la Parra, R F D; Terem-Rapoport, C A; Benyahi, D; Nos, C; Clough, K B

    2017-09-01

    Fat grafting is an efficient method to correct large volumetric defects after mastectomy. There is an ongoing debate regarding the best method of processing the harvested fat before fat grafting. This study aimed to introduce a new MRI model and to compare two fat processing techniques measuring the gain in soft tissue thickness after fat grafting to the chest wall. Fifty-one mastectomy patients (one double sided), who required delayed implant reconstruction, with poor skin conditions were proposed fat grafting prior to implant reconstruction. At the time of fat grafting, patients were randomly assigned to centrifugation or sedimentation of the aspirated fat. The trial was undertaken in a single-center private practice setting. The gain in soft tissue thickness of the chest wall was measured using an MRI model, with 12 predefined points for measurement. Two MRIs were performed, one prior to fat grafting and one 8 weeks thereafter. The radiologist was blinded to the fat graft processing method used. Seven cases were excluded because they did not complete their second MRI. The analyses were thus based on 44 patients (one double sided). Centrifugation was performed in 21 cases and sedimentation in 24 cases. The mean gain in soft tissue thickness was +7.0 mm in the centrifugation group and +8.8 mm in the sedimentation group (p = .268). The mean operative time was 88 min in the centrifugation group and 78 min in the sedimentation group (p = .11). There were no adverse events for any of the patients. We developed a simple and reproducible MRI model to objectively measure and evaluate different fat processing techniques prior to fat grafting. At a median time of 8 weeks after one session of fat grafting, there was no benefit of centrifugation over sedimentation. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. The second fat graft has significantly better outcome than the first fat graft for Romberg syndrome: A study of three-dimensional volumetric analysis.

    Science.gov (United States)

    Jiang, Taoran; Xie, Yun; Zhu, Ming; Zhao, Peijuan; Chen, Zhuxin; Cheng, Chen; Huang, Rulin; Liu, Kai; Li, Qingfeng

    2016-12-01

    Patients with congenital or acquired deformities always need fat graft at least twice to remodel facial contour. The purpose of this study was to objectively evaluate the outcomes of the first and second fat grafts for Romberg syndrome by using three-dimensional (3D) volumetric analysis. A retrospective study was conducted using the medical records of 13 patients with Romberg disease who were treated with fat graft twice for facial filling. Patient and surgeon satisfactions were evaluated by comparing the preoperative and postoperative two-dimensional (2D) photographs. The preoperative and postoperative 3D images were analyzed with professional analysis software to calculate the volume discrepancy between them. According to the 2D photographs, both patients and the surgeon were more satisfied with the cosmetic results of the second fat graft. There was no significant statistical difference in the injection volumes between the two surgeries (p = 0.1); however, the survival rate of the second fat graft (75.1% ± 7.7%) was much higher than that of the first (43.3% ± 11.1%) with a significant difference (p < 0.01). In this study, 3D images were used to objectively evaluate the survival rate of fat graft. The results showed that the second fat graft without any sophisticated procedures could acquire better cosmetic result and volume retention in Romberg syndrome. This study result could serve as a guide for clinical surgeons to forecast the outcome of sequential fat graft for patients with congenital or acquired deformities. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Buccal mucosa is a promising graft in Peyronie’s disease surgery. Our experience and a brief literature review on autologous grafting materials

    Directory of Open Access Journals (Sweden)

    Andrea Fabiani

    2016-07-01

    Full Text Available Aim: Peyronie’s Disease (PD is an under reported acquired benign condition that, at the moment, is not curable with medical therapy. Surgery represent the gold standard of treatment. Surgical approaches are several and they consist in “plication techniques” or plaque incision/excision with grafting of resulting albuginea defect. Among grafting procedures, albuginea defect substitution with autologous materials demonstrated over the years not inferior results respect to heterologous grafts. Buccal mucosa graft (BMG is not usually emphasized in many review articles and clinical series are yet limited. Methods: We present our experience with seventeen plaque incision procedures and BMG in surgical correction of complex penile curvatures due to PD performed in a period of 30 months. Our analyses was focused on buccal mucosa graft characteristics as major determinant of the surgical success. We also conducted a brief literature review on autologous grafting materials used in reconstructive penile surgery for PD. Results: Our cosmetics and functional results consists in a 100% of functional penile straightening with no relapses and 5,8% of de novo erectile dysfunction. Mean age was 56.4 years, mean follow-up of 22.5 (6-36 months. No complications graft related were observed. Operative time was 115.3 minutes in mean. Over 94% of patients referred they were “really much better” and “much better” satisfied based on PGI-I questionnaire administrated at the last follow- up visit. Conclusion: BMG is revealing as an optimal choice for reconstructive surgery in PD. Anatomical characteristics consisting in the great elasticity, the quick integration time and the easy harvesting technique lead to high cosmetics and functional success rate, without omitting economical and invasiveness aspects.

  2. [Application of small freeze-drying allogeneic bone plots mixed with autologous bone graft in spinal fusion].

    Science.gov (United States)

    Tian, Changqing; Li, Zhenyu; Zhou, Wenyu; Zeng, Tenghui; Sun, Shiquan; Li, Baoxing

    2009-05-01

    To investigate the osteoblasts effect, complications and influencing factors in the application of small freeze-drying allogeneic bone plots mixed autologous bone fragments in spinal surgery, and to compare with autogenous bone graft. From January 2003 to January 2007, 515 cases of spinal injuries were treated. A total of 324 cases were treated with small freeze-drying allogeneic bone plots mixed with autologous bone grafts (group A), including 211 males and 113 females with an average age of 36 years (18-83 years). There were 182 cases of thoracolumbar vertebra fracture, 68 cases of lumbar spondylolisthesis, 47 cases of lumbar vertebral canal stenosis, 17 cases of cervical disc herniation, 5 cases of cervical spine fracture-dislocation and 5 cases of thoracolumbar vertebra tumor. The weight of bone graft was 10-60 g (mean 30 g). A total of 191 cases were treated with autogenous bone grafting (group B), including 135 males and 56 females with an average age of 32 years (23-78 years). There were 109 cases of thoracolumbar vertebra fracture, 23 cases of lumbar spondylolisthesis, 17 cases of lumbar vertebral canal stenosis, 19 cases of cervical disc herniation, and 23 cases of cervical spine fracture-dislocation. The weight of bone graft was 10-50 g (mean 25 g). In group A, effusion of wound increased in 4 cases and the result of bacterial culture was negative; effusion was absorbed after 2 weeks of local irrigation, drainage and cortin management. In group B, no obvious effusion was observed. The follow-up time was 10-36 months (mean 17.4 months) in group A and 8-36 months (mean 16.8 months) in group B. The bone healing was achieved in 308 cases within 4-10 months (mean 8.1 months) and in 184 cases within 4-10 months (mean 5.8 months), and the bone fusion rates were 95.06% and 96.34% in groups A and B, respectively. There was no significant difference in bone fusion rate between groups (P > 0.05). According to Mankin and Komender evaluation standard, the response

  3. Combined use of platelet-rich plasma and autologous bone grafts in the treatment of long bone defects in mini-pigs.

    Science.gov (United States)

    Hakimi, M; Jungbluth, P; Sager, M; Betsch, M; Herten, M; Becker, J; Windolf, J; Wild, M

    2010-07-01

    The use of platelet-rich plasma (PRP) for improving of bone defect healing is discussed controversially. The aim of this study was to assess the effect of PRP in combination with autologous cancellous graft on bone defect healing in a critical metaphyseal long bone defect. A critical size defect in the tibial metaphysis of 16 mini-pigs was filled either with autologous cancellous graft as control group or with autologous cancellous graft combined with autologous PRP. Compared to native blood platelets were enriched about 4.9-fold in the PRP. After 6 weeks, the specimens were assessed by X-ray and histological evaluation. Histomorphometrical analysis revealed that the area of new bone was significantly higher in the PRP group concerning the central area of the defect zone (pbone formation, but only defects of the PRP group regenerated entirely. The PRP group was superior to the control group even in the semi-quantitative assessment of the osseous bridging in both observed areas of the defect. Within the limits of the present study it could be demonstrated that PRP combined with autologous cancellous graft leads to a significantly better bone regeneration compared to isolated application of autologous cancellous graft in an in vivo critical size defect on load-bearing long bones of mini-pigs. 2009 Elsevier Ltd. All rights reserved.

  4. [Effects of autologous periosteum wrapping allogenic tendon graft on tendon-bone healing inside a bone tunnel in rabbits].

    Science.gov (United States)

    Long, Xianbin; Chen, Zhiwei; Cao, Shengjun

    2008-10-01

    To explore the situation of tendon-bone healing when allogenic tendon graft is wrapped with autologous periosteum around the tendon in rabbits. Twenty healthy New Zealand white rabbits with the age of 4-5 months were used in the experiment, weighing 2.5-3.0 kg. One-side posterior limb was selected randomly as the test, and the contralateral limb was served as the control at the same time. The allogenic tendon graft was designed as a tendon-bone model in the proximal tibial metaphysis of rabbits. The portion of tendon in the bone tunnel was wrapped with autologous periosteal graft in which the cambium layer was facing the bone tunnel in the experimental group, while the portion of tendon in the bone tunnel was not wrapped with autologous periosteal graft in the control group. The histologic examination of the tendon-bone interface (n = 2) and the biomechanical test for maximal pullout load (n = 8) were conducted 4 and 8 weeks after operation, respectively. All specimens were observed with naked eyes 4 and 8 weeks after the operation. Many new bones around bone tunnel outlet were seen in the experimental group, while a few or few new bones were seen in the control group. Four weeks after operation, histological observation showed there were a lot of proliferative mesenchymal cells in the periosteal germinal layer in the experimental group and conspicuous membrane bone formation was obvious. The arrangement of massive osteoblasts around newborn bone trabecula was similar to palisade. The newborn bone trabecula was linked with the periosteum. Some loose connective tissues and few newborn bones between the tendon graft and the bone tunnel were seen in the control group, and the connection of them was loose. Eight weeks after operation, the connection between the tendon graft and the bone tunnel was tight and no gap existed in the experimental group. The number of newborn bones was large and their arrangement was relatively regular. The tidemark line was seen between the

  5. Predictive value of ridge dimensions on autologous bone graft resorption in staged maxillary sinus augmentation surgery using Cone-Beam CT.

    NARCIS (Netherlands)

    Klijn, R.J.; Beucken, J.J.J.P van den; Bronkhorst, E.M.; Berge, S.J.; Meijer, G.J.; Jansen, J.B.M.J.

    2012-01-01

    INTRODUCTION: No studies are available that provide predictive parameters regarding the expected amount of resorption after maxillary sinus augmentation surgery using autologous bone grafts. Therefore, the aim of this study was to determine parameters influencing the outcome of the bone graft

  6. Tissue-engineered rhesus monkey nerve grafts for the repair of long ulnar nerve defects: similar outcomes to autologous nerve grafts

    Directory of Open Access Journals (Sweden)

    Chang-qing Jiang

    2016-01-01

    Full Text Available Acellular nerve allografts can help preserve normal nerve structure and extracellular matrix composition. These allografts have low immunogenicity and are more readily available than autologous nerves for the repair of long-segment peripheral nerve defects. In this study, we repaired a 40-mm ulnar nerve defect in rhesus monkeys with tissue-engineered peripheral nerve, and compared the outcome with that of autograft. The graft was prepared using a chemical extract from adult rhesus monkeys and seeded with allogeneic Schwann cells. Pathomorphology, electromyogram and immunohistochemistry findings revealed the absence of palmar erosion or ulcers, and that the morphology and elasticity of the hypothenar eminence were normal 5 months postoperatively. There were no significant differences in the mean peak compound muscle action potential, the mean nerve conduction velocity, or the number of neurofilaments between the experimental and control groups. However, outcome was significantly better in the experimental group than in the blank group. These findings suggest that chemically extracted allogeneic nerve seeded with autologous Schwann cells can repair 40-mm ulnar nerve defects in the rhesus monkey. The outcomes are similar to those obtained with autologous nerve graft.

  7. Complications following autologous bone graft harvesting from the iliac crest and using the RIA: a systematic review.

    Science.gov (United States)

    Dimitriou, Rozalia; Mataliotakis, George I; Angoules, Antonios G; Kanakaris, Nikolaos K; Giannoudis, Peter V

    2011-09-01

    Bone grafting is a commonly performed surgical procedure to augment bone regeneration in a variety of cases in orthopaedic and maxillofacial surgery. Autologous bone graft remains to be the 'gold standard' and the iliac crest to be the most common harvesting site. The intramedullary canal of long bones represents another potential site for large volume of autologous bone graft harvesting and is recently being used as an alternative donor site. However, harvesting of autologous bone graft is associated with morbidity and a number of complications. The aim of this systematic review was to collect and summarise the existing data on reported complications after harvesting autologous bone from the iliac crest (anterior and posterior) and the long bone intramedullary canal using the RIA device. We searched the PubMed Medline and Ovid Medline databases, from January 1990 to October 2010, to retrieve all relevant articles. A total of 92 articles (6682 patients) were included in the analysis. Overall, the complication rate following RIA was 6% (14 complications in 233 patients) and 19.37% after iliac crest bone graft harvesting (1249 complications in 6449 patients). The rate of each of the reported complications was assessed and, when the donor site was properly documented, comparison within the anterior and posterior iliac crest donor sites was performed. Although the difference of the overall morbidity rates between the two harvesting sites was not statistically significant (p=0.71); the rates of certain complications were found to significantly differ when anterior or posterior iliac crest was used. The rates of infection (p=0.016), haematoma formation (p=0.002), fracture (p=0.017), and hyperthrophic scar (p=0.017) were significantly higher when the donor site was the anterior iliac crest compared to the posterior iliac crest; whereas the rates of chronic donor site pain (p=0.004) and sensory disturbances (p=0.003) were significantly lower. The incidence of bone graft

  8. Pulmonary fat embolism induced intravenous injection of autologous bone marrow in rabbit: CT and pathologic correlation

    International Nuclear Information System (INIS)

    Park, Seong Jin; Sung, Dong Wook; Jun, Yang Hyun; Oh, Joo Hyung; Ko, Young Tae; Lee, Joo Hee; Yoon, Yup

    1999-01-01

    To evaluate the correlation between CT and pathologic findings of pulmonary fat embolism in rabbits. In 16 rabbits, pulmonary fat embolism was induced by intravenous injection of autologous bone marrow(mean 3.3 mL). Chest CT scans were obtained immediately(within 1 hour), and 1, 3, and 7 days after embolization. The rabbits were divided into four groups. Group 1 underwent CT scanning immediately after embolization, group 2 immediately and 1 day after embolization, group 3 immediately, 1 day and 3 days after embolization, group 4 immediately, 1 day, 3 days and 7 days after embolization. Pathologic specimens were obtained immediately after the last CT scan. The earliest CT findings of pulmonary fat embolism in rabbits were peripheral lung lucency(16/16, 100%), perivascular ground-glass(12/16, 75.0%) and enlargement of the central pulmonary artery(11/16, 68.8%). Pathologically, perivascular ground-glass opacity correlated with extensive perivascular alveolar congestion and enlargement of the central pulmonary artery correlated with perivascular connective tissue edema and reactive pulmonary arterial engorgement. Peripheral lung lucency was probably caused by embolic occlusion of the pulmonary artery and decreased perfusion and air trapping induced by arterial and bronchial spasm associated with hypoxia. CT scans obtained 1 and 3 days after embolization showed nodules and patchy ground-glass opacity and consolidation. Aggregation of nodules resulted in patch opacities. Pathologically, pulmonary nodules correlated with focal inflammation surrounding an artery and parenchymal opacity correlated with parenchymal consolidation and hemorrhagic edema. CT scans and pathologic specimens obtained 7 days after embolization showed improvement of parenchymal lung abnormalities. Pulmonary fat embolism in rabbits show CT and pathologic findings which vary with dynamic change. Typical earliest findings of pulmonary fat embolism were peripheral lung lucency, perivascular ground

  9. Incidence, degree, and development of graft hypertrophy 24 months after matrix-induced autologous chondrocyte implantation: association with clinical outcomes.

    Science.gov (United States)

    Ebert, Jay R; Smith, Anne; Fallon, Michael; Butler, Rodney; Nairn, Robert; Breidahl, William; Wood, David J

    2015-09-01

    Graft hypertrophy is a common occurrence after periosteal, collagen-covered and matrix-induced autologous chondrocyte implantation (MACI). The purpose of this study was to investigate the incidence, development, and degree of graft hypertrophy at 24 months after MACI. The hypothesis was that graft hypertrophy would not be associated with clinical outcome at 24 months. Case series, Level of evidence, 4. This study was undertaken in 180 consecutive patients (113 male, 67 female) after MACI in the knee. All patients were assessed clinically using the Knee injury and Osteoarthritis Outcome Score (KOOS) and underwent magnetic resonance imaging (MRI) at 3, 12, and 24 months after surgery. The incidence of hypertrophy relevant to anatomic graft site was investigated, as was the progressive change in hypertrophic studies postoperatively. The degree of tissue overgrowth in hypertrophic cases was investigated, as was its association with patient clinical outcome at 24 months after surgery. Of the 180 patients, 50 demonstrated a hypertrophic graft at 1 or more postoperative time points. This included 9 grafts (5.0%) at 3 months and 32 grafts (18.7%) at 12 months. At 24 months, 47 grafts (26.1%)-43 (32.1%) tibiofemoral and 4 (8.7%) patellofemoral-were hypertrophic. Patients with hypertrophic grafts at 24 months (n = 47) were younger (P = .051), they had a lower body mass index (BMI; P = .069), and significantly fewer of them had patellofemoral grafts (P = .007) compared with patients who had grafts with full (100%) tissue infill (n = 61). There were no significant differences in any of the KOOS subscales between patients with graft hypertrophy or full (100%) tissue infill at 24 months after surgery, while the severity of graft hypertrophy was not associated with KOOS subscales at 24 months. Hypertrophic grafts after MACI were common and continued to develop through to 24 months after surgery. Hypertrophic growth was associated with being younger and having a lower BMI, was

  10. rhBMP-2 with a demineralized bone matrix scaffold versus autologous iliac crest bone graft for alveolar cleft reconstruction.

    Science.gov (United States)

    Francis, Cameron S; Mobin, Sheila S Nazarian; Lypka, Michael A; Rommer, Elizabeth; Yen, Stephen; Urata, Mark M; Hammoudeh, Jeffrey A

    2013-05-01

    Secondary alveolar cleft reconstruction using autologous iliac crest bone graft is currently the standard treatment for alveolar clefts. Although effective, harvesting autologous bone may result in considerable donor-site morbidity, most commonly pain and the potential for long-term sensory disturbances. In an effort to decrease patient morbidity, a novel technique using recombinant human bone morphogenetic protein (rhBMP)-2 encased in a demineralized bone matrix scaffold was developed as an alternative to autografting for secondary alveolar cleft reconstruction. A chart review was conducted for the 55 patients who underwent secondary alveolar cleft reconstruction over a 2-year period with a mean follow-up of 21 months. Of these, 36 patients received rhBMP-2/demineralized bone matrix scaffold (including 10 patients with previously failed repairs using iliac crest bone grafting) and 19 patients underwent iliac crest bone grafting. Postoperatively, bone stock was evaluated using occlusal radiographs rated according to the Bergland and Chelsea scales. Alveolar clefts repaired using rhBMP-2/demineralized bone matrix scaffold were 97.2 percent successful compared with 84.2 percent with iliac crest bone grafting. Radiographically, initial repairs with rhBMP-2/demineralized bone matrix scaffold were superior to iliac crest bone grafting according to both Bergland and Chelsea scales, and significantly more patients in the rhBMP-2/demineralized bone matrix scaffold group had coronal bridging. The postoperative intraoral infection rate following iliac crest bone grafting was significantly greater than for rhBMP-2/demineralized bone matrix scaffold. The cost of rhBMP-2/demineralized bone matrix scaffold products was offset by cost savings associated with a reduction in operative time averaging 102 minutes. rhBMP-2 encased in a demineralized bone matrix scaffold appears to be a viable alternative for secondary alveolar cleft repair. Patients are spared donor-site morbidity and

  11. Graft of autologous fibroblasts in gingival tissue in vivo after culture in vitro. Preliminary study on rats.

    Science.gov (United States)

    Simain-Sato, F; Lahmouzi, J; Heinen, E; Defresne, M P; De Pauw-Gillet, M C; Grisar, T; Legros, J J; Legrand, R

    1999-08-01

    Several grafting techniques and guided tissue regeneration techniques (GTR) have been well-developed in periodontal surgery. However, these techniques could induce pain and side effects, such as a gingival recession during the healing period following the therapy. The graft of a small autologous connective tissue, using non-invasive surgical techniques could yield several benefits for the patients. Our preliminary study explores the feasibility of collecting healthy gingival tissues, culturing them in vitro to amplify rat gingival fibroblasts (RGF) and inoculating the obtained cells into autologous rat gingival tissues in vivo. Gingival tissues samples were cultured as explants as described by Freshney et al. and Adolphe. Confluent cells surrounding explants were detached after 7 d of culture from Petri dishes using 0.05% trypsin and designated "first transferred cells" (T1). At the third passage (T3), cells cultured as monolayer were either examined under microscopy--phase contrast, scanning, or transmission electron--or numerated after trypan blue exclusion test. Autologous RGF labelled with fluorochrome were inoculated at the vestibular and palatine site of gingival tissue close to the superior incisors. In this preliminary study, 12 Wistar rats were used; for each, 2 biopsies were dissected and fixed for phase contrast or fluorescence microscopy. On d 1, 3 and 7 after injection in rat gingival tissues, fluorochrome-labelled cells could be detected in all these.

  12. A Novel Technique of Fabricating a Modified Removable Provisional Prosthesis over an Autologous Bone Grafted Maxillary Anterior Edentulous Segment Prior to Implant Placement

    OpenAIRE

    Andonissamy, Leoney; Vidhya, N. Sri

    2017-01-01

    Implant dentistry has provided a lot of surgical as well as prosthetic techniques for improving the success of the implants. The surgical technique commonly followed now prior to implant placement is bone grafting procedure. One of the commonest techniques is the use of autologous block graft harvested from mandibular chin region. However, interference in healing as well as excessive bone resorption due to the use of removable provisional prosthesis over the bone grafted region has been commo...

  13. Autologous Graft versus Host Disease: An Emerging Complication in Patients with Multiple Myeloma

    Directory of Open Access Journals (Sweden)

    Anu Batra

    2014-01-01

    Full Text Available Autologous graft versus host disease (autoGVHD is a rare transplant complication with significant morbidity and mortality. It has been hypothesized that patients with multiple myeloma might be predisposed to autoGVHD through dysregulation of the immune response resulting from either their disease, the immunomodulatory agents (IMiDs used to treat it, or transplant conditioning regimen. Hematopoietic progenitor cell (HPC products were available from 8 multiple myeloma patients with biopsy-proven autoGVHD, 16 matched multiple myeloma patients who did not develop autoGVHD, and 7 healthy research donors. The data on number of transplants prior to developing autoGVHD, mobilization regimens, exposure to proteasome inhibitors, use of IMiDs, and class I human leukocyte antigen types (HLA A and B were collected. The HPC products were analyzed by flow cytometry for expression of CD3, CD4, CD8, CD25, CD56, and FoxP3. CD3+ cell number was significantly lower in autoGVHD patients compared to unaffected controls (P=0.047. On subset analysis of CD3+ cells, CD8+ cells (but not CD4+ cells were found to be significantly lower in patients with autoGVHD (P=0.038. HLA-B55 expression was significantly associated with development of autoGVHD (P=0.032. Lower percentages of CD3+ and CD8+ T-cells and HLA-B55 expression may be predisposing factors for developing autoGVHD in myeloma.

  14. Future Economics of Liver Transplantation: A 20-Year Cost Modeling Forecast and the Prospect of Bioengineering Autologous Liver Grafts

    Science.gov (United States)

    Habka, Dany; Mann, David; Landes, Ronald; Soto-Gutierrez, Alejandro

    2015-01-01

    During the past 20 years liver transplantation has become the definitive treatment for most severe types of liver failure and hepatocellular carcinoma, in both children and adults. In the U.S., roughly 16,000 individuals are on the liver transplant waiting list. Only 38% of them will receive a transplant due to the organ shortage. This paper explores another option: bioengineering an autologous liver graft. We developed a 20-year model projecting future demand for liver transplants, along with costs based on current technology. We compared these cost projections against projected costs to bioengineer autologous liver grafts. The model was divided into: 1) the epidemiology model forecasting the number of wait-listed patients, operated patients and postoperative patients; and 2) the treatment model forecasting costs (pre-transplant-related costs; transplant (admission)-related costs; and 10-year post-transplant-related costs) during the simulation period. The patient population was categorized using the Model for End-Stage Liver Disease score. The number of patients on the waiting list was projected to increase 23% over 20 years while the weighted average treatment costs in the pre-liver transplantation phase were forecast to increase 83% in Year 20. Projected demand for livers will increase 10% in 10 years and 23% in 20 years. Total costs of liver transplantation are forecast to increase 33% in 10 years and 81% in 20 years. By comparison, the projected cost to bioengineer autologous liver grafts is $9.7M based on current catalog prices for iPS-derived liver cells. The model projects a persistent increase in need and cost of donor livers over the next 20 years that’s constrained by a limited supply of donor livers. The number of patients who die while on the waiting list will reflect this ever-growing disparity. Currently, bioengineering autologous liver grafts is cost prohibitive. However, costs will decline rapidly with the introduction of new manufacturing

  15. Allogeneic versus autologous derived cell sources for use in engineered bone-ligament-bone grafts in sheep anterior cruciate ligament repair.

    Science.gov (United States)

    Mahalingam, Vasudevan D; Behbahani-Nejad, Nilofar; Horine, Storm V; Olsen, Tyler J; Smietana, Michael J; Wojtys, Edward M; Wellik, Deneen M; Arruda, Ellen M; Larkin, Lisa M

    2015-03-01

    The use of autografts versus allografts for anterior cruciate ligament (ACL) reconstruction is controversial. The current popular options for ACL reconstruction are patellar tendon or hamstring autografts, yet advances in allograft technologies have made allogeneic grafts a favorable option for repair tissue. Despite this, the mismatched biomechanical properties and risk of osteoarthritis resulting from the current graft technologies have prompted the investigation of new tissue sources for ACL reconstruction. Previous work by our lab has demonstrated that tissue-engineered bone-ligament-bone (BLB) constructs generated from an allogeneic cell source develop structural and functional properties similar to those of native ACL and vascular and neural structures that exceed those of autologous patellar tendon grafts. In this study, we investigated the effectiveness of our tissue-engineered ligament constructs fabricated from autologous versus allogeneic cell sources. Our preliminary results demonstrate that 6 months postimplantation, our tissue-engineered auto- and allogeneic BLB grafts show similar histological and mechanical outcomes indicating that the autologous grafts are a viable option for ACL reconstruction. These data indicate that our tissue-engineered autologous ligament graft could be used in clinical situations where immune rejection and disease transmission may preclude allograft use.

  16. Low-dose G-CSF improves fat graft retention by mobilizing endogenous stem cells and inducing angiogenesis, whereas high-dose G-CSF inhibits adipogenesis with prolonged inflammation and severe fibrosis.

    Science.gov (United States)

    Cai, Junrong; Li, Bin; Liu, Kaiyang; Feng, Jingwei; Gao, Kai; Lu, Feng

    2017-09-23

    Hematopoietic stem cells (HSCs) promote fat graft survival by modulating its revascularization. The authors hypothesize that mobilization of HSCs by G-CSF will improve fat graft survival. Hence, we evaluated the effect of different doses of G-CSF on fat grafting. Male 8-week-old C57 mice received high-dose G-CSF (100 μg/kg), low-dose G-CSF (10 μg/kg), and PBS (control) intraperitoneally for 7 consecutive days right after autologous fat grafting. Grafted fat was harvested at 1, 4, and 12 weeks for examination. The low-dose G-CSF, high-dose G-CSF, and control groups had retention rates of 73.6% ± 3.1%, 51.6% ± 4.4%, and 44.5% ± 4.0%, respectively, at 12 weeks (low-dose G-CSF versus control and low-dose G-CSF versus high-dose G-CSF, both p cells in fat grafts, contributing to improved angiogenesis. However, high-dose G-CSF caused a prolonged macrophage infiltration and elevated level of inflammation (IL-6 and TNF-α), which led to severe fibrosis and impaired adipogenesis (downregulated expression of PPAR-γ and CEBP-α). Low-dose G-CSF treatment successfully improved fat graft survival by mobilizing HSCs and inducing angiogenesis. However, high-dose G-CSF prolonged inflammation and caused severe fibrosis, leading to impaired adipogenesis and poor fat graft survival. Copyright © 2017. Published by Elsevier Inc.

  17. Calf Contouring with Endoscopic Fascial Release, Calf Implant, and Structural Fat Grafting

    Directory of Open Access Journals (Sweden)

    Ercan Karacaoglu, MD

    2013-08-01

    Conclusions: A novel endoscopic approach for lower leg contouring is discussed. Endoscopic fasciotomy technique with calf implant and structural fat grafting for improved lower leg aesthetics is a simple, effective, reliable, and predictable technique for calf contouring.

  18. Adipose-derived mesenchymal stem cells promote the survival of fat grafts via crosstalk between the Nrf2 and TLR4 pathways.

    Science.gov (United States)

    Chen, Xiaosong; Yan, Liu; Guo, Zhihui; Chen, Zhaohong; Chen, Ying; Li, Ming; Huang, Chushan; Zhang, Xiaoping; Chen, Liangwan

    2016-09-08

    Autologous fat grafting is an effective reconstructive surgery technique; however, its success is limited by inconsistent graft retention and an environment characterized by high oxidative stress and inflammation. Adipose-derived stem cells (ADSCs) increase the survival of fat grafts, although the underlying mechanisms remain unclear. Here, TLR4(-/-) and Nrf2(-/-) mice were used to explore the effects of oxidative stress and inflammation on the viability and function of ADSCs in vitro and in vivo. Enrichment of fat grafts with ADSCs inhibited inflammatory cytokine production, enhanced growth factor levels, increased fat graft survival, downregulated NADPH oxidase (NOX)1 and 4 expression, increased vascularization and reduced ROS production in a manner dependent on toll-like receptor (TLR)-4 and nuclear factor erythroid 2-related factor 2 (Nrf2) expression. Immunohistochemical analysis showed that exposure to hypoxia enhanced ADSC growth and promoted the differentiation of ADSCs into vascular endothelial cells. Hypoxia-induced inflammatory cytokine, growth factor and NOX1/4 upregulation, as well as increased ROS production and apoptosis in ADSCs were dependent on TLR4 and Nrf2, which also modulated the effect of ADSCs on promoting endothelial progenitor cell migration and angiogenesis. Western blot analyses showed that the effects of hypoxia on ADSCs were regulated by crosstalk between Nrf2 antioxidant responses and NF-κB- and TLR4-mediated inflammatory responses. Taken together, our results indicate that ADSCs can increase the survival of fat transplants through the modulation of inflammatory and oxidative responses via Nrf2 and TLR4, suggesting potential strategies to improve the use of ADSCs for cell therapy.

  19. Operative technique of two parallel compression screws and autologous bone graft for ankle arthrodesis after failed total ankle replacement.

    Science.gov (United States)

    Jehan, Shah; Hill, Simon O

    2012-09-01

    The management of failed total ankle replacement (TAR) depends on the primary indication, presence of infection, condition of adjacent joints, and available bone stock. In addition, the patient's expectations, age, and general health should also be taken into account. This article describes a technique of arthrodesis in failed TAR with two parallel screws inserted in opposite directions and autologous cancellous bone graft. Four patients were managed using this technique. The subtalar joint and both malleoli were preserved. The average time for radiological union was 14.8 weeks. There were no hardware-related complications or infections. One patient developed subsequent subtalar arthritis and is waiting for subtalar joint fusion. The results from this small series of patients suggest that arthrodesis following failed total ankle replacement with two parallel screws and bone graft may be an effective technique.

  20. Studies in Fat Grafting: Part I. Effects of Injection Technique on in vitro Fat Viability and in vivo Volume Retention

    Science.gov (United States)

    Chung, Michael T.; Paik, Kevin J.; Atashroo, David A.; Hyun, Jeong S.; McArdle, Adrian; Senarath-Yapa, Kshemendra; Zielins, Elizabeth R.; Tevlin, Ruth; Duldulao, Chris; Hu, Michael S.; Walmsley, Graham G.; Parisi-Amon, Andreina; Momeni, Arash; Rimsa, Joe R.; Commons, George W.; Gurtner, Geoffrey C.; Wan, Derrick C.; Longaker, Michael T.

    2014-01-01

    Background Fat grafting has become increasingly popular for the correction of soft tissue deficits at many sites throughout the body. Long-term outcomes, however, depend on delivery of fat in the least traumatic fashion to optimize viability of the transplanted tissue. In this study, we compare the biologic properties of fat following injection using two methods. Methods Lipoaspiration samples were obtained from five female donors and cellular viability, proliferation, and lipolysis were evaluated following injection using either a modified Coleman technique or an automated, low shear device. Comparisons were made to minimally processed, uninjected fat. Volume retention was also measured over twelve weeks following injection of fat under the scalp of immunodeficient mice using either the modified Coleman technique or the Adipose Tissue Injector. Finally, fat grafts were analyzed histologically. Results Fat viability and cellular proliferation were both significantly greater with the Adipose Tissue Injector relative to injection with the modified Coleman technique. In contrast, significantly less lipolysis was noted using the automated device. In vivo fat volume retention was significantly greater than with the modified Coleman technique at 4, 6, 8, and 12 week time points. This corresponded with significantly greater histological scores for healthy fat and lower scores for injury following injection with the device. Conclusions Biological properties of injected tissues reflect how disruptive and harmful techniques for placement of fat may be, and our in vitro and in vivo data both support the use of the automated, low shear devices compared to the modified Coleman technique. PMID:24622574

  1. Autologous fat injection therapy including a high concentration of adipose-derived regenerative cells in a vocal fold paralysis model: animal pilot study.

    Science.gov (United States)

    Nishio, N; Fujimoto, Y; Suga, K; Iwata, Y; Toriyama, K; Takanari, K; Kamei, Y; Yamamoto, T; Gotoh, M

    2016-10-01

    To verify the effectiveness and safety of the addition of adipose-derived regenerative cells to autologous fat injection therapy. Unilateral vocal fold paralysis models were made by cutting the right recurrent laryngeal nerve in two pigs. At day 30, 0.5 ml adipose-derived regenerative cells mixed with 1 ml autologous fat was injected into the right vocal fold of one pig, with the other receiving 0.5 ml Ringer's solution mixed with 1 ml autologous fat. At day 120, fibrescopy, laser Doppler flowmeter, computed tomography, vocal function evaluation and histological assessment were conducted. Although histological assessment revealed atrophy of the thyroarytenoid muscle fibre in both pigs, there was remarkable hypertrophy of the thyroarytenoid muscle fibre in the area surrounding the adipose-derived regenerative cells injection site. The addition of a high concentration of adipose-derived regenerative cells to autologous fat injection therapy has the potential to improve the treatment outcome for unilateral vocal fold paralysis.

  2. Use of platelet-rich fibrin and platelet-rich plasma in combination with fat graft: which is more effective during facial lipostructure?

    Science.gov (United States)

    Keyhan, Seied Omid; Hemmat, Seifollah; Badri, Amir Ali; Abdeshahzadeh, Arshad; Khiabani, Kazem

    2013-03-01

    Fat grafts have always represented a challenge in inducing the necessary neoangiogenesis, which results in significant resorption. This study was designed to compare the efficiency of first- and second-generation platelet-rich plasmas (PRPs) combined with a fat graft during facial lipostructure surgery. To address the research purpose, the investigators designed and implemented a double-blinded prospective clinical trial. The patients underwent bilateral facial lipostructure, a natural long-lasting method of filling and supporting the face using intricate layers of infiltrated autologous fat. The method involved the use of PRP on 1 side and platelet-rich fibrin (PRF) on the other side. The study population was composed of all patients presenting to the authors' department for the evaluation and management of facial contouring in the cheek and cheekbone areas from June 2008 through December 2010. The primary predictor variable was the type of combination (PRP/fat or PRF/fat). The outcome variables were the amount of resorption, which was estimated by comparing pre- and postsurgical photographic views, pain, edema, and bruising. The statistical evaluation of the findings was performed using SPSS software. Parametric tests (t test and Levene test) were used to compare the treatment efficacy and complications between the groups. Twenty-five patients (8 men and 17 women) underwent bilateral facial lipostructure surgery in the cheek and cheekbone areas using PRP and PRF. One year after the operation, a slight esthetic asymmetry was noticeable, with greater average resorption on the PRP/fat side. This first comparative clinical study highlights the value of using concentrated platelets for adipocyte grafts. The results suggest that the combination of fat and PRF is more effective than the combination of fat and PRP in the context of facial lipostructure surgery. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All

  3. Sports Activity After Reconstruction of Osteochondral Lesions of the Talus With Autologous Spongiosa Grafts and Autologous Matrix-Induced Chondrogenesis.

    Science.gov (United States)

    Wiewiorski, Martin; Werner, Lorenzo; Paul, Jochen; Anderson, Andrew E; Barg, Alexej; Valderrabano, Victor

    2016-10-01

    For the treatment of osteochondral lesions of the talus (OCLTs), autologous matrix-induced chondrogenesis (AMIC) is a safe 1-step procedure with good clinical and radiological results. However, data regarding postoperative sports activity after AMIC are limited. To identify significant factors influencing the rate of postoperative sports and recreational activities. Case series; Level of evidence, 4. The sports and recreational activities of 60 patients (mean age, 34.9 ± 11.5 years) undergoing the AMIC procedure were retrospectively analyzed at a mean of 46.9 ± 17.8 months (range, 24.5-87.0 months) postoperatively. The visual analog scale (VAS) for pain score, Tegner activity scale score, activity rating scale (ARS) score, and satisfaction with surgery outcomes were assessed. Corrective calcaneal osteotomy was performed in 38 of 60 (63.3%) patients. Ligament repair was performed in 41 of 60 (68.3%) patients. The mean VAS score improved significantly from 6.9 ± 1.6 points (range, 5-10 points) preoperatively to 2.3 ± 1.9 points (range, 0-6 points) at latest follow-up (P sports activity before the onset of symptoms became significantly lower at the time of surgery (from 95.0% to 53.3%; P sports frequency and the duration of sports activity was found postoperatively. Patients undergoing AMIC repair of an OCLT participate at a similar low postoperative sports and recreational activity level compared with the preoperative level. © 2016 The Author(s).

  4. [Effects of rat allogeneic adipose-derived stem cells on the early neovascularization of autologous fat transplantation].

    Science.gov (United States)

    Tian, Tian; Jia, Chiyu; Liu, Yi; Liu, Zhen; Hu, Guodong; Wang, Ruichen; Chang, Chunjuan

    2014-12-01

    To investigate the effects of allogeneic adipose-derived stem cells (ADSCs) of rat on the early neovascularization of autologous fat transplantation. (1) Experiment 1. Adipose tissue was collected from both inguinal regions of two SD rats to isolate, culture, and purify ADSCs through collagen enzyme digestion, density gradient centrifugation, and adherence method. The fourth passage of cells were collected for morphologic observation, detection of expressions of surface markers CD34, CD49d, CD106, and CD45 of ADSCs with flow cytometer, identification of adipogenic and osteogenic differentiation, and determination of the cell proliferation ability with thiazolyl blue method. (2) Experiment 2. Another 30 SD rats were divided into allogeneic adipose granule (AG) group (A, n = 6), autologous AG group (B, n = 8), autologous ADSCs+autologous AG group (C, n = 8), and allogeneic ADSCs+autologous AG group (D, n = 8) according to the random number table. The fourth passage of ADSCs were obtained from adipose tissue from one side of inguinal region of SD rats in group C. Adipose tissue obtained from one side of inguinal region of SD rats of the other 3 groups was abandoned. The AG was prepared from another side of inguinal region of SD rats in the 4 groups. The mixture of 0.6 g AG from one rat and 1 mL DMEM/F12 nutrient solution was injected subcutaneously into the back of another rat in group A, and so on. Autologous AG was injected into its own body of the rats in group B. The mixture of 1 mL autologous ADSCs mixture which contains 3.0 × 10⁶ cells per mililitre autologous ADSCs combined with autologous AG was injected into the rats in group C. The mixture of 1 mL allogeneic ADSCs mixture which contains 3.0 × 10⁶ cells per mililitre ADSCs extractived from the former 2 rats in experiment 1 combined with autologous AG was injected into the rats in group D. At 7 days post transplantation, fat transplants were harvested for gross observation, measurement of wet weight

  5. Autologous bone marrow grafting combined with demineralized bone matrix improves consolidation of docking site after distraction osteogenesis.

    Science.gov (United States)

    Hatzokos, Ippokratis; Stavridis, Stavros I; Iosifidou, Eirini; Karataglis, Dimitrios; Christodoulou, Anastasios

    2011-04-06

    Distraction osteogenesis is used for the reconstruction of extensive osseous defects. Delay in docking site consolidation results in significant prolongation of this surgical procedure. The primary aim of the present study was to retrospectively compare three different treatment options, all aimed at improving and accelerating docking site consolidation. We further sought to clarify whether the application of autologous bone marrow cells combined with demineralized bone matrix would substantially improve docking site consolidation. Between 1995 and 2008, forty-three patients (mean age, 38.28 years) were managed with bone transport for the treatment of a tibial bone defect (mean length, 9.49 cm). The patients were divided into three groups according to the "docking site procedure" used: closed compression (Group A), surgical debridement of the docking site and application of autologous iliac bone graft (Group B), or surgical debridement and local application of bone marrow concentrate and demineralized bone matrix (Group C). Docking site consolidation was assessed both radiographically and clinically, and the results were statistically analyzed. The median "healing time" required for docking site consolidation was significantly longer in the compression group as compared with the demineralized bone matrix plus bone marrow group (p = 0.021), whereas there was no difference between the other groups. There was no significant difference among the groups in terms of complication rates (p = 0.702). Docking site consolidation was completed prior to regenerate consolidation in nine of the ten patients in Group C and in 13.6% of the patients in Group B, whereas in all of the remaining patients, completion of regenerate healing always preceded docking site consolidation. The application of demineralized bone matrix and autologous bone marrow is at least equivalent to autologous cancellous bone graft in terms of substantially reducing docking site healing time compared with

  6. Sinus lift tissue engineering using autologous pulp micro-grafts: A case report of bone density evaluation

    Directory of Open Access Journals (Sweden)

    Giorgio Brunelli

    2013-01-01

    Full Text Available Background: Although autografts are the standard procedure for bone grafting, the use of bone regeneration by means of dental pulp stem cell is an alternative that opens a new era in this field. Rigenera Protocol is a new technique able to provide the surgeon autologous pulp micro-grafts. Materials and Methods: At the Department of Oral Surgery, Don Orione Hospital, Bergamo, Italy, one patient underwent sinus lift elevation with pulp stem micro-grafts gentle poured onto collagen sponge. A CT scan control was performed after 4 months and DICOM data were processed with medical imaging software which gives the possibility to use a virtual probe to extract the bone density. Pearson′s Chi-square test was used to investigate difference in bone density (BD between native and newly formed bone. Results: BD in newly formed bone is about the double of native bone. Conclusion: This report demonstrated that micro-grafts derived from dental pulp poured onto collagen sponge are a useful method for bone regeneration in atrophic maxilla.

  7. Use of non-vascularized autologous fibula strut graft in the treatment ...

    African Journals Online (AJOL)

    Orthopedic surgeons in developed countries have the option of choosing vascularized bone transfers, bone transport, allogenic bone grafts, bone graft substitutes ... tissue envelope assessment, neurological examination, and debridement under general anesthesia with fracture stabilization with external fixators or casts.

  8. [TIBIAL PERIOSTEAL FLAP PEDICLED WITH INTERMUSCULAR BRANCH OF POSTERIOR TIBIAL VESSELS COMBINED WITH AUTOLOGOUS BONE GRAFT FOR TIBIAL BONE DEFECT].

    Science.gov (United States)

    Ni, Yulong; Gao, Shunhong; Zhang, Jingyu; Dong, Huishuang; Zhang, Yunpeng; Fu, Jiansong

    2015-10-01

    To investigate the effectiveness of tibial periosteal flap pedicled with intermuscular branch of posterior tibial vessels combined with autologous bone graft in the treatment of tibial bone defects. Between January 2007 and December 2013, 19 cases of traumatic tibia bone and soft tissue defects were treated. There were 14 males and 5 females, aged from 18 to 49 years (mean, 28 years). The tibial fracture site located at the middle tibia in 6 cases and at the distal tibia in 13 cases. According to Gustilo type, 4 cases were rated as type III A, 14 cases as type III B, and 1 case as type III C (injury of anterior tibial artery). The length of bone defect ranged from 4.3 to 8.5 cm (mean, 6.3 cm). The soft tissue defects ranged from 8 cm x 5 cm to 17 cm x 9 cm. The time from injury to operation was 3 to 8 hours (mean, 4 hours). One-stage operation included debridement, external fixation, and vacuum sealing drainage. After formation of granulation tissue, the fresh wound was repaired with sural neurovascular flap or posterior tibial artery perforator flap. The flap size ranged from 10 cmx6 cm to 19 cm x 11 cm. In two-stage operation, tibial periosteal flap pedicled with intermuscular branch of posterior tibial vessels combined with autologous bone graft was used to repair tibial defect. The periosteal flap ranged from 6.5 cm x 4.0 cm to 9.0 cm x 5.0 cm; bone graft ranged from 4.5 to 9.0 cm in length. External fixation was changed to internal fixation. All flaps survived with soft texture, and no ulcer and infection occurred. All incisions healed by the first intention. All patients were followed up 18-40 months (mean, between normal and affected sides.The function of the knee an ankle joint was good without infection, malunion, and equinus. According to the Johner standard at last follow-up, the results were excellent in 15 cases, good in 3 cases, and fair in 1 case, with an excellent and good rate of 94.7%. Tibial periosteal flap pedicled with intermuscular branch of

  9. [Tumor-segmental resection of hand-foot-giant cell tumor of bone and autologous iliac bone graft reconstruction].

    Science.gov (United States)

    Ge, Jianhua; Chen, Ge; Zhang, Zhongjie; Wan, Yongxian; Lu, Xiaobo

    2010-08-01

    To evaluate the effectiveness of tumor-segmental resection and autologous iliac bone graft reconstruction combined with internal fixation in treating hand-foot-giant cell tumor of bone. Between August 1997 and April 2008, 8 cases of hand-foot-giant cell tumor of bone were treated, including 3 males and 5 females with an average age of 28.5 years (range, 16-42 years). The locations were metacarpal bones in 3 cases, metatarsal bones in 4 cases, and phalanges of toes in 1 case. According to Campanacci's gradation of X-ray films, there were 1 case of grade I and 7 cases of grade II; according to pathological examination before operation, there were 3 cases of grade I to II, 4 cases of grade II, and 1 case of grade II to III; and according to TNM staging, there were 1 case of TisN0M0, 4 cases of T1N0M0, and 3 cases of T2N0M0. There were 2 cases of recurrence, the time from the first operation to recurrence were 11 and 14 months, respectively. The tumor size was 1.8 cm x 1.0 cm to 6.0 cm x 2.0 cm, the cortical bone became thinner, and the boundary between tumor and periosteum was clear. All patients underwent tumor-segmental resection combined with autologous iliac bone graft reconstruction, and miniplate internal fixation by lumbar anesthesia or trachea cannula anesthesia. All incision healed by first intention. Eight patients were followed up 10 to 84 months with an average of 46 months. Radiographs showed that fracture union was achieved at 3 to 9 months (mean, 5 months). No significant rotation, angular, and shortening deformity occurred in iliac bone graft. The function of iliac bone donor site recovered excellently. The pathological examination showed giant cell tumor of bone in all cases, including 2 case of grade I-II, 5 cases of grade II, and 1 case of grade II-III. The hand or foot function recovered excellently. No tumor recurrence or lung metastasis occurred during follow-up. Tumor-segmental resection combined with autologous iliac bone graft reconstruction

  10. Implementation of the hyaluronic acid fat graft myringoplasty technique, pitfalls and lessons learned

    NARCIS (Netherlands)

    Grotenhuis, N. (Nienke); J.P. Koopman (J.); J.M. Kruyt; Rothuizen, L.K. (Laura Kiki); Knevel, R. (Rachel); H.M. Blom

    2017-01-01

    textabstractBackground: Myringoplasty is a common procedure in otorhinolaryngology. Many techniques with different complications and outcomes have been described, one of which is hyaluronic acid fat graft myringoplasty (HAFGM). This technique, as proposed by Saliba, uses fat tissue and hyaluronic

  11. Nanofat-derived stem cells with platelet-rich fibrin improve facial contour remodeling and skin rejuvenation after autologous structural fat transplantation.

    Science.gov (United States)

    Wei, Hua; Gu, Shi-Xing; Liang, Yi-Dan; Liang, Zhi-Jie; Chen, Hai; Zhu, Mao-Guang; Xu, Fang-Tian; He, Ning; Wei, Xiao-Juan; Li, Hong-Mian

    2017-09-15

    Traditional autologous fat transplantation is a common surgical procedure for treating facial soft tissue depression and skin aging. However, the transplanted fat is easily absorbed, reducing the long-term efficacy of the procedure. Here, we examined the efficacy of nanofat-assisted autologous fat structural transplantation. Nanofat-derived stem cells (NFSCs) were isolated, mechanically emulsified, cultured, and characterized. Platelet-rich fibrin (PRF) enhanced proliferation and adipogenic differentiation of NFSCs in vitro . We then compared 62 test group patients with soft tissue depression or signs of aging who underwent combined nanofat, PRF, and autologous fat structural transplantation to control patients (77 cases) who underwent traditional autologous fat transplantation. Facial soft tissue depression symptoms and skin texture were improved to a greater extent after nanofat transplants than after traditional transplants, and the nanofat group had an overall satisfaction rate above 90%. These data suggest that NFSCs function similarly to mesenchymal stem cells and share many of the biological characteristics of traditional fat stem cell cultures. Transplants that combine newly-isolated nanofat, which has a rich stromal vascular fraction (SVF), with PRF and autologous structural fat granules may therefore be a safe, highly-effective, and long-lasting method for remodeling facial contours and rejuvenating the skin.

  12. Sinus floor augmentation surgery using autologous bone grafts from various donor sites: a meta-analysis of the total bone volume.

    NARCIS (Netherlands)

    Klijn, R.J.; Meijer, G.J.; Bronkhorst, E.M.; Jansen, J.A.

    2010-01-01

    BACKGROUND: To date, no studies have been published that evaluated histomorphometric data from a large number of patients while comparing different sites and methods of autologous bone grafting in sinus floor augmentation procedures. A meta-analysis of the English literature from January 1995 till

  13. Dynamic-definition male pectoral reshaping and enhancement in slim, athletic, obese, and gynecomastic patients through selective fat removal and grafting.

    Science.gov (United States)

    Hoyos, Alfredo; Perez, Mauricio

    2012-10-01

    One of the most appealing characteristics of an athletic male body is a well-defined pectoral area. For decades, implants have been the gold standard method for the treatment of this area, but it is not suitable for every case. The goal was to design a mixed technique combining autologous fat extraction and grafting in an anatomically guided fashion to produce a highly athletic contour in the male pectoral. The patient criteria included a body mass index (BMI) lower than 30 kg/m(2), adequate skin tone, and general good health. A three-phase procedure was performed, beginning with infiltration of tumescent solution and followed by fragmentation of extra fat in an anatomic fashion using internal third-generation ultrasound; extraction that blends deep, intermediate, and superficial fat removal; and multilayer fat grafting in the pectoral area. In the presence of gynecomastia, a selective pull-through technique was used in an anatomic manner. In a series of 154 consecutive male patients, the minor complications (n = 15) included asymmetries (n = 10) and residual gynecomastia (n = 5). The major complications (n = 3) included unilateral hematoma (n = 2), and abscess that required sonographic-guided removal (n = 1). An appealing muscular contour was produced in most patients, and the satisfaction rate was very high. Implants are no longer the only option for defining and augmenting the male chest. Combining fat grafting in a multilayer fashion with precise anatomic fat and gland removal achieved a contoured and athletic male pectoral in a safe and reproducible manner. This journal requires that authors assign a level of evidence to each article.

  14. The safety and efficacy of combined autologous concentrated bone marrow grafting and low-intensity pulsed ultrasound in the treatment of osteonecrosis of the femoral head.

    Science.gov (United States)

    Mishima, Hajime; Sugaya, Hisashi; Yoshioka, Tomokazu; Aoto, Katsuya; Wada, Hiroshi; Akaogi, Hiroshi; Ochiai, Naoyuki

    2016-04-01

    Osteonecrosis of the femoral head (ONFH) is commonly treated with total hip arthroplasty; however, the disadvantages of this form of treatment, especially in young patients, include the need for revision arthroplasty. Here we describe a novel, combined approach to the treatment of ONFH based on autologous concentrated bone marrow grafting and low-intensity pulsed ultrasound (LIPUS). The 7 male and 7 female patients (mean age: 40 years; 22 hips) underwent autologous concentrated bone marrow grafting followed by 6 months of continuous LIPUS. The mean follow-up period was 26 months. We evaluated site-specific bacterial infection of the grafted bone marrow concentrate microbiologically and site-specific cancer by magnetic resonance imaging 24 months after grafting. All patients were assessed using the visual analogue scale (VAS) for pain and the Japanese Orthopedic Association (JOA) hip score. Clinical and plain radiographic evaluations were performed before grafting and at the most recent follow-up. Computed tomography (CT) scans were obtained before and 12 months after grafting. None of the grafted bone marrow concentrates were infected, and none of the patients developed a tumor at the treatment site. The VAS and JOA scores improved in all patients. Collapse progressed in 8 of the 22 hips, but none required total hip arthroplasty. The mean volume of new bone formation 12 months post-grafting as seen on CT was 1256 mm(3). New bone formation was observed in all patients. Our study demonstrates the safety and efficacy of autologous concentrated bone marrow grafting and LIPUS as a joint-preserving procedure for patients with ONFH.

  15. Fat Graft Survival After Recipient Site Pretreatment With Fractional Carbon Dioxide Laser.

    Science.gov (United States)

    Kim, Sung-Eun; Lee, Jun Ho; Kim, Tae Gon; Kim, Yong-Ha; Chung, Kyu Jin

    2017-12-01

    Fat grafting is a commonly performed procedure not only for augmenting the soft tissue but also for regeneration in esthetic and reconstructive plastic surgery.However, unpredictable fat survival rate because of high resorption rate is remained as the main problem. The purpose of this study was to investigate the effect of pretreatment of the recipient site to the fat survival using fractional carbon dioxide (CO2) laser. The rats were divided to 2 groups. Inguinal fat pads of rats were transplanted to the dorsum without pretreatment in the control group. The study group was preconditioned by fractional CO2 laser to the recipient site 1 week before fat graft.The pulse energy was set to 100 mJ. Transplanted fat tissues were harvested at postoperative days 1, 3, 7, 14, and 28 and were analyzed morphologically, histologically, and immunohistochemically. Weight and volume in the control group was more decreased than in the study group at postoperative day 28. Histological evaluation showed less inflammation, less fibrosis, less vacuolization, and better integrity of adipocytes. Immunohistologically, microvessel density in the study group was higher than in the control group (P CO2 laser helped vascularization in the early stage in fat graft and solved the ischemic condition, so it improved fat survival rate.

  16. Randomized, controlled, prospective clinical trial of autologous greater omentum free graft versus autogenous cancellous bone graft in radial and ulnar fractures in miniature breed dogs.

    Science.gov (United States)

    Ree, Jennifer J; Baltzer, Wendy I; Nemanic, Sarah

    2018-02-19

    To determine the rate of radiographic healing, complications, vascularization, and bone density after repair of radial and ulnar fractures in dogs bone graft (BG) or free autologous omentum graft (OG). Prospective, randomized, controlled clinical trial with owners/radiologists blinded to treatment. 25 dogs with naturally occurring traumatic radial/ulnar fractures. Fractures underwent plate fixation with OG or BG. Power Doppler ultrasonographic, computed tomographic (CT), and radiographic examinations of the affected antebrachium were performed preoperatively and every 3 weeks postoperatively until healed. Pressure-sensitive walkway gait analysis and owner and veterinarian assessments were obtained preoperatively (0 weeks) and 3, 6, 9, 12, and 24 weeks postoperatively. Owner/veterinarian assessments improved postoperatively but did not differ significantly between groups. The improvement in peak vertical force/vertical impulse was greater in dogs with OG than in those with BG, beginning 3 weeks postoperatively. Radiographic healing occurred earlier in bones treated with OG (median, 9 weeks) than in those treated with BG (12 weeks). Cortical bone density derived from CT of the distal ulna was higher in bones with BG compared with bones with OG. Signal intensity and the number of vessels in the fracture callus declined over time in both groups, according to results of ultrasonography. However, bones retained more vessels and greater signal intensity when treated with OG compared with treatment with BG, according to multiple views at 6 and 9 weeks postoperatively. Omental grafting was not associated with major complications, and it accelerated bone healing and return to weight bearing in dogs. Omental grafting should be considered as an adjunct to stabilization of antebrachial fractures in toy and small breed dogs. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

  17. Use of non-vascularized autologous fibula strut graft in the treatment ...

    African Journals Online (AJOL)

    Background: Fractures resulting in segmental bone loss challenge the orthopedic surgeon. Orthopedic surgeons in developed countries have the option of choosing vascularized bone transfers, bone transport, allogenic bone grafts, bone graft substitutes and several other means to treat such conditions. In developing ...

  18. Longitudinal growth of the autologous vessels above and below the Gore-Tex graft after the extracardiac conduit Fontan procedure.

    Science.gov (United States)

    Ochiai, Yoshie; Imoto, Yutaka; Sakamoto, Masato; Sese, Akira; Tsukuda, Masaaki; Watanabe, Mamie; Ohno, Takuro; Joo, Kunitaka

    2010-05-01

    Reflecting excellent mid-term outcomes, extracardiac conduit Fontan procedure (ECFP) using Gore-Tex tube graft has been performed with increasing frequency in patients with functional single ventricle. Nevertheless, due to the lack of growth potential of the artificial conduit, the status of the venous pathway along with somatic growth is a continuing concern. In this study, we evaluated the longitudinal growth of the autologous vessels above and below the Gore-Tex graft used in the ECFP. This study included 34 patients who had completed cardiac catheterisations at 1 month and 5.1 years after the ECFP. The average age, weight and height at the ECFP were 3.8+/-2.5 years (1.8-12.7 years), 12.7+/-4.6 kg (7.4-33.0 kg) and 92.9+/-16.1cm (72.5-153.5 cm), respectively. We measured the vertical lengths of three different parts angiographically: the length between the confluence point of the innominate vein and the anastomotic site of the conduit to the pulmonary artery (SVC-C), the conduit vertical length (C) and the length between the confluence point of the hepatic vein and the conduit's anastomotic site to the inferior vena cava (IVC-C). We have not observed stenosis or thrombus formation in the conduit or distortion of the conduit or pulmonary artery in any of the cases. No intervention or re-operation related to the extracardiac conduit was required, and laminar flow through the conduit was maintained with efficient Fontan haemodynamics. At 5.1 years after the ECFP, the average weight and height gain were 10.3+/-4.4 kg and 28.5+/-1.9 cm, respectively. The length of SVC-C, C and IVC-C were significantly increased as 124+/-15%, 106+/-7% and 132+/-24%, respectively, compared to the lengths at 1 month after the ECFP. The degree of increase in SVC-C and IVC-C was significantly larger than that in C. Along with the patient's somatic growth, longitudinal growth of the autologous vessels above and below the Gore-Tex graft was demonstrated to compensate for the lack of growth

  19. Improvement of Fat Transplantation: Fat Graft With Adipose-Derived Stem Cells and Oxygen-Generating Microspheres.

    Science.gov (United States)

    Jung, Dong-Woo; Kim, Yong-Ha; Kim, Tae Gon; Lee, Jun Ho; Chung, Kyu Jin; Lim, Jeong Ok; Choi, Jeong Yeon

    2015-10-01

    Autologous fat transplantation has become increasingly popular in plastic surgery. However, high resorption rate limits the utility of this technique. To address this problem, this study examined fat transplantation with oxygen-generating microspheres and adipose-derived stem cells (ASCs) in a rat model. The rats were assigned to four groups. Group 1 had fat transplantation only; group 2, fat transplantation with oxygen-generating microspheres; group 3, fat transplantation with ASCs; group 4, fat transplantation with oxygen-generating microspheres and ASCs. At postoperative 2 weeks, compared to the control group, weight and volume increased significantly in groups 3 and 4. The survival distance of fat cells from the margin of transplanted tissue was 247 μm in group 1, 379 μm group 2, 521 μm in group 3, and 669 μm in group 4. All of the experimental groups were significantly increased. Growth factors (fibroblast growth factor- 2 [FGF-2], insulin-like growth factor-1, epidermal growth factor, and vascular endothelial growth factor) analysis was performed through real-time polymerase chain reaction. Compared to the control group, the mean of the periods was statistically significant at FGF-2 in group 3 and FGF-2, insulin-like growth factor-1, and epidermal growth factor in group 4. In this study, fat transplantation was improved with oxygen-generating microspheres and ASCs. The oxygen-generating microspheres supply oxygen to adipocytes and ASCs where diffusion does not occur, increasing cell survival rate. Surviving ASCs become involved in the metabolic processes for adipocytes and induce angiogenesis. Therefore, fat transplantation result was improved. Excessive oxygen supply, however, reduces angiogenesis and may cause oxygen toxicity. So, further evaluation of oxygen-generating microspheres is necessary for application to tissues to determine appropriate oxygen concentration and a valid oxygen release period.

  20. Median Nerve Repair with Autologous Sciatic Nerve Graft: A Case Report

    OpenAIRE

    Ragel, Brian T.; Park, Gregory C.; Brevard, Sid

    2011-01-01

    Background. Peripheral nerve injury treatment options are limited to primary nerve repair, nerve grafting, and tendon transfers. In this case, a large suitable donor site was easily accessible and delayed grafting was indicative of poor prognosis. Case Description. A 25-year-old soldier presented to a military hospital in Afghanistan following a roadside bomb attack. The patient had a medial shrapnel wound in the bicipital groove with a cool pulseless hand and catastrophic lower extremity inj...

  1. A meta-analysis of histomorphometric results and graft healing time of various biomaterials compared to autologous bone used as sinus floor augmentation material in humans.

    Science.gov (United States)

    Klijn, Reinoud J; Meijer, Gert J; Bronkhorst, Ewald M; Jansen, John A

    2010-10-01

    To date, no studies have been published in which histomorphometric data from a large group of patients comparing various biomaterials for sinus floor augmentation procedures were evaluated. A meta-analysis of the English literature from January 1993 till April 2009 was carried out. Out of 147 titles, according to our criteria, 64 articles were selected for analysis describing the use of autologous bone and their alternatives, such as allogenic, xenogenic, and alloplastic materials. On the basis of autologous bone grafting, a reference value for total bone volume (TBV) of 63% was found. Particulation of the bone graft resulted in a general reduction of −18% in TBV. Delayed implant placement reduced the TBV with −7%. Overall TBV was 8% or 6% higher if a biopsy was, respectively, taken before 4.5 months or after 9.0 months after initial sinus augmentation surgery. Allogenic, xenogenic, alloplastic, or combinations of graft materials all resulted in a significant lower amount of TBV compared to autologous bone grafting ranging from −7% to −26%. Inventorying the effect of "biopsy time" for autologous bone, the TBV was significantly higher before 4.5 and after 9.0 months of healing time compared to period in between. Surprisingly, no significant differences in TBV with respect to "biopsy time" for bone substitutes were found. On the basis of the aspect of TBV autologous bone still has to be considered to be the gold standard in sinus augmentation surgery. However, the consequence of the TBV for implant survival is still unraveled yet.

  2. Autologous serum eye drops for severe dry eye syndrome in a patient with chronic graft-versus-host disease: a case report.

    Science.gov (United States)

    Mixon, Bill; Mixon, Jan; Isbey, Edward K; Sprinkle, Shari

    2014-01-01

    We present the case of a 49-year-old woman with severe dry eye syndrome caused by chronic graft-versus-host disease that developed after an allogeneic hematopoietic transplant to treat acute myelogenous leukemia. After the use of commercially manufactured products for the treatment of dry eye failed to relieve her photosensitivity, blurred. vision, and severe bilateral ocular pain, she benefitted significantly from therapy with compounded autologous serum eye drops. Comments from that patient are included in this report, as are a formulation for the preparation of autologous eye drops and suggestions for their safe and effective use.

  3. Three-Dimensional Ultrasound Versus Computerized Tomography in Fat Graft Volumetric Analysis.

    Science.gov (United States)

    Blackshear, Charles Philip; Rector, Michael Anthony; Chung, Natalie Narie; Irizarry, Dre Michael; Flacco, John Stephen; Brett, Elizabeth Anne; Momeni, Arash; Lee, Gordon Kwanlyp; Longaker, Michael T; Wan, Derrick C

    2018-03-01

    Studies evaluating fat grafting in mice have frequently used micro-computed tomography (micro-CT) as an accurate radiographic tool to measure longitudinal volume retention without killing the animal. Over the past decade, however, microultrasonography has emerged as an equally powerful preclinical imaging tool. Given their respective strengths in 3-dimensional reconstruction, there is no study to our knowledge that directly compares micro-CT with microultrasound in volumetric analysis. In this study, we compared the performance of micro-CT with microultrasound in the evaluation of adipose tissue graft volume in a murine model. Fifteen immunodeficient mice were given 200 μL of adipose tissue grafts. In vivo volumetric analysis of the grafts by micro-CT and microultrasound was conducted at discrete time points up to postoperative day 105. Three mice were killed at multiple time points, and explanted grafts were reimaged by CT and ultrasound, as mentioned previously. Analysis revealed that in vivo graft volumes measured by micro-CT do not differ significantly from those of microultrasound. Furthermore, both micro-CT and microultrasound were capable of accurately measuring fat grafts as in vivo volumes closely correlated with explanted volumes. Finally, ultrasound was found to yield improved soft tissue contrast compared with micro-CT. Therefore, either modality may be used, depending on experimental needs.

  4. Orthogonal Double Plating and Autologous Bone Grafting of Postoperative Humeral Shaft Nonunion - A Rare Case Report and Review of Literature.

    Science.gov (United States)

    Metikala, Sreenivasulu; Bhogadi, Prabhudheer

    2015-01-01

    Nonunion following surgical stabilization of humeral shaft fractures, although infrequent, remains a challenge as limited surgical options are available. The difficulties in re-fixation are due to osteolysis produced by the loose implant components and disuse osteopenia of the entire bone segment. We share our experience in the management of a long standing diaphyseal nonunion of humerus following titanium LCP fixation. A 58 years old woman presented with 20 months old nonunion following titanium LCP fixation of her closed humeral shaft fracture, done elsewhere. The interesting intraoperative findings, noteworthy, are about the extensive metallosis and the gross cortical defect measuring 10cm x 1cm x 1cm, corresponding to the foot print of the previous plate with exposed medullary canal. It was managed by debridement, dual plate fixation using 9 holed and 12 holed stainless steel LCPs in an orthogonal fashion and autologous bone grafting. The nonunion healed in 5 months and she regained all the movements except for terminal 10° of elbow extension and 15° of shoulder abduction at her final follow up of 30 months. According to Stewart and Hundley classification the final result was found to be good. We recommend the judicious use of long and short plates in 90-90 orientation along with autogenous bone grafting in the management of a long standing humeral shaft nonunion having extensive cortical resorption following surgical stabilization by plating.

  5. The use of prosthetic grafts in complex military vascular trauma: a limb salvage strategy for patients with severely limited autologous conduit.

    Science.gov (United States)

    Vertrees, Amy; Fox, Charles J; Quan, Reagan W; Cox, Mitchell W; Adams, Eric D; Gillespie, David L

    2009-04-01

    The use of prosthetic grafts for reconstruction of military vascular trauma has been consistently discouraged. In the current conflict, however, the signature wound involves multiple extremities with significant loss of soft tissue and potential autogenous venous conduits. We reviewed the experience with the use of prosthetic grafts for the treatment of vascular injuries sustained during recent conflicts in Iraq and Afghanistan. Trauma registry records with combat-related vascular injuries repaired using prosthetic grafts were retrospectively reviewed from March 2003 to April 2006. Data collected included age, gender, mechanism of injury, vessel injured, conduit, graft patency, complications, including amputation and eventual outcome of repair. Prosthetic grafts were placed in 14 of 95 (15%) patients undergoing extremity bypass for vascular injuries. Patients were men with an average age of 25 years (range, 19-39 years). All prosthetic grafts in this series were made of polytetrafluoroethylene. Mechanism of injury included blast (n = 6), gunshot wounds (n = 6), and blunt trauma (n = 2), resulting in prosthetic repair of injuries to the superficial femoral (n = 8), brachial (n = 3), common carotid (n = 1), subclavian (n = 1), and axillary (n = 1) arteries. Mean evacuation time from injury to stateside arrival was 7 days (range, 3-9 days). Twelve grafts were placed initially at the time of injury, and two after vein graft blow out with secondary hemorrhage. The mean follow-up period was 427 days (range, 49-1,285 days). Seventy-nine percent of prosthetic grafts stayed patent in the short term, allowing patient stabilization, transport to a stateside facility, and elective revascularization with the remaining autologous vein graft. Three prosthetic grafts were replaced urgently for thrombosis. The remaining seven grafts were replaced electively for severe stenosis (3) or exposure (4) with presumed infection. There were no prosthetic graft blow outs or deaths in this

  6. Decellularized Matrix and Supplemental Fat Grafting Leads to Regeneration following Traumatic Fingertip Amputation.

    Science.gov (United States)

    Sivak, Wesley N; Ruane, Edward J; Hausman, Steven J; Rubin, J Peter; Spiess, Alexander M

    2016-10-01

    Decellularized scaffold materials are capable of regenerating missing tissues when utilized under appropriate conditions. Fat grafting also has reported advantages in revitalizing damaged tissue beds. This report details a case of traumatic fingertip amputation treated with a combination of decellularized materials in conjunction with fat grafting, resulting in a supple and functional reconstruction of the affected digit. After traumatic fingertip amputation, a patient was initially treated with decellularized porcine urinary bladder matrix powder. As a second stage, the healed tip scar tissue was reexcised, and a second application of powder was applied. As a third stage, the tip scar tissue was reexcised and a decellularized bilayer was sewn into the soft tissues of the debrided tip, resulting in an improved soft tissue envelope. As a final stage, the restored fingertip soft tissue envelope was fat grafted for additional bulk. Patient underwent treatment every other day with decellularized porcine urinary bladder matrix (powder and bilayer) and was able to reasonably regenerate the traumatic fingertip soft tissue envelope. This resulted in an envelope that was further enhanced with fat grafting. The resulting digit was sensate with maintained length, and possessed a more normal appearance than would be achieved by healing by secondary intention, or local flap or graft coverage. Decellularized materials can be utilized in conjunction with fat grafting to treat traumatic fingertip amputations in select patients. This combination approach is able to achieve a sensate fingertip and regain length lost in the affected digit. Additionally, we describe a novel technique that can be employed to maximize the amount of soft tissue regenerated by the decellularized products.

  7. Sinus floor augmentation surgery using autologous bone grafts from various donor sites: a meta-analysis of the total bone volume.

    Science.gov (United States)

    Klijn, Reinoud J; Meijer, Gert J; Bronkhorst, Ewald M; Jansen, John A

    2010-06-01

    To date, no studies have been published that evaluated histomorphometric data from a large number of patients while comparing different sites and methods of autologous bone grafting in sinus floor augmentation procedures. A meta-analysis of the English literature from January 1995 till April 2009 was carried out. PubMed search engine and the following journals were explored: Clinical Oral Implant Research, International Journal of Oral and Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, and the Journal of Periodontology. Out of 147 titles, according to our criteria, 25 articles were left for analysis. The majority were prospective controlled studies (21) and 2 randomized clinical trials, 1 pilot study and 1 case series. A reference value of 47% for total bone volume (TBV) was found while using iliac bone grafting as a standard. Use of intraoral bone grafts increases the TBV, with 11% for chin bone and 14% for bone grafted from other intraoral sites. Particulation of the bone graft has a negative effect on the TBV of 18%. Surprisingly, no correlation between TBV and the time of graft healing was found. Histological section thickness seemed to be a significant variable, as every micron increase of section thickness leads to an increase of 0.4% of TBV. Bone grafting from the iliac crest resulted in a significantly lower TBV compared with intraoral bone grafting. However, due to the limited availability of intraoral bone to be harvested, iliac grafts still have to be considered the gold standard in augmenting the severely atrophic maxilla.

  8. Efficacy of Autologous Microfat Graft on Facial Handicap in Systemic Sclerosis Patients.

    Science.gov (United States)

    Sautereau, Nolwenn; Daumas, Aurélie; Truillet, Romain; Jouve, Elisabeth; Magalon, Jéremy; Veran, Julie; Casanova, Dominique; Frances, Yves; Magalon, Guy; Granel, Brigitte

    2016-03-01

    Autologous adipose tissue injection is used in plastic surgery for correction of localized tissue atrophy and has also been successfully offered for treatment of localized scleroderma. We aimed to evaluate whether patients with systemic sclerosis (SSc) and facial handicap could also benefit from this therapy. We included 14 patients (mean age of 53.8 ± 9.6 years) suffering from SSc with facial handicap defined by Mouth Handicap in Systemic Sclerosis Scale (MHISS) score more than or equal to 20, a Rodnan skin score on the face more than or equal to 1, and maximal mouth opening of less than 55 mm. Autologous adipose tissue injection was performed under local anesthesia using the technique of subcutaneous microinjection. The main objective of this study was an improvement of the MHISS score 6 months after the surgical treatment. The procedure was well tolerated. We observed a mean decrease in the MHISS score of 10.7 points (±5.1; P handicap, skin sclerosis, mouth opening limitation, sicca syndrome, and facial pain. Thus, this minimally invasive approach offers a new hope for face therapy for patients with SSc.

  9. Association of oxidative stress and DNA damage with grafting time in patients with multiple myeloma and lymphoma submitted to autologous hematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Thayna Nogueira dos Santos

    Full Text Available ABSTRACT The aim of the study was to investigate the association between oxidative stress and DNA damage with grafting time in patients submitted to autologous hematopoietic stem-cell transplantation (HSCT. The study included 37 patients submitted to autologous HSCT diagnosed with Multiple Myeloma (MM and lymphoma (Hodgkin’s and non-Hodgkin’s. Biomarkers of oxidative stress and DNA damage index (DI were performed at baseline (pre-CR of the disease and during the conditioning regimen (CR, one day after the HSCT, ten days after HSCT and twenty days after HSCT, as well as in the control group consisting of 30 healthy individuals. The outcomes showed that both groups of patients had an hyperoxidative state with high DI when compared to baseline and to the control group and that the CR exacerbated this condition. However, after the follow-up period of the study, this picture was re-established to the baseline levels of each pathology. The study patients with MM showed a mean grafting time of 10.75 days (8 to 13 days, with 10.15 days (8 to 15 days for the lymphoma patients. In patients with MM, there was a negative correlation between the grafting time and the basal levels of GPx (r = -0.54; p = 0.034, indicating that lower levels of this important enzyme are associated with a longer grafting time. For the DI, the correlation was a positive one (r = 0.529; p = 0.030. In the group with lymphoma, it was observed that the basal levels of NOx were positively correlated with grafting time (r = 0.4664, p = 0.032. The data indicate the potential of these biomarkers as predictors of toxicity and grafting time in patients with MM and Lymphomas submitted to autologous HSCT.

  10. Computer-based planning of optimal donor sites for autologous osseous grafts

    Science.gov (United States)

    Krol, Zdzislaw; Chlebiej, Michal; Zerfass, Peter; Zeilhofer, Hans-Florian U.; Sader, Robert; Mikolajczak, Pawel; Keeve, Erwin

    2002-05-01

    Bone graft surgery is often necessary for reconstruction of craniofacial defects after trauma, tumor, infection or congenital malformation. In this operative technique the removed or missing bone segment is filled with a bone graft. The mainstay of the craniofacial reconstruction rests with the replacement of the defected bone by autogeneous bone grafts. To achieve sufficient incorporation of the autograft into the host bone, precise planning and simulation of the surgical intervention is required. The major problem is to determine as accurately as possible the donor site where the graft should be dissected from and to define the shape of the desired transplant. A computer-aided method for semi-automatic selection of optimal donor sites for autografts in craniofacial reconstructive surgery has been developed. The non-automatic step of graft design and constraint setting is followed by a fully automatic procedure to find the best fitting position. In extension to preceding work, a new optimization approach based on the Levenberg-Marquardt method has been implemented and embedded into our computer-based surgical planning system. This new technique enables, once the pre-processing step has been performed, selection of the optimal donor site in time less than one minute. The method has been applied during surgery planning step in more than 20 cases. The postoperative observations have shown that functional results, such as speech and chewing ability as well as restoration of bony continuity were clearly better compared to conventionally planned operations. Moreover, in most cases the duration of the surgical interventions has been distinctly reduced.

  11. A Novel Technique of Fabricating a Modified Removable Provisional Prosthesis over an Autologous Bone Grafted Maxillary Anterior Edentulous Segment Prior to Implant Placement.

    Science.gov (United States)

    Andonissamy, Leoney; Vidhya, N Sri

    2017-09-01

    Implant dentistry has provided a lot of surgical as well as prosthetic techniques for improving the success of the implants. The surgical technique commonly followed now prior to implant placement is bone grafting procedure. One of the commonest techniques is the use of autologous block graft harvested from mandibular chin region. However, interference in healing as well as excessive bone resorption due to the use of removable provisional prosthesis over the bone grafted region has been commonly observed/reported. Hence now-a-days, fixed provisional prosthesis is preferred over removable provisional prosthesis for the added advantages of superior aesthetics and patient acceptance. This article highlights a new technique of fabricating removable provisional prosthesis, which is superior in aesthetics and strength, consumes less chair time and exerts zero pressure onto the grafted site.

  12. [Repairing bone defects of benign bone neoplasm by grafting of bioactive glass combined with autologous bone marrow].

    Science.gov (United States)

    Liu, Hongwei; Sun, Junying; Wang, Yong; Yang, Xing; Zhu, Ershan

    2008-11-01

    To investigate the clinical application of grafting with bioactive glass (BG) and autologous bone marrow for defect after resection and curettage of benign bone neoplasm. From January 2004 to May 2007, 34 patients with bone defects were repaired. There were 21 males and 13 females with a mean age of 25.6 years (8 to 56 years). There were 14 cases of simple bone cysts, 6 cases of fibrous dysplasia, 3 cases of osteoid osteoma, 4 cases of non-ossifying fibroma, 2 cases of enchondroma and 3 cases of giant cell tumor of bone. Tumor sizes varied from 2.0 cm x 1.5 cm x 1.0 cm to 9.0 cm x 3.0 cm x 2.5 cm. Benign bone neoplasm was removed thoroughly with a curet or osteotome, bone defects ranged from 3.0 cm x 2.0 cm x 1.5 cm to 11.0 cm x 3.5 cm x 3.0 cm, which was closed-up with the mixtures of BG and autogenous red bone marrow. Six cases of pathologic fracture were fixed with steel plate or intramedullary nail. The postoperative systemic and local reactions were observed, and the regular X-ray examinations were performed to observe the bone healing. All the patients had good wound healing after operation. There was no yellow effusion nor white crystal and skin rash appeared around wound, indicating no allergic reaction occurred. A follow-up of 1 to 4 years (mean 24.6 months) showed satisfactory healing without complications. At averaged 16 weeks after operation, patients with bone tumor in lower limbs resumed walking independently and those with bone tumor in upper limbs resumed holding object. There was no tumor recurrence during follow-up. Radiographically, the interface between the implanted bone and host bone became fuzzy 1 month after implantation. Two months after operation, the BG was absorbed gradually, new bone formation could be seen in the defects. Four months after operation, implanted bone and host bone merged together, bone density increased. Six to ten months after operation, the majority of the implanted BG was absorbed and substituted for new bone, bone

  13. Use of human fat grafting in the prevention of perineural adherence: Experimental study in athymic mouse.

    Directory of Open Access Journals (Sweden)

    Mario Cherubino

    Full Text Available Perineural adherences represent a problem after surgery involving peripheral neural system. Fat-grafting with adipose derived stem cells (ASCs with their pro-regenerative characteristics can be important to prevent the neural damage or to facilitate the neural regeneration. Our idea was to use the fat-grafting as an anti-adherence device and test its efficacy on a postsurgical scar animal model and comparing to an antiadhesive gel. 32 athymic mice were operated under magnification, we exposed both sciatic nerves. We randomly divided all sciatic nerves into four experimental groups: burning (1, burning + carboxy-methylcellulose and poly- ethylene oxide (CMC-PEO (2 + human adipose fat tissue (3, control group (4. Bio-mechanical evaluation was performed to measure the peak force required to pull out the nerve from the muscular bed.in the CMC-PEO group the peak pull out force was 0.37 Newton. In the fat grafted group we registered a peak pull out force of 0.35 N (t Student 0.913. In burning group the force necessary to tear the nerve apart was markedly superior (0.46 N. In control group, we reported the minimal strength (0.31 N to slide the nerve from the tissue. Histologically, in the group treated with fat-grating, a thinner scar layer was highlighted. Considering the results of this study we can support the efficacy in animal experimental model of fat graft as an anti-adherence device in peripheral nerve surgery.

  14. Improvement in autologous human fat transplant survival with SVF plus VEGF-PLA nano-sustained release microspheres.

    Science.gov (United States)

    Li, Liqun; Pan, Shengsheng; Ni, Binting; Lin, Yuanshao

    2014-08-01

    Early neovascularization is important for autologous fat transplant survival. SVF cells are ideal seed cells. Both vascular endothelial growth factor (VEGF) and SVF cells can promote neovascularization. However, the half-life (about 50 min) of VEGF is too short to sustain an adequate local concentration. We have investigated whether VEGF-polylactic acid (PLA) nano-sustained release microspheres plus SVF cells can improve neovascularization and survival of transplanted fat tissues. SVF cells were harvested and constructed VEGF-PLA nano-sustained release microspheres in vitro. Human fat tissues was mixed with SVF cells plus VEGF-PLA, SVF cells alone or Dulbecco's modified Eagle's medium as the control. These three mixtures were injected into random sites in 18 nude mice. Two months later, the transplants were weighed and examined histologically; and capillaries were counted to quantify neovascularization. Hematoxylin-eosin (HE) and anti-VEGF stains were applied to reveal cell infiltration. The mean wet weight of fat in the SVF plus VEGF-PLA, SVF alone, and control transplants were 0.18 ± 0.013 g, 0.16 ± 0.015 g, and 0.071 ± 0.12 g, respectively; the differences between groups were statistically significant. More vessels were present in the SVF plus VEGF-PLA transplants than in the other two types. Transplants mixed with SVF cells also had an acceptable density of capillaries. Histological analysis revealed that both the SVF plus VEGF-PLA and SVF alone transplants, but not the control transplants, were composed of adipose tissue, and had less fat necrosis and less fibrosis than control specimens. SVF plus VEGF-PLA transplants had significantly greater capillary density and VEGF expression than the other two transplant groups. Thus transplanted fat tissue survival and quality can be enhanced by the addition of VEGF-PLA nano-sustained release microspheres plus SVF cells. © 2014 International Federation for Cell Biology.

  15. Co-transplantation of exosomes derived from hypoxia-preconditioned adipose mesenchymal stem cells promotes neovascularization and graft survival in fat grafting.

    Science.gov (United States)

    Han, Yu-di; Bai, Yun; Yan, Xin-Long; Ren, Jing; Zeng, Quan; Li, Xiao-Dong; Pei, Xue-Tao; Han, Yan

    2018-02-26

    Adipose-derived stromal cells (ADSCs)-derived exosomes (ADSC-Exos) account for the proangiogenic potential of stem cell. This study aimed to investigate the effect of ADSC-derived exosomes (ADSC-Exos) on the survival in fat grafting. A nude mouse model of subcutaneous fat grafting was adopted. Hypoxic preconditioned ADSC-Exos and ADSC-Exos were injected around the grafted tissue. The fat graft sample was weighed and examined by hematoxylin and eosin (H&E) staining and immunohistochemistry. Laser Doppler flowmetry and CD31 immunofluorescence staining were used to analyze neovascularization. ADSC-Exo and hypoxic ADSC-Exo groups had a significantly higher weight of fat graft and more perilipin-positive adipocytes than the control groups from 2 to 8 weeks after grafting, and the hypoxic ADSC-Exo group had better outcomes (all P cells around the fat grafts. Laser Doppler flowmetry showed that the two ADSC-Exo groups had better blood perfusion in the graft tissue than the control groups (all P cells than the ADSC-Exo group. In vitro study showed that hypoxic ADSC-Exos treatment significantly increased the migration (at 12 and 24 h) and in vitro capillary network formation (at 12 h) in the human umbilical vein endothelial cells (HUVECs) as compared with the ADSC-Exo group and control group (all P fat grafts. Hypoxia treatment can further enhance the beneficial effect of ADSC-Exos. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. Bioengineering of cultured epidermis from adult epidermal stem cells using Mebio gel sutable as autologous graft material

    Directory of Open Access Journals (Sweden)

    Lakshmana K Yerneni

    2007-01-01

    Full Text Available Closure of burn wound is the primary requirement in order to reduce morbidity and mortality that are otherwise very high due to non-availability of permanent wound covering materials. Sheets of cultured epidermis grown from autologous epidermal keratinocyte stem cells are accepted world over as one of the best wound covering materials. In a largely populated country like ours where burn casualties occur more frequently due to inadequate safety practices, there is a need for indigenous research inputs to develop such methodologies. The technique to culturing epidermal sheets in vitro involves the basic Reheinwald-Green method with our own beneficial inputs. The technique employs attenuated 3T3 cells as feeders for propagating keratinocyte stem cells that are isolated from the epidermis of an initial skin biopsy of about 5 cm2 from the patient. The cultures are then maintained in Dulbecco's modified Eagle's medium strengthened with Ham's F12 formula, bovine fetal serum and various specific growth-promoting agents and factors in culture flasks under standard culture conditions. The primary cultures thus established would be serially passaged to achieve the required expansion. Our major inputs are into the establishment of (1 an efficient differential trypsinization protocol to isolate large number epidermal keratinocytes from the skin biopsy, (2 a highly specific, unique and foolproof attenuation protocol for 3T3 cells and (3 a specialized and significant decontamination protocol. The fully formed epidermal sheet as verified by immuno-histochemical and light & electron microscopic studies, is lifted on to paraffin gauze by incubating in a neutral protease. The graft is then ready to be transported to the operating theatre for autologous application. We have a capability of growing cultured epidermal sheets sufficient enough to cover 40 per cent burn wound in 28 days. The preliminary small area clinical applications undertaken so far revealed

  17. Treatment of stable and recalcitrant depigmented skin conditions by autologous punch grafting

    Directory of Open Access Journals (Sweden)

    Lahiri Koushik

    1997-01-01

    Full Text Available Sixty cases of stable and refractory depigmented skin conditions which include local vitiligo, segmental vitiligo, chemical leucoderma, vitiligo vulgaris, post-burn depigmentation etc constitute the study group. 39 of them were female and 21 male. Age ranged between 6 and 67 years. 1057 grafts were placed over 114 lesions and the cases were followed up to a period of 18 months. 70% to 100% repigmentation was observed in 56 lesions of 31 patients. Rate and extent of perigraft pigment spread was noted. Patients under PUVASOL showed a distinctly better response. Sequelae like cobble-stoning and polka-dotting were found to be disappearing with time or interference.

  18. Fat, Stem Cells, and Platelet-Rich Plasma.

    Science.gov (United States)

    James, Isaac B; Coleman, Sydney R; Rubin, J Peter

    2016-07-01

    The ideal filler for aesthetic surgery is inexpensive and easy to obtain, natural in appearance and texture, immunologically compatible, and long lasting without risk of infection. By most metrics, autologous fat grafts meet these criteria perfectly. Although facial fat grafting is now a commonly accepted surgical procedure, there has been a wave of activity applying stem cells and platelet-rich plasma (PRP) therapies to aesthetic practice. This article addresses technical considerations in the use of autologous fat transfer for facial rejuvenation, and also explores the current evidence for these stem cell and PRP therapies in aesthetic practice. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Morphometric analysis of bone vascular channels during the biointegration of autologous bone grafts.

    Science.gov (United States)

    Petrescu, H P; Dinu, G; Nodiţi, G; Craina, M; Berceanu-Văduva, Delia; Berceanu-Văduva, M; Vermeşan, D

    2013-01-01

    Vascularization of the transplanted bone tissue is a key factor for success and precedes the formation of bone tissue. Vascularized bone grafts have been widely used in bone transplantation for their efficiency. Maturation of the bone tissue at the place of the transplant involves the change in the vascular patterning, from plexiform irregular vascular networks, to regular, polygonal networks following the structure of osteons. Seven dogs were performed bone transplantation and intravenous injection with China ink in order to highlight the network of blood vessels during bone formation at the place of the transplant. The area occupied by blood vessels increased during osteogenesis, and their length decreased in evolution, suggesting a maturation of the vascular pattern.

  20. Management of an irradiated anophthalmic socket following dermis-fat graft rejection: A case report

    Directory of Open Access Journals (Sweden)

    Raizada Kuldeep

    2008-01-01

    Full Text Available Dermis-fat graft (DFG is often the only promising option in cases of severely contracted sockets. However, there is an increased risk of graft failure in irradiated sockets with decreased vascularity. In such difficult cases, repeat DFG implantation also has higher risks of graft failure. We describe an ingenious method of successful management of an irradiated anophthalmic socket following DFG infection and necrosis, with acceptable cosmetic results. At surgery, an orbital impression was taken with ophthalmic grade alginate. Based on this measurement, a custom-made stem pressure socket-expander made up of high density polymethyl methacrylate (PMMA was fitted, a week post surgery and kept in situ for six weeks. On review, the fornices had considerably deepened. The expander device was removed and the patient was now fitted with a custom-made thicker prosthesis made up of high-density PMMA. The patient has followed up for a year subsequently and the prosthesis has remained stable.

  1. Three-level anterior cervical discectomy and fusion in elderly patients with wedge shaped tricortical autologous graft: A consecutive prospective series

    Directory of Open Access Journals (Sweden)

    Lee Suk

    2008-01-01

    Full Text Available Background: Treatment of multilevel cervical spondylotic myelopathy/radiculopathy is a matter of debate, more so in elderly patients due to compromised physiology. We evaluated the clinical and radiological results of cervical fusion, using wedge-shaped tricortical autologous iliac graft and Orion plate for three-level anterior cervical discectomy in elderly patients. Materials and Methods: Twelve elderly patients with mean age of 69.7 years (65-76 years were treated between April 2000 and March 2005, for three-level anterior cervical discectomy and fusion, using wedge-shaped tricortical autologous iliac graft and Orion plate. Outcome was recorded clinically according to Odom′s criteria and radiologically in terms of correction of lordosis angle and intervertebral disc height span at the time of bony union. The mean follow-up was 29.8 months (12-58 months. Results: All the patients had a complete recovery of clinical symptoms after surgery. Postoperative score according to Odom′s criteria was excellent in six patients and good in remaining six. Bony union was achieved in all the patients with average union time of 12 weeks (8-20 weeks. The mean of sum of three segment graft height collapse was 2.50 mm (SD = 2.47. The average angle of lordosis was corrected from 18.2° (SD = 2.59° preoperatively to 24.9° (SD = 4.54° at the final follow-up. This improvement in the radiological findings is statistically significant (P < 0.05. Conclusion: Cervical fusion with wedge-shaped tricortical autologous iliac graft and Orion plate for three-level anterior cervical discectomy is an acceptable technique in elderly patients. It gives satisfactory results in terms of clinical outcome, predictable early solid bony union, and maintenance of disc space height along with restoration of cervical lordosis.

  2. Synovial Mesenchymal Stem Cells Promote Meniscus Regeneration Augmented by an Autologous Achilles Tendon Graft in a Rat Partial Meniscus Defect Model

    Science.gov (United States)

    Ozeki, Nobutake; Muneta, Takeshi; Matsuta, Seiya; Koga, Hideyuki; Nakagawa, Yusuke; Mizuno, Mitsuru; Tsuji, Kunikazu; Mabuchi, Yo; Akazawa, Chihiro; Kobayashi, Eiji; Saito, Tomoyuki; Sekiya, Ichiro

    2015-01-01

    Although meniscus defects and degeneration are strongly correlated with the later development of osteoarthritis, the promise of regenerative medicine strategies is to prevent and/or delay the disease's progression. Meniscal reconstruction has been shown in animal models with tendon grafting and transplantation of mesenchymal stem cells (MSCs); however, these procedures have not shown the same efficacy in clinical studies. Here, our aim was to investigate the ability of tendon grafts pretreated with exogenous synovial-derived MSCs to prevent cartilage degeneration in a rat partial meniscus defect model. We removed the anterior half of the medial meniscus and grafted autologous Achilles tendons with or without a 10-minute pretreatment of the tendon with synovial MSCs. The meniscus and surrounding cartilage were evaluated at 2, 4, and 8 weeks (n = 5). Tendon grafts increased meniscus size irrespective of synovial MSCs. Histological scores for regenerated menisci were better in the tendon + MSC group than in the other two groups at 4 and 8 weeks. Both macroscopic and histological scores for articular cartilage were significantly better in the tendon + MSC group at 8 weeks. Implanted synovial MSCs survived around the grafted tendon and native meniscus integration site by cell tracking assays with luciferase+, LacZ+, DiI+, and/or GFP+ synovial MSCs and/or GFP+ tendons. Flow cytometric analysis showed that transplanted synovial MSCs retained their MSC properties at 7 days and host synovial tissue also contained cells with MSC characteristics. Synovial MSCs promoted meniscus regeneration augmented by autologous Achilles tendon grafts and prevented cartilage degeneration in rats. Stem Cells 2015;33:1927–1938 PMID:25993981

  3. Surgical repair of massive rotator cuff tendon tears: Autologous quadriceps tendon graft versus arthroscopic repair.

    Science.gov (United States)

    Tempelaere, C; Desmoineaux, P; Lespagnol, F; Pierrart, J; Beaufils, P; Pujol, N

    2017-05-01

    Massive rotator cuff tear repair results are variable. The main purpose of this study was to compare functional outcome between two procedures: open repair by autologous quadriceps-patella tendon patch, and arthroscopic suture. The study hypothesis was that there is no significant difference in results between the two techniques. A retrospective study included all patients younger than 70 years operated on from 1995 to 2013 for massive rotator cuff tear. Exclusion criteria comprised history of dislocation, fracture or surgery or osteoarthritis in the affected shoulder, and infra- and supra-spinatus fatty degeneration equal to or greater than stage 3. Two consecutive groups were distinguished: group 1, from 1995 to 2003, comprised 23 patients (24 shoulders; mean age, 55.8 years) treated by open repair using quadriceps tendon autograft; group 2, from 2003 to 2013, comprised 27 patients (29 shoulders: mean age, 60.3 years) treated by arthroscopic repair. Preoperatively, mean Constant score was 42.9 in group 1 and 45.7 in group 2 (P=0.36), pain score 5.5/15 and 7.6/15 (P=0.08), strength 3.0kg and 2.4kg (P=0.30), and subacromial space 6.3 and 6.7mm (P=0.05), respectively. At respectively 58 and 55 months' mean follow-up, Constant score was 71.1 in group 1 and 71.8 in group 2 (P=0.086), pain 11.9/15 and 12.7/15 (P=0.76), gain in strength 1.4kg and 2.3kg (P=0.0006), and subacromial space 7.1mm and 6.3mm (P=0.29), respectively. The complications rate was 70% in group 1 and there were no specific complications in group 2. Functional improvement was significant and comparable between the 2 groups. Quadriceps tendon harvesting was associated with high morbidity, but the technique increased subacromial space. IV, retrospective, single-center. Copyright © 2017. Published by Elsevier Masson SAS.

  4. Fat grafting to the hand in patients with Raynaud phenomenon: a novel therapeutic modality.

    Science.gov (United States)

    Bank, Jonathan; Fuller, Sam M; Henry, Ginard I; Zachary, Lawrence S

    2014-05-01

    Raynaud phenomenon causes progressively decreasing blood flow to the extremities, resulting from an imbalance between vasoconstriction and vasodilation. Treatment options include biofeedback, phosphodiesterase inhibitors, calcium channel inhibitors, botulinum toxin injection, or surgical sympathectomy. The authors propose fat grafting to the hands as a method to delay progression of the disease. Indications included symptomatic Raynaud phenomenon with failure of previous management. Fat is harvested from abdominal depots. Approximately 30 ml of decanted fat is injected by means of blunt cannulae: 10 to 15 ml in the dorsum of the hand, 2 to 3 ml in the snuffbox, 1 to 2 ml in each dorsal webspace, 3 to 4 ml along the superficial palmar arch, 1 to 2 ml in volar webspaces 2 to 4, and 2 to 3 ml in the first webspace. Patients underwent preoperative and postoperative laser speckle imaging study to assess changes in perfusion. A total of 13 patients were treated (21 hands). Twelve patients had undergone prior botulinum toxin injection, and 11 patients had prior sympathectomies. Findings included reduced pain (average reduction, 6.86 of 10 to 2.38 of 10), fewer cold attacks, improved skin and soft-tissue texture, decrease in ulcerations, and patient-reported improved function. Three patients had no changes. Increased blood flow per imaging was noted in five of 11 hands tested. Six patients had decreased readings on laser imaging. None of the laser speckle imaging changes were statistically significant, and they did not correlate clinically. There were no major complications. Preliminary results of fat grafting to the hands of patients with Raynaud phenomenon revealed improved symptomatology with evidence suggestive of measurably increased perfusion in some cases. Fat grafting may benefit the management of this patient population. Therapeutic, IV.

  5. Use of Fat Grafts in Facial Reconstruction on the Wounded Soldiers From the First World War (WWI) by Hippolyte Morestin (1869-1919).

    Science.gov (United States)

    Benmoussa, Nadia; Hansen, Kevin; Charlier, Philippe

    2017-11-01

    During the Great War of 1914 to 1918, spectacular progress was made in the field of facial reconstruction. The sheer number and severity of facial lesions inflicted during the fighting obliged French and German surgeons to take a close interest in the treatment of patients wounded in such a manner. As head surgeon of the fifth division "blessés de la face" at the hospital of Val-de-Grace, Hippolyte Morestin was responsible for one of the largest surgical departments specializing in facial surgery and reconstruction during the war. During his time of service, he developed various surgical techniques such as autoplasties using cartilaginous and adipose grafts to reconstruct tissue defects. This study focuses primarily on the adipose graft techniques and their aesthetic outcome used by Morestin during and in the aftermath of World War I. This is a historical descriptive study. Our research is based on documents available at the museum and archives of the Val-de-Grace Army Health Service (hospital activity reports, pre- and postoperative patient photographs, newspaper clippings, documented accounts of ward nurses, wax anatomy models). Thirty-four clinical cases published by Hippolyte Morestin dealing with facial reconstruction during the World War I were studied. Fat was mainly used to fill craniofacial substance losses after carrying out often complex reconstructions. The surgical technique is well documented and subdivided into 3 succeeding procedures. Most of the time, the grafts were of autologous origin but sometimes heterologous samples were used. Although the primary objective was to increase volume, an improved quality of skin healing and better skin flexibility were observed. The fat thus allowed the filling of substance losses, and its positive effects on scarring were noticed even before the regenerative properties of the stem cells present in body fat were discovered. Hippolyte Morestin can be named one of the pioneers of facial reconstruction. A

  6. Local review of treatment of hand enchondroma (artificial bone substitute versus autologous bone graft) in a tertiary referral centre: 13 years' experience.

    Science.gov (United States)

    Hung, Y W; Ko, W S; Liu, W H; Chow, C S; Kwok, Y Y; Wong, Clara W Y; Tse, W L; Ho, P C

    2015-06-01

    To evaluate the treatment outcomes of enchondroma of the hand with artificial bone substitute versus autologous (iliac) bone graft. Historical cohort study. Tertiary referral centre, Hong Kong. A total of 24 patients with hand enchondroma from January 2001 to December 2013 who underwent operation at the Prince of Wales Hospital and Alice Ho Miu Ling Nethersole Hospital in Hong Kong were reviewed. Thorough curettage of the tumour was performed in all patients, followed by either autologous bone graft impaction under general anaesthesia in 13 patients, or artificial bone substitute in 11 patients (10 procedures were performed under local or regional anaesthesia and 1 was done under general anaesthesia). The functional outcomes and bone incorporation were measured by QuickDASH (shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire) scores and radiological appearance, respectively. The mean follow-up period was 59 months. There were eight men and 16 women, with a mean age of 40 years. Overall, 17 cases involved phalangeal bones and seven involved metacarpal bones. Among both groups of patients, most of the affected digits had good range of motion and function after surgery. One patient in each study group had complications of local soft tissue inflammation. One patient in the artificial bone substitute group was suspected to have recurrence 8 years after operation. Among the autologous bone graft group, four patients had persistent donor site morbidity at the last follow-up. In all patients, radiographs showed satisfactory bone incorporation. Artificial bone substitute is a safe and effective treatment option for hand enchondroma, with satisfactory functional and radiographic outcomes. Artificial bone substitute offers the additional benefits of enabling the procedure to be done under local anaesthesia on a day-case basis with minimal complications.

  7. Infrapatellar fat pad-derived stem cells maintain their chondrogenic capacity in disease and can be used to engineer cartilaginous grafts of clinically relevant dimensions.

    Science.gov (United States)

    Liu, Yurong; Buckley, Conor Timothy; Almeida, Henrique V; Mulhall, Kevin J; Kelly, Daniel John

    2014-11-01

    A therapy for regenerating large cartilaginous lesions within the articular surface of osteoarthritic joints remains elusive. While tissue engineering strategies such as matrix-assisted autologous chondrocyte implantation can be used in the repair of focal cartilage defects, extending such approaches to the treatment of osteoarthritis will require a number of scientific and technical challenges to be overcome. These include the identification of an abundant source of chondroprogenitor cells that maintain their chondrogenic capacity in disease, as well as the development of novel approaches to engineer scalable cartilaginous grafts that could be used to resurface large areas of damaged joints. In this study, it is first demonstrated that infrapatellar fat pad-derived stem cells (FPSCs) isolated from osteoarthritic (OA) donors possess a comparable chondrogenic capacity to FPSCs isolated from patients undergoing ligament reconstruction. In a further validation of their functionality, we also demonstrate that FPSCs from OA donors respond to the application of physiological levels of cyclic hydrostatic pressure by increasing aggrecan gene expression and the production of sulfated glycosaminoglycans. We next explored whether cartilaginous grafts could be engineered with diseased human FPSCs using a self-assembly or scaffold-free approach. After examining a range of culture conditions, it was found that continuous supplementation with both transforming growth factor-β3 (TGF-β3) and bone morphogenic protein-6 (BMP-6) promoted the development of tissues rich in proteoglycans and type II collagen. The final phase of the study sought to scale-up this approach to engineer cartilaginous grafts of clinically relevant dimensions (≥2 cm in diameter) by assembling FPSCs onto electrospun PLLA fiber membranes. Over 6 weeks in culture, it was possible to generate robust, flexible cartilage-like grafts of scale, opening up the possibility that tissues engineered using FPSCs

  8. The role of environmental factors in regulating the development of cartilaginous grafts engineered using osteoarthritic human infrapatellar fat pad-derived stem cells.

    Science.gov (United States)

    Liu, Yurong; Buckley, Conor T; Downey, Richard; Mulhall, Kevin J; Kelly, Daniel J

    2012-08-01

    Engineering functional cartilaginous grafts using stem cells isolated from osteoarthritic human tissue is of fundamental importance if autologous tissue engineering strategies are to be used in the treatment of diseased articular cartilage. It has previously been demonstrated that human infrapatellar fat pad (IFP)-derived stem cells undergo chondrogenesis in pellet culture; however, the ability of such cells to generate functional cartilaginous grafts has not been adequately addressed. The objective of this study was to explore how environmental conditions regulate the functional development of cartilaginous constructs engineered using diseased human IFP-derived stem cells (FPSCs). FPSCs were observed to display a diminished chondrogenic potential upon encapsulation in a three-dimensional hydrogel compared with pellet culture, synthesizing significantly lower levels of glycosaminoglycan and collagen on a per cell basis. To engineer more functional cartilaginous grafts, we next explored whether additional biochemical and biophysical stimulations would enhance chondrogenesis within the hydrogels. Serum stimulation was observed to partially recover the diminished chondrogenic potential within hydrogel culture. Over 42 days, stem cells that had first been expanded in a low-oxygen environment proliferated extensively on the outer surface of the hydrogel in response to serum stimulation, assembling a dense type II collagen-positive cartilaginous tissue resembling that formed in pellet culture. The application of hydrostatic pressure did not further enhance extracellular matrix synthesis within the hydrogels, but did appear to alter the spatial accumulation of extracellular matrix leading to the formation of a more compact tissue with superior mechanically functionality. Further work is required in order to recapitulate the environmental conditions present during pellet culture within scaffolds or hydrogels in order to engineer more functional cartilaginous grafts using

  9. Application of platelet-rich plasma and platelet-rich fibrin in fat grafting: basic science and literature review.

    Science.gov (United States)

    Liao, Han-Tsung; Marra, Kacey G; Rubin, J Peter

    2014-08-01

    Due to the natural properties of fat, fat grafting remains a popular procedure for soft tissue volume augmentation and reconstruction. However, clinical outcome varies and is technique dependent. Platelet-rich plasma (PRP) contains α-granules, from which multiple growth factors such as platelet-derived growth factor, transforming growth factor-β, vascular endothelial growth factor, and epidermal growth factor can be released after activation. In recent years, the scope of PRP therapies has extended from bone regeneration, wound healing, and healing of musculoskeletal injuries, to enhancement of fat graft survival. In this review, we focus on the definition of PRP, the different PRP preparation and activation methods, and growth factor concentrations. In addition, we discuss possible mechanisms for the role of PRP in fat grafting by reviewing in vitro studies with adipose-derived stem cells, preadipocytes, and adipocytes, and preclinical and clinical research. We also review platelet-rich fibrin, a so-called second generation PRP, and its slow-releasing biology and effects on fat grafts compared to PRP in both animal and clinical research. Finally, we provide a general foundation on which to critically evaluate earlier studies, discuss the limitations of previous research, and direct plans for future experiments to improve the optimal effects of PRP in fat grafting.

  10. Predictive value of ridge dimensions on autologous bone graft resorption in staged maxillary sinus augmentation surgery using Cone-Beam CT.

    Science.gov (United States)

    Klijn, R J; van den Beucken, J J J P; Bronkhorst, E M; Berge, S J; Meijer, G J; Jansen, J A

    2012-04-01

    No studies are available that provide predictive parameters regarding the expected amount of resorption after maxillary sinus augmentation surgery using autologous bone grafts. Therefore, the aim of this study was to determine parameters influencing the outcome of the bone graft resorption process. In 20 patients, three-dimensional analysis of alveolar ridge dimensions and bone graft volume change in the atrophic posterior maxilla was performed by Cone-Beam Computerized Tomography imaging. Ridge dimensions were assessed before maxillary sinus augmentation surgery. Bone graft volumes were compared after maxillary sinus floor augmentation surgery and a graft healing interval of several months. To analyze the relation between bone volume changes with the independent variables, patients' gender, age, alveolar crest height and width, and graft healing time interval, a multi-level extension of linear regression was applied. A residual bone height of 6.0 mm (SD = 3.6 mm) and 6.2 mm (SD = 3.6 mm) was found at the left and right sides, respectively. Moreover, alveolar bone widths of 6.5 mm (SD = 2.2 mm) and 7.0 mm (SD = 2.3 mm) at the premolars, and 8.8 mm (SD = 2.2 mm) and 8.9 mm (SD = 2.5 mm) at the molars regions were found at the left and right site, respectively. Bone graft volume decreased by 25.0% (SD = 21.0%) after 4.7 months (SD = 2.7, median = 4.0 months) of healing time. The variables "age" (P = 0.009) and mean alveolar crest "bone height" (P = 0.043), showed a significant influence on bone graft resorption. A decrease of 1.0% (SE = 0.3%) of bone graft resorption was found for each year the patient grew older, and an increase in bone graft resorption of 1.8% (SE = 0.8%) was found for each mm of original bone height before sinus floor augmentation. Graft resorption occurs when using autologous bone grafts for maxillary sinus augmentation. Alveolar crest bone height and patient age have a significant effect on graft

  11. Improved fat graft survival by different volume fractions of platelet-rich plasma and adipose-derived stem cells.

    Science.gov (United States)

    Li, Feng; Guo, Weihua; Li, Kun; Yu, Mei; Tang, Wei; Wang, Hang; Tian, Weidong

    2015-03-01

    The success of soft-tissue augmentation is offset by the low survival rates of grafted fat tissue. Research shows that adipose-derived stem cells (ASCs) and platelet-rich plasma (PRP) are beneficial to tissue healing. To evaluate the long-term effects of different volume fractions of PRP combined with ASCs on fat graft. ASCs were isolated from human fat tissue, and PRP was obtained from human blood. Cell count kit-8 and real-time polymerase chain reaction (PCR) were used to evaluate the influence of PRP (0%, 10%, 20%, and 30%; volume/volume [v/v]) in medium on ASC proliferation and adipogenic differentiation, respectively. A novel lipoinjection consisting of granular fat, PRP, and ASCs was subcutaneously transplanted into nude mice. The grafts were volumetrically and histologically evaluated 10, 30, 60, and 90 days after transplantation. The addition of PRP improved ASC proliferation. Expression of adipogenic-related genes, peroxisome proliferator-activated receptor-γ, lipoprotein lipase, and adipophilin were up-regulated in PRP-induced ASCs. Compared with other groups, granular fat grafts formed with 20% (v/v) and 30% (v/v) PRP significantly improved residual volumes. More intact adipocytes and capillary formation, but less vacuolization, were observed in the 20% (v/v) and 30% (v/v) PRP groups at 30, 60, and 90 days. However, no significant difference was observed between the 20% (v/v) and 30% (v/v) PRP groups in retaining fat grafts and improving histology. Fat grafting with 20% (v/v) PRP and ASCs constitutes an appropriate transplantation strategy for improving graft survival and provides a potential approach for soft-tissue restoration in plastic and reconstructive surgery. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  12. Graft hypertrophy of matrix-based autologous chondrocyte implantation: a two-year follow-up study of NOVOCART 3D implantation in the knee.

    Science.gov (United States)

    Niethammer, Thomas R; Pietschmann, Matthias F; Horng, Annie; Roßbach, Björn P; Ficklscherer, Andreas; Jansson, Volkmar; Müller, Peter E

    2014-06-01

    Graft hypertrophy is a major complication in the treatment for localized cartilage defects with autologous chondrocyte implantation (ACI) using periosteal flap and its further development, Novocart (a matrix-based ACI procedure). The aim of the present study is to investigate individual criteria for the development of graft hypertrophy by NOVOCART 3D implantation of the knee in the post-operative course of 2 years. Forty-one consecutive patients with 44 isolated cartilage defects of the knee were treated with NOVOCART 3D implants. Individual criteria and defect-associated criteria were collected. Follow-up MRIs were performed at 3, 6, 12 and 24 months. The NOVOCART 3D implants were measured and classified. The modified MOCART Score was used to evaluate quality and integration of the NOVOCART 3D implants in MRI. Graft hypertrophy was observed in a total of 11 patients at all post-operative time points. We were able to show that NOVOCART 3D implantation of cartilage defects after acute trauma and osteochondritis dissecans (OCD) led to a significantly increased proportion of graft hypertrophy. No other individual criteria (age, gender, BMI) or defect-associated criteria (concomitant surgery, second-line treatment, defect size, fixation technique) showed any influence on the development of graft hypertrophy. The modified MOCART Score results revealed a significant post-operative improvement within 2 years. The aetiology of cartilage defects appears to have a relevant influence for the development of graft hypertrophy. Patients, who were treated with NOVOCART 3D implants after an acute event (acute trauma or OCD), are especially at risk for developing a graft hypertrophy in the post-operative course of two years. Case series, Level IV.

  13. Autologous grafts of double-strut fibular cortical bone plate to treat the fractures and defects of distal femur: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    CHEN Xu

    2012-02-01

    Full Text Available 【Abstract】We reported a 23-year-old man who was involved in a high-speed motorcycle accident. He sustained a closed fracture at the right distal femur. The primary fracture happened on February 2008. He underwent open reduction and internal fixation with cloverleaf plate. And one hundred days after the surgery, the proximal screws were pulled-out, but the bone union was not achieved. Treatment consisted of exchanging the cloverleaf plate with a locking compression plate and using an auto-iliac bone graft to fill the nonunion gap. In July 2009, the patient had a sharp pain in the right lower limb. The X-ray revealed that the plate implanted last year was broken, causing a nonunion at the fracture site. Immediately the plate and screws were removed and an intramedullary nail was inserted reversely from the distal femur as well as a 7 cm long bone from the right fibula was extracted and longitudinally split into two pieces to construct cortical bone plates. Then we placed them laterally and medially to fracture site, drilled two holes respectively, and fastened them with suture. We carried on auto-iliac bone grafting with the nonunion bone grafts. The follow-up at 15 months after operation showed that the treatment was successful, X-ray confirmed that there was no rotation and no angular or short deformity. We briefly reviewed the literature regarding such an unusual presentation and discussed in details the possible etiology and the advantages of autologous double-strut fibular grafts to cope with such an intractable situation. Key words: Femur; Transplantation, autologous; Bone screws

  14. The Use Of Laser Irradiation To Stimulate Adipose Derived Stem Cell Proliferation And Differentiation For Use In Autologous Grafts

    Science.gov (United States)

    Abrahamse, Heidi

    2009-09-01

    fluences on ADSC viability and proliferation. This paper reviews the development of MSCs as potential therapeutic interventions such as autologous grafts as well as the contribution of low intensity laser irradiation on the maintenance of these cells.

  15. Correlation of lung abnormalities on high-resolution CT with clinical graft-versus-host disease after allogeneic versus autologous bone marrow transplantation in children

    Energy Technology Data Exchange (ETDEWEB)

    Merlini, Laura; Borzani, Irene Maria Olivia; Anooshiravani, Mehrak; Hanquinet, Sylviane [University of Geneva Children' s Hospital, Paediatric Radiology Unit, Geneva (Switzerland); Rochat, Isabelle [University of Geneva Children' s Hospital, Paediatric Pneumology Unit, Geneva (Switzerland); Ozsahin, Ayse Hulya [University of Geneva Children' s Hospital, Paediatric Oncology Unit, Geneva (Switzerland)

    2008-11-15

    Late-onset noninfectious pulmonary complications (LONIPCs) are life-threatening complications of bone marrow transplantation (BMT). Several pathological patterns are described in the literature with different prognoses, and with different relationships to graft-versus-host disease (GVHD). The role of high-resolution CT (HRCT) is not yet well established. To illustrate different patterns of LONIPCs on HRCT in allogeneic versus autologous BMT in order to investigate the correlation with chronic GVHD (cGVHD). A total of 67 HRCT scans were performed in 24 patients with noninfectious pulmonary disease at least 3 months after BMT (16 allogeneic, 8 autologous). Abnormality patterns and extension on HRCT images were correlated with the clinical outcome and with the severity of cGVHD. Of 24 patients, 9 showed LONIPCs (1 autologous, 8 allogeneic). There was a significant association between abnormalities on HRCT and severe cGVHD (P = 0.038), with no specific pattern. Prognosis seemed to be related to the severity of cGVHD and not to the extent of abnormalities on HRCT. The significant association between abnormalities on HRCT and severe GVHD suggests that LONIPCs can be a pulmonary manifestation of the disease. HRCT is a useful tool when combined with clinical data. (orig.)

  16. Treatment of breast cancer-related lymphedema with adipose-derived regenerative cells and fat grafts

    DEFF Research Database (Denmark)

    Toyserkani, Navid Mohamadpour; Jensen, Charlotte Harken; Andersen, Ditte Caroline

    2017-01-01

    Breast cancer-related lymphedema (BCRL) is a debilitating late complication with a lack of treatment opportunities. Recent studies have suggested that mesenchymal stromal cells can alleviate lymphedema. Herein, we report the results from the first human pilot study with freshly isolated adipose-derived...... regenerative cells (ADRC) for treating lymphedema with 6 months follow-up. Ten BCRL patients were included. ADRC was injected directly into the axillary region, which was combined with a scar-releasing fat graft procedure. Primary endpoints were change in arm volume. Secondary endpoints were change in patient...

  17. Orthognathic surgery with or without autologous fat micrograft injection: preliminary report on aesthetic outcomes and patient satisfaction.

    Science.gov (United States)

    Raffaini, M; Pisani, C

    2015-03-01

    Orthognathic surgery leaves the intrinsic volume of the facial soft tissues untouched, sometimes resulting in unsatisfactory improvements in aesthetics. The aim of this study was to evaluate the aesthetic outcomes and patient satisfaction following bimaxillary orthognathic surgery with or without simultaneous facial lipofilling procedures. The preoperative and postoperative facial appearances of 210 patients were compared through analysis of photographs and postoperative clinical evaluation. A patient questionnaire was used to assess the perceived improvement in aesthetics. One hundred and twenty patients (mean age 20.3 years) underwent bimaxillary orthognathic surgery and simultaneous facial lipofilling procedures (group I). The remaining 90 patients (mean age 19.8 years) underwent skeletal procedures only (group II). The overall aesthetic improvement was similar in the two groups (group I 92.5%, group II 91.1%). Greater higher-level aesthetic improvement scores were recorded for group I (group I 80%, group II 55.6%). The overall patient satisfaction was 98.3% for group I and 97.8% for group II. Greater higher-level satisfaction scores were recorded for group I (group I 14.2%, group II 6.7%). The simultaneous use of the autologous fat micrograft is a promising technique that may improve the aesthetic outcomes of orthognathic surgery, leading to greater patient satisfaction. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Reduction in deposition of indium 111-labeled platelets after autologous endothelial cell seeding of Dacron aortic bifurcation grafts in humans: a preliminary report

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    Ortenwall, P.; Wadenvik, H.; Kutti, J.; Risberg, B.

    1987-07-01

    Autologous endothelial seeding (AES) of vascular prostheses in dogs increases thrombus-free surface and improves prosthetic prostacyclin production, patency, and the ability to withstand hematogenous challenge with bacteria. No such information is available in human subjects. In the present study one limb of an aortic Dacron bifurcation prosthesis was seeded with autologous endothelial cells (ECs) harvested from the distal portion of the saphenous vein by enzymatic treatment. The deposition of indium 111-labeled platelets on the vascular prostheses was studied 1 and 4 months after operation. In seven of nine patients seeding resulted in decreased accumulation of radiolabeled platelets compared with sham-seeded control limbs (p less than 0.04), when studied 1 month after surgery. A decrease in platelet accumulation occurred over the whole prosthesis between 1 and 4 months, and no significant difference was noted at 4 months between seeded and nonseeded graft limbs. Although the seeding density was very low (440 ECs/cm2), the observed difference in platelet accumulation for AES-treated graft limbs in the early postoperative course merits further investigation of this technique in human beings.

  19. Autologous Concentrated Bone Marrow Grafting for the Treatment of Osteonecrosis of the Humeral Head: A Report of Five Shoulders in Four Cases

    Directory of Open Access Journals (Sweden)

    Takeshi Makihara

    2017-01-01

    Full Text Available Five shoulders in four patients affected by advanced osteonecrosis of the humeral head were treated with autologous concentrated bone marrow grafting. Bone marrow sample was aspirated from the iliac crests, concentrated by a centrifugation technique, and injected into the necrotic site. The shoulders were evaluated radiologically with X-ray scoring and clinically with measurement of range of motion and pain score (visual analogue scale, VAS. The mean follow-up period was 49.4 (range, 24–73 months. The concentration ratio of nucleated cells was calculated and the number of transplanted mesenchymal stem cells (MSC was estimated by a colony-forming assay. All four shoulders with stage 3 disease achieved joint sparing. One shoulder with stage 4 disease required replacement surgery. Clinical evaluation of the spared joints showed improvement in range of motion in two cases and deterioration in two cases. VAS scores were 0 after surgery in three cases. The mean concentration ratio was 2.73, and the mean number of transplanted MSC was 1125. The outcomes of autologous concentrated bone marrow grafting for advanced osteonecrosis of the humeral head were varied. Further research is needed to determine the effectiveness and the indications of the present surgery.

  20. Cleft Patient-Reported Postoperative Donor Site Pain Following Alveolar Autologous Iliac Crest Bone Grafting: Comparing Two Minimally Invasive Harvesting Techniques.

    Science.gov (United States)

    Raposo-Amaral, Cesar Augusto; Denadai, Rafael; Chammas, Danilo Zanardo; Marques, Frederico Figueiredo; Pinho, André Silveira; Roberto, Wellington Matheus; Buzzo, Celso Luiz; Raposo-Amaral, Cassio Eduardo

    2015-10-01

    Autologous bone grafting is still considered the standard method for alveolar cleft repair. However, donor site morbidities remain a relevant problem in cleft care. Thus, the authors assessed postoperative donor site pain in cleft patients who underwent alveolar cleft repair by iliac crest bone graft transferring through a prospective randomized study comparing 2 minimally invasive harvesting techniques. Fifty-six consecutive patients with cleft lip and palate who underwent iliac crest bone grafting for alveolar cleft repair were randomly divided into 2 groups: bone graft harvested by minimally invasive techniques without (group 1) and with (group 2) periosteum elevation. Postoperative donor site pain was evaluated using a unidimensional numerical pain intensity rating scale (0, "no pain;" 10, "worst pain imaginable") at 1, 3, 6, 9, and 12 hours after the procedures and on the 3rd, 7th, 14th, 21st, and 28th days after surgeries. Intergroup comparisons were performed. The mean measurements of donor site pain revealed no significant differences (all P > 0.05) in any of the evaluated postoperative period comparisons between groups 1 and 2. There was a greater number (P < 0.05) of group 1 patients who reported "no pain" in the donor site compared with group 2, suggesting that periosteum elevation may play a role in pain intensity measurement. This prospective randomized study showed no difference in pain intensity among cleft patients who had postoperative pain. However, a greater number of patients in group 1 reported "no pain" in comparison to patients in group 2.

  1. Is Centrifugation Necessary for Processing Lipoaspirate Harvested via Water-Jet Force Assisted Technique before Grafting? Evidence of Lipoaspirate Concentration With Enhanced Fat Graft Survival.

    Science.gov (United States)

    Yin, Shilu; Luan, Jie; Fu, Su; Zhuang, Qiang

    2016-10-01

    Although water-jet force-assisted liposuction technique (WAL) was demonstrated to have favorable effects on fat grafting, controversy continues concerning the application of centrifugation for lipoaspirate harvested via WAL. As a controversial technique, plastic surgeons often get perplexed to the necessity of using centrifugation during fat grafting procedure. In the present study, we adopted the recommended centrifugal intensity (1200g, 3 minutes) to process lipoaspirate and focused on the influence of centrifugation on the fate of lipoaspirate harvested with WAL technique. Lipoaspirate was obtained from 10 healthy Chinese female patients who underwent cosmetic liposuction. The harvested lipoaspirate was either not centrifuged (group A) or centrifuged at 1200g for 3 minutes (group B). Lipoaspirate from each group was compared in the in vitro and in vivo experiments. The influence of centrifugation on lipoaspirate viability and lipoaspirate survival after grafting were evaluated. The viability of the lipoaspirates was similar between equally volumetric uncentrifugal and centrifugal lipoaspirate. However, centrifugation at 1200g for 3 minutes concentrated stromal vascular fraction cells and adipose-derived stem cells in lipoaspirate; greater angiogenesis and weight retention rates were observed in centrifugal lipoaspirate after grafting than those uncentrifugal lipoaspirate. Centrifugation at 1200g for 3 minutes enhanced the survival of lipoaspirate harvested via WAL technique after grafting. Centrifugation at 1200g for 3 minutes was recommended to process lipoaspirate harvested with water-jet force assistance before grafting.

  2. Dermal-fat graft for anophthalmic socket in children enucleated for retinoblastoma.

    Science.gov (United States)

    Bosch-Canto, V; Cruz, C; Ordaz-Favila, J C

    2018-01-01

    Retinoblastoma is the most frequent intraocular tumour in childhood. The definitive treatment is enucleation. The management of the anophthalmic socket consists in the use of a plastic implant. The problem is that they are expensive and they usually extrude. The use of dermal-fat grafts minimises the hemi-facial hypoplasia. They usually grow with the face, and help to expand the orbital bones, thus avoiding the psychological and physical consequences. To determine if there is hemi-facial hypoplasia, using MRI images after the use of a dermal-fat implant in patients enucleated for RB. The study included patients enucleated for RB in which a dermal-fat implant was used and MRI images were taken in the period between June 2010 and December 2012. Facial growth and cosmesis was measured. The study included 12 patients, aged between 6 to 41 months. After 24 months of follow up, none of them developed hemifacial hypoplasia. All had a good cosmesis with the prosthesis. There were no complications after the surgery. The use of dermal-fat implant is a good option for the anophthalmic socket in patients with RB after enucleation. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Comparison of the Application of Allogeneic Fibroblast and Autologous Mesh Grafting With the Conventional Method in the Treatment of Third-Degree Burns.

    Science.gov (United States)

    Moravvej, Hamideh; Hormozi, Abdoljalil Kalantar; Hosseini, Seyed Nejat; Sorouri, Rahim; Mozafari, Naser; Ghazisaidi, Mohammad Reza; Rad, Mahnaz Mahmoudi; Moghimi, Mohammad Hossein; Sadeghi, Shahin Mohammad; Mirzadeh, Hamid

    2016-01-01

    Wound healing is a multipart process involving different cell types and growth factors. Third-degree burns are usually treated by early excision and skin grafting. Tissue engineering has been developed in this field in response to limitations associated with autografts. Allogeneic fibroblasts on meshed split thickness skin grafts (STSGs) are known to have useful properties in wound healing and can be used to construct a new model of living skin substitute. Fourteen patients were chosen from June 2009 until December 2010 as the sample for this study. After debridement and wound excision, meshed STSG was used to cover the entire wound. Alloskin (allofibroblasts cultured on a combination of silicone and glycosaminoglycan) was applied on one side and petroleum jelly-impregnated gauze (Iran Polymer and Petrochemical Institute) was applied on the other. The healing time, scar formation, and pigmentation score were assessed for the patients. All analyses were undertaken with SPSS 17 software. Alloskin demonstrated good properties compared to petroleum jelly-impregnated gauze. The average healing time and hypertrophic scar formation were significantly different between the two groups. In addition, the skin pigmentation score in the alloskin group was closer to normal. Alloskin grafting, including fibroblasts on meshed STSG, may be a useful method to reduce healing time and scar size and may require less autologous STSG in extensive burns where a high percentage of skin is burned and there is a lack of available donor sites.

  4. Autologous Impaction Bone Grafting for Bone Defects of the Medial Tibia Plateau During Primary Total Knee Arthroplasty: Propensity Score Matched Analysis With a Minimum of 7-Year Follow-Up.

    Science.gov (United States)

    Sohn, Jong M; In, Yong; Jeon, Sang H; Nho, Jin Y; Kim, Man S

    2018-03-06

    The aims of this study were to (1) describe a novel technique for appropriate treatment of bone defects in medial tibial plateau grafted with autologous resected bone and (2) compare clinical outcomes, radiographic results, and survivorship of these knees with those of standard total knee arthroplasty (TKA) without bone defect. We retrospectively reviewed 50 cases of primary TKA involving bone defects of medial tibial plateau managed with bone grafting for a minimum follow-up of 7 years. Autologous resected bones were used for bone graft after removing solid cortical bones at the defect site. After bone graft group was completed, one-to-one patient-matched control was accomplished based on propensity score matching of 50 knees. Survivorship was analyzed using the Kaplan-Meier method. The endpoint of survival was revision of implant. Clinical outcomes were also assessed including Knee Society Score and Western Ontario and McMaster Universities Osteoarthritis Index score. The mean follow-up was 117 months in the group with bone graft and 108 months in the group without bone graft. There were no significant differences in postoperative clinical scores and knee alignment. Nonprogressive radiolucent lines measuring bone graft and 9 knees in the group without bone graft. During the follow-up period, 1 patient with late infection underwent 2-stage revision and another revision for tibial loosening occurred in both groups. The 10-year cumulative survival rate for revision was 96.0% in both groups. Our technique of management of medial tibial bone defect using autologous bone graft yielded desirable results based on survival rate and clinical outcome. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Fat embolism in liposuction and intramuscular grafts in rabbits Embolia gordurosa na lipoaspiração e enxertia intramuscular em coelhos

    Directory of Open Access Journals (Sweden)

    Victor Araujo Felzemburgh

    2012-05-01

    Full Text Available PURPOSE: To evaluate the effects of fat embolism in organs such as lung and liver. METHODS: Twenty rabbits underwent autologous intramuscular fat grafting in the right thigh after liposuction. The groups were determined according to the postoperative day that occurred in euthanasia: 60, 90 and 120 day. Then, lung and liver were excised and sent to the histopathology laboratory for analysis in search of late injury secondary to a prior event of fat embolism in the tissues. RESULTS: The results showed a change in the macroscopic sample with discoloration of the liver tissue heterogeneously. There were no changes consistent with embolic effect under the microscope. CONCLUSION: The option of performing a technique of fat grafting with a less traumatic surgical procedure can be considered protective against embolic events, with no impact to late embolic events on the tissues.OBJETIVO: Avaliar a repercussão da embolia gordurosa em órgãos como pulmão e fígado. MÉTODOS: Vinte coelhos foram submetidos à enxertia autóloga intramuscular de gordura em coxa direita após lipoaspiração. Os grupos foram determinados conforme os dias pós-operatórios (DPO em que ocorreu a eutanásia: 60 DPO, 90DPO, 120 DPO. Em seguida, o pulmão e o fígado foram ressecados e encaminhados ao laboratório de histopatologia para análise em busca de lesão tardia secundária a evento de embolia gordurosa prévia nos tecidos. RESULTADOS: Foi evidenciada uma alteração na amostra a analise macroscópica com alteração da coloração do tecido hepático de forma heterogênea. Não houve alterações compatíveis com repercussão de processo embólico à microscopia. CONCLUSÃO: A opção pela realização de uma técnica de lipoenxertia menos traumática e com pequeno tempo cirúrgico pode ser considerada protetora para eventos embólicos, não havendo repercussão embólica a tardiamente.

  6. The comparison of acellular dermal matric (Alloderm), Dacron, Gore-Tex, and autologous cartilage graft materials in an experimental animal model for nasal septal repair surgery.

    Science.gov (United States)

    Mola, Ferhat; Keskin, Gurkan; Ozturk, Murat; Muezzinoglu, Bahar

    2007-01-01

    The aim of this study was to compare the compatibility of Alloderm, Dacron, Gore-Tex, and autologous cartilage graft materials with host tissues in nasal septal perforation repair surgery. The materials were placed into the nasal septum of 16 New Zealand rabbits. At the end of the 3rd month, septums of the rabbits were removed totally and reactions, such as inflammation;foreign body giant cell; or fibrosis that developed in the surrounding tissue against the implant material were evaluated. Acute inflammation reactions occurred mostly with Gore-Tex. There were no differences between groups according to chronic inflammation. When the number of reactions and tissue compatibility were taken into consideration, cartilage performed the best followed by Alloderm. There were more reactions with Dacron, but it still showed compatibility. Cartilage was found to be the best material followed by Alloderm and Dacron, but Gore-Tex was found unsuitable.

  7. A comparison of total amount of blood needed in patients taking autologous or homologous blood transfusion in coronary artery bypass grafting a clinical randomized case control trial

    International Nuclear Information System (INIS)

    Akhlagh, S.H.; Chohedri, A.H.; Bazojoo, A.; Nemati, M.H.

    2007-01-01

    The aim of this clinical case-control trial was to compare the total amount of blood needed in patients taking autologous or homologous blood transfusion in coronary artery bypass grafting (CABG) surgery. Sixty patients scheduled for CABG were randomly allocated to ANH (Acute Normovulemic Hemodynamic) group (A group) or control group (B group). Hematocrit before operation and 24 hours after the operation were checked. The amount of the total blood needed in each group was measured at the end of the operation. There was no significant difference between the two groups as regards post operational hematocrit. The mean total blood infused to the control and ANH group was 2010 ml and 1815 ml respectively. However there was significant difference between the two groups as regards the total amount of the blood needed during operation. Our randomized, double blinded case control study demonstrated that autologous blood, beside carrying lower risks for hemolytic and nonhemolytic transfusion reactions decrease the total amount of blood needed for CABG. However larger studies with more patients are needed to confirm the results. (author)

  8. The effects of the centrifugation speed on the survival of autogenous fat grafts in a rat model.

    Science.gov (United States)

    Bozkurt, Mehmet; Kapı, Emin; Şirinoğlu, Hakan; Güvercin, Emre; Filinte, Gaye Taylan; Filinte, Deniz

    2016-06-01

    Purpose The most important problem in fat transplantation is the durability, which is closely associated with the applied technique. This study includes the comparison of different centrifugation speeds on the survival of autogenous fat grafts in rats. Materials and methods Forty-nine Sprague-Dawley rats were divided into seven groups and the left inguinal fat pad was extracted and re-implanted under the scalp after performing appropriate preparation processes. In the first group the fatty tissue was re-implanted in en-bloc fashion and in the second group it was re-implanted after trimming. After trimming, centrifugation with a G-force of 111.8 (1000 rpm) was performed in the third group, 447.2 (2000 rpm) in the fourth group, 1006.2 (3000 rpm) in the fifth group, 1788.8 (4000 rpm) in the sixth group, and 2795 (5000 rpm) in the seventh group for 4 minutes. The fat grafts were taken after 3 months and histopathological and statistical evaluations were performed. Results The rate of viable fat grafts was significantly higher in the 4th and 5th groups comparing to the first three groups. Total weight and volume amounts of the 4th and 5th groups were also significantly higher comparing to the first three groups. Conclusion Maximal long-term durability and fat cell viability results were obtained in the groups with 2000 rpm or 447.2 G-force/4 minutes and 3000 rpm or 1006.2 G-force/4 minutes centrifugation speed, indicating that 4 minutes centrifugation with an average G-force of 698.75 or 2500 rpm provides the best results for the survival of autogenous fat grafts.

  9. Platelet released growth factors boost expansion of bone marrow derived CD34(+) and CD133(+) endothelial progenitor cells for autologous grafting.

    Science.gov (United States)

    Lippross, Sebastian; Loibl, Markus; Hoppe, Sven; Meury, Thomas; Benneker, Lorin; Alini, Mauro; Verrier, Sophie

    2011-01-01

    Stem cell based autologous grafting has recently gained mayor interest in various surgical fields for the treatment of extensive tissue defects. CD34(+) and CD133(+) cells that can be isolated from the pool of bone marrow mononuclear cells (BMC) are capable of differentiating into mature endothelial cells in vivo. These endothelial progenitor cells (EPC) are believed to represent a major portion of the angiogenic regenerative cells that are released from bone marrow when tissue injury has occurred. In recent years tissue engineers increasingly looked at the process of vessel neoformation because of its major importance for successful cell grafting to replace damaged tissue. Up to now one of the greatest problems preventing a clinical application is the large scale of expansion that is required for such purpose. We established a method to effectively enhance the expansion of CD34(+) and CD133(+) cells by the use of platelet-released growth factors (PRGF) as a media supplement. PRGF were prepared from thrombocyte concentrates and used as a media supplement to iscove's modified dulbecco's media (IMDM). EPC were immunomagnetically separated from human bone morrow monocyte cells and cultured in IMDM + 10% fetal calf serum (FCS), IMDM + 5%, FCS + 5% PRGF and IMDM + 10% PRGF. We clearly demonstrate a statistically significant higher and faster cell proliferation rate at 7, 14, 21, and 28 days of culture when both PRGF and FCS were added to the medium as opposed to 10% FCS or 10% PRGF alone. The addition of 10% PRGF to IMDM in the absence of FCS leads to a growth arrest from day 14 on. In histochemical, immunocytochemical, and gene-expression analysis we showed that angiogenic and precursor markers of CD34(+) and CD133(+) cells are maintained during long-term culture. In summary, we established a protocol to boost the expansion of CD34(+) and CD133(+) cells. Thereby we provide a technical step towards the clinical application of autologous stem cell

  10. A case of mandible hypoplasia treated with autologous bone graft from mandibular symphysis: Expression of VEGF and receptors in bone regeneration.

    Science.gov (United States)

    Marini, Mirca; Bertolai, Roberto; Manetti, Mirko; Sgambati, Eleonora

    2016-07-01

    The vascular endothelial growth factor (VEGF)/VEGF receptor (VEGFR) system plays an important role in angiogenesis and osteogenesis during both skeletal development and postnatal bone growth and repair. Indeed, protein expression changes of this system could contribute to craniofacial defects commonly associated with a variety of congenital syndromes. Similarly to other craniofacial bones, mandible arises from neural crest cells of the neuroectodermal germ layer, and undergoes membranous ossification. Here, we report a case of left mandibular hypoplasia in a 42-year-old man treated with autologous bone graft from mandibular symphysis. After 3 months from surgical reconstruction, the protein expression of VEGF and receptors (VEGFR-1, -2 and -3) in regenerated bone tissue was evaluated by immunohistochemistry. At variance with the mandibular symphysis bone harvested for graft surgery, we observed de novo expression of VEGF and VEGFRs in osteoblasts and osteocytes from post-graft regenerating mandible bone tissue. In particular, while VEGFR-1 and VEGFR-3 immunopositivity was widespread in osteoblasts, that of VEGFR-2 was scattered. Among the three receptors, VEGFR-3 was the more intensively expressed both in osteoblasts and osteocytes. These findings suggest that VEGFR-2 might be produced during the early period of regeneration, while VEGFR-1 might participate in bone cell maintenance during the middle or late consolidation period. VEGFR-3 might, instead, represent a specific signal for ectomesenchymal lineage differentiation during bone regeneration. Modulation of VEGF/VEGFR signaling could contribute to graft integration and new bone formation during mandibular regeneration. Copyright © 2016 Elsevier GmbH. All rights reserved.

  11. A 3-Dimensional Biomimetic Platform to Interrogate the Safety of Autologous Fat Transfer in the Setting of Breast Cancer.

    Science.gov (United States)

    Toyoda, Yoshiko; Celie, Karel-Bart; Xu, Jonathan T; Buro, Justin S; Jin, Julia; Lin, Alexandra J; Brown, Kristy A; Spector, Jason A

    2018-04-01

    Obesity is a known risk factor for the development and prognosis of breast cancer. Adipocytes have been identified as a source of exogenous lipids in other cancer types and may similarly provide energy to fuel malignant survival and growth in breast cancer. This relationship is of particular relevance to plastic surgery, because many reconstructions after oncologic mastectomy achieve optimal aesthetics and durability using adjunctive autologous fat transfer (AFT). Despite the increasing ubiquity and promise of AFT, many unanswered questions remain, including safety in the setting of breast cancer. Clinical studies to examine this question are underway, but an in vitro system is critical to elucidate the complex interplay between the cells that normally reside at the surgical recipient site. To study these interactions and characterize possible lipid transfer between adipocytes to breast cancer cells, we designed a 3-dimensional in vitro model using primary patient-derived tissues. Breast adipose tissue was acquired from patients undergoing breast reduction surgery. The tissue was enzymatically digested and sorted to retrieve adipocytes and adipose stromal cells. Polydimethylsiloxane wells were filled with type I collagen-encapsulated adipocytes labeled with the fluorescent lipid dye boron dipyrromethene, as well as unlabeled adipose stromal cells. A monolayer of red fluorescently labeled MDA-MB-231 and MDA-MB-468 breast cancer cells was seeded on the surface of the construct. Lipid transfer at the interface between adipocytes and breast cancer cells was analyzed. Confocal microscopy revealed a dense culture of native adipocytes containing fluorescent lipid droplets in the 3-dimensional collagen culture platform. RFP-positive breast cancer cells were found in close proximity to lipid-laden adipocytes. Lipid transfer from adipocytes to breast cancer cells was observed by the presence of boron dipyrromethene-positive lipid droplets within RFP-labeled breast cancer

  12. Breast Reconstruction with Enhanced Stromal Vascular Fraction Fat Grafting: What Is the Best Method?

    Science.gov (United States)

    Gentile, Pietro; Scioli, Maria Giovanna; Orlandi, Augusto; Cervelli, Valerio

    2015-06-01

    Actually, there are 2 main methods to obtain stromal vascular fraction (SVF): enzymatic digestion and mechanical filtration; however, the available systems report heterogeneous and sometimes not univocal results. The aim of this study is to evaluate different procedures for SVF isolation and compare their clinical efficacy in the treatment of soft-tissue defects in plastic and reconstructive surgery. The authors evaluated Celution and Medikhan, enzymatic systems, and Fatstem and Mystem system, mechanical separation systems. Fifty patients affected by breast soft-tissue defects were treated in the Plastic and Reconstructive Surgery Department of Tor Vergata University of Rome. Four groups of 10 patients were managed with enhanced SVF fat grafts using cells obtained by Celution (Cytori Therapeutics, Inc., San Diego, Calif.), Medikhan (Medi-Khan Inc., West Hollywood, Calif.), Fatstem (Fatstem CORIOS Soc. Coop, San Giuliano Milanese, Italy), and Mystem (Mystem evo Bi-Medica, Treviolo, Italy) systems. A control group of 10 patients was treated with only centrifuged fat according to Coleman's technique. In enhanced SVF-treated patients treated with cells obtained by Celution system, we observed a 63% ± 6.2% maintenance of contour restoring after 1 year, compared with 39% ± 4.4% of control group. In patients treated with SVF obtained by Medikhan system, we observed a 39% ± 3.5% maintenance, whereas enhanced SVF with Fatstem and Mystem systems gave a 52% ± 4.6% and 43% ± 3.8% maintenance of contour restoring, respectively. SVF cell counting indicated that Celution and Fatstem were the most efficient systems to obtain SVF cells. Celution and Fatstem were the 2 best automatic systems to obtain SVF and to improve maintenance of fat volume and prevent the reabsorption.

  13. 2. The Effect of Combined Therapy, Percutaneous Autologous Concentrated Bone Marrow Grafting and Low-Intensity Pulsed Ultrasound (LIPUS), on the Treatment of Non-Unions.

    Science.gov (United States)

    Mishima, Hajime; Sugaya, Hisashi; Yoshioka, Tomokazu; Wada, Hiroshi; Aoto, Katsuya; Hyodo, Kojirou; Tomaru, Youhei; Kumagai, Hiroshi; Akaogi, Hiroshi; Ochiai, Naoyuki; Yamazaki, Masashi

    2016-08-01

    We discuss the effect of combined therapy of percutaneous autologous concentrated bone graft and LIPUS on complex non-union treatment. Seventeen of 27 treated patients who had received the therapy at least 1 year before were discussed (10 femurs, 5 tibiae, 1 humerus, and 1 ulna). The average age of the patients was 40.7, and atrophic degeneration was observed in all cases. After 12 months of treatment, bone union was recognized in 76% in all cases, and in 87% of lower long bones. It was reported that LIPUS was effective at improving blood flow, accelerating cytokines which induce angiogenesis, promoting the transport of nutrition and enzymes to living cells, developing the differentiation of osteoblast from mesenchymal stem cells (MSC), inhibiting the differentiation and development of osteoclast, and promoting endochondral ossification. In this study, all patients had been treated with LIPUS for more than 3 months before the grafting was conducted, but the bone union seemed to stop. It was thought that this combined therapy provided a bone marrow cell growth factor sufficient to enable new bone formation to re-start bone union, and then LIPUS worked effectively to promote the initial differentiation, contributing to new bone formation. This combination therapy-less invasive, safe, and low cost-was considered one useful treatment option for non-union.

  14. Orthogonal Double Plating and Autologous Bone Grafting of Postoperative Humeral Shaft Nonunion – A Rare Case Report and Review of Literature

    Science.gov (United States)

    Metikala, Sreenivasulu; Bhogadi, Prabhudheer

    2015-01-01

    Introduction: Nonunion following surgical stabilization of humeral shaft fractures, although infrequent, remains a challenge as limited surgical options are available. The difficulties in re-fixation are due to osteolysis produced by the loose implant components and disuse osteopenia of the entire bone segment. We share our experience in the management of a long standing diaphyseal nonunion of humerus following titanium LCP fixation. Case Report: A 58 years old woman presented with 20 months old nonunion following titanium LCP fixation of her closed humeral shaft fracture, done elsewhere. The interesting intraoperative findings, noteworthy, are about the extensive metallosis and the gross cortical defect measuring 10cm x 1cm x 1cm, corresponding to the foot print of the previous plate with exposed medullary canal. It was managed by debridement, dual plate fixation using 9 holed and 12 holed stainless steel LCPs in an orthogonal fashion and autologous bone grafting. The nonunion healed in 5 months and she regained all the movements except for terminal 10° of elbow extension and 15° of shoulder abduction at her final follow up of 30 months. According to Stewart and Hundley classification the final result was found to be good. Conclusion: We recommend the judicious use of long and short plates in 90-90 orientation along with autogenous bone grafting in the management of a long standing humeral shaft nonunion having extensive cortical resorption following surgical stabilization by plating. PMID:27299099

  15. Allogeneic Adipose-Derived Stem Cells Protect Fat Grafts at the Early Stage and Improve Long-Term Retention in Immunocompetent Rats.

    Science.gov (United States)

    Zhang, Jun; Wang, Yunchuan; Zhao, Bin; Fan, Lei; Bai, Xiaozhi; Yang, Longlong; Chang, Peng; Hu, Dahai; Liu, Xiaoyan

    2015-08-01

    Syngeneic adipose-derived stem cells (ASCs) promote the survival of fat grafts. But it is unclear whether allogeneic ASCs have a similar protective effect. In this study, we investigated the protective effect of allogeneic ASCs in a fat graft model of immunocompetent rats. Syngeneic and allogeneic ASCs were derived from Lewis (LEW) and Norway-Brown rats, respectively. Fifty-four LEW rats were divided into three groups. Each LEW rat was injected subcutaneously at two paravertebral spots with adipose granules premixed with DMEM (AFT group), syngeneic ASCs (SYNG group), or allogeneic ASCs (ALLG group). Fat grafts were harvested at 7 and 14 days to examine apoptosis rates and immunochemistry staining was performed for Perilipin A and CD34. At 3 months, fat graft volume retentions were measured. The proportion of regulatory T (Treg) cells and the ratio of CD4/CD8 cells in blood were analyzed at 7 days. Expression of Perilipin A and CD34 was higher in the ALLG group than the AFT group at 14 days (P fat graft volume retentions (P cells and CD4/CD8 cells ratio between groups. There were no statistically significant difference between ALLG and SYNG groups at all time points (P > 0.05). Allogeneic ASCs protected fat grafts at the early stage and improved long-term volume retention in the fat graft model of immunocompetent rats with no or little obvious immune rejection.

  16. In vitro regulation of immunoglobulin synthesis after human marrow transplantation. II. Deficient T and non-T lymphocyte function within 3-4 months of allogeneic, syngeneic, or autologous marrow grafting for hematologic malignancy

    International Nuclear Information System (INIS)

    Witherspoon, R.P.; Lum, L.G.; Storb, R.; Thomas, E.D.

    1982-01-01

    Immunoglobulin secretion was studied in 37 patients between 19 and 106 days after allogeneic HLA-identical (30 patients), allogeneic one HLA-haplotype-identical (three patients), syngeneic (three patients), or autologous (one patient) marrow grafting. E rosette-positive (T) and E rosette-negative (non-T) peripheral blood mononuclear cells were cocultured with pokeweed mitogen for 6 days. Polyvalent immunoglobulin secretion was determined by counting plaque forming cells in a reverse hemolytic plaque assay. The number of antibody secreting cells in cocultures of autologous T and non-T lymphocytes was low in 40 of 44 tests conducted on samples from the 37 patients. Mononuclear or non-T cells from 38 of 40 tests failed to produce antibody when cultured with normal helper T cells. T cells from 23 of 37 tests failed to help normal non-T cells secrete antibody. T lymphocytes from 23 of 41 tests suppressed antibody production greater than 80% by normal T and non-T cells. The suppressor cells were radiosensitive in 17 of the 25 tests. The abnormal function of lymphocyte subpopulations in patients during the first 3 mo after syngeneic, allogeneic or autologous marrow grafting was similar regardless of the type of graft or the presence of acute graft versus host disease

  17. Results from an Italian multicentric registry comparing heparin-bonded ePTFE graft and autologous saphenous vein in below-knee femoro-popliteal bypasses.

    Science.gov (United States)

    Dorigo, W; Pulli, R; Piffaretti, G; Castelli, P; Griselli, F; Dorrucci, V; Ferilli, F; Ottavi, P; De Blasis, G; Scalisi, L; Monaca, V; Battaglia, G; Vecchiati, E; Casali, G; Pratesi, C

    2012-04-01

    The aim of this study was to evaluate early and follow-up results of below-knee bypasses performed with a bioactive heparin-treated ePTFE graft in patients with peripheral arterial obstructive disease (PAOD) in a multicentric retrospective registry involving seven Italian vascular centers and to compare them with those obtained in patients operated on with autologous saphenous vein (ASV) in the same centres in the same period of time. Over a nine-year period, ending in 2010, a heparin bonded prosthetic graft (Propaten Gore-Tex, W.L. Gore & Associates Inc, Flagstaff, AZ, USA) was implanted in 556 patients undergoing below-knee revascularization for PAOD (HePTFE group). In the same period of time 394 below-knee bypasses with ipsilateral ASV were performed (ASV group). Data concerning these interventions were retrospectively collected in a multicenter registry with a dedicated database. Early (<30 days) results were analyzed in terms of graft patency, major amputation rates and mortality. Follow-up results were analyzed in terms of primary and secondary graft patency, limb salvage and survival. Among patients of HePTFE group, 413 had critical limb ischemia (74%); the corresponding figure for ASV group was 84% (332 interventions, P<0.001). Eighty-nine patients in HePTFE group (16%) and 207 patients in ASV group (52.5%; P<0.001) had distal tibial anastomosis. Patients in HePTFE group had more frequently adjunctive procedures performed at distal anastomotic sites in order to improve run-off status. Thirty-day death rate was 1.9% in HePTFE group and 0.5% in ASV group (P=0.08). The rates of perioperative thromboses and amputations were 6% and 3.5% in HePTFE group, and 5% and 1.7% in ASV group, without significant differences between the two groups. Mean duration of follow-up was 28.5±22.1 months; 921 patients (97%) had at least one postoperative clinical and ultrasonographic control. Estimated 48-month survival rates were 81% in HePTFE group and 74% in ASV group (P=0

  18. One versus two titanium screw fixation of autologous onlay bone grafts in the anterior maxilla: a randomised histological pilot study

    NARCIS (Netherlands)

    Burger, Evita A. C.; Meshkini, Hamid; Lindeboom, Jerome A. H.

    2011-01-01

    The aim of this study was to compare the histological presentation of local mandibular bone grafts fixed with one screw or two screws in buccal anterior maxillary augmentation procedures. Local buccal defects of the anterior maxilla were reconstructed in 12 patients (mean age 47 ± 17 years, range 18

  19. Closure of oroantral communication using buccal fat pad graft - case report

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    Keim, Frederico Santos

    2008-09-01

    Full Text Available Introduction: There are many causes of fistulas that involve the nasal and antral cavities or both. They may result from pathological entities or secondary to removal of tumors or maxillary cysts. However, the extraction of a maxillary molar or premolar is the most common cause of oroantral fistula. This is explained by the close relationship between the apex of these teeth and the thinness of the antral floor. When the primary fistula repair fails to heal spontaneously during the first three weeks after surgery, a secondary repair may be indicated. During treatment process of the fistulas, there are procedures to make a direct close or the use of a sliding mucosal flap, all techniques own an equal and high degree of failure. Objective: To show a case report of oroantral fistula and its closure. Case Report: A 6-month-Surgical treatment of oroantral fistula, after a tooth removal, using the buccal fat pad method as a pedicled graft associated with a sliding mucosal flap. Conclusion: The mentioned treatment is simple, complete and allows an extensive applicability in most of cases.

  20. Increased survival of human free fat grafts with varying densities of human adipose-derived stem cells and platelet-rich plasma.

    Science.gov (United States)

    Li, Kun; Li, Feng; Li, Jie; Wang, Hang; Zheng, Xiaohui; Long, Jie; Guo, Weihua; Tian, Weidong

    2017-01-01

    The high absorption rate of transplanted fat has limited the application of autogenous fat grafts in the clinical setting. Therefore, this study aimed to evaluate the effects of platelet-rich plasma (PRP) and adipose-derived stem cells (ASCs) on fat regeneration by investigating the impact of PRP and conditioned medium on the biological characteristics of ASCs. Fat grafts were prepared with ASCs at densities of 10 7 /ml, 10 6 /ml, 10 5 /ml, 10 4 /ml and 0/ml with and without PRP and injected subcutaneously into nude mice. Liquid overflow method, haematoxylin and eosin staining, and immunohistochemical analyses were used to examine the fat grafts. The residual fat volume of the 10 5 /ml ASC + PRP group was significantly higher than that of other treatment conditions after 90 days. Furthermore, histological examination revealed that in 10 5 /ml ASCs-treated grafts normal adipocyte area and capillary formation were increased dramatically compared with other treatment conditions. It is concluded that fat grafts consisting of PRP and 10 5 /ml ASCs constitute an ideal transplant strategy, which may result in decreased absorption and accelerated fat regeneration. This simple and reliable method could provide a valuable and needed tool in plastic and reconstructive surgery. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

  1. TO EVALUATE THE SURGICAL OUTCOME OF NON-UNION CLAVICLE USING PLATE AND SLIVERS OF AUTOLOGOUS ILIAC CREST CORTICOCANCELLOUS BONE GRAFT

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    Mohammed

    2016-03-01

    Full Text Available INTRODUCTION Clavicle fracture is one of the most common fracture presenting to the fracture clinic, accounting for about 5-10% of all the adult trauma reported but still the controversy exists with regards to the definitive management. AIM To evaluate the surgical outcome of nonunion clavicle in patients treated previously with surgical management or conservative management, using plate and slivers of autologous iliac crest corticocancellous bone. DESIGN Retrospective analysis of patients operated between May 2005 and February 2013 for nonunion of the clavicle. METHODS AND MATERIALS Twenty patients who were operated between May 2005 and February 2013 for nonunion of the clavicle at our hospital were recruited for our study and followup data was collected from our hospital records till their last outpatient visit. Inclusion criteria included patients with no evidence of radiological union, persistence of pain, cosmetic deformity, dysfunction or gross movement at the fracture site even after 16 weeks of conservative treatment or in cases of primary fixation failure. STATISTICAL ANALYSIS All Statistical analyses were made using Statistical Package Software for Social Sciences (SPSS version 17.0 software (Chicago, IL, USA for descriptive data. Chi2 test was used to compare the categorical data. RESULTS At the end of an average followup of 19 months, the average Visual Analogue Score for pain was 1.9±2.2 (range 0-6, the mean ASES score was 81±18.5 (51-100, and the mean Constant–Murley score was 80±17 (51-100. All the patients had a stable radiological union at the end of the followup period. There were no complications pertaining to the hardware or infection. CONCLUSION Treatment of nonunion of clavicle by using corticocancellous bone is well documented; however, use of iliac corticocancellous bone graft shaped in long slivers will give mechanical stability to the plate reconstruct in addition to providing a scaffold for new bone formation than

  2. Arthroscopic second generation autologous chondrocytes implantation associated with bone grafting for the treatment of knee osteochondritis dissecans: Results at 6 years.

    Science.gov (United States)

    Filardo, Giuseppe; Kon, Elizaveta; Berruto, Massimo; Di Martino, Alessandro; Patella, Silvio; Marcheggiani Muccioli, Giulio Maria; Zaffagnini, Stefano; Marcacci, Maurilio

    2012-10-01

    The aim of this study was to analyze the clinical outcome obtained with arthroscopic second generation autologous chondrocyte implantation (ACI) associated with bone grafting for the treatment of knee osteochondritis dissecans (OCD) at medium term follow-up. Thirty-four knees affected by symptomatic OCD grade III or IV on the ICRS (International Cartilage Repair Society) scale were treated and prospectively evaluated at 12, 24 months of follow-up, and at a final mean 6 ± 1 years of follow-up. The mean age at treatment was 21 ± 6 years. The average size of the defects was 3 ± 1cm(2). Patients were evaluated with IKDC, EQ-VAS, and Tegner scores. A statistically significant improvement in all scores was observed after the treatment. The IKDC subjective score improved from 38 ± 13 to 81 ± 20, and 91% of the knees were rated as normal or nearly normal in the objective IKDC at the final evaluation. EQ-VAS and Tegner scores showed a statistically significant linear trend of improvement over time passing from 52 ± 18 to 83 ± 14 and from 2 ± 1 to 5 ± 3, respectively, at 6 years' follow-up. A better outcome was obtained in men, sport active patients, and smaller lesions. Second generation ACI associated with bone grafting is a valid treatment option for knee OCD and may offer a good and stable clinical outcome at mean 6 years of follow-up. Further studies are needed to confirm the results over time, and determine if there is only a symptomatic improvement, or if this procedure may also prevent or delay further knee degeneration. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. Subclinical pulmonary function defects following autologous and allogeneic bone marrow transplantation: relationship to total body irradiation and graft-versus-host disease

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    Tait, R.C.; Burnett, A.K.; Robertson, A.G.; McNee, S.; Riyami, B.M.; Carter, R.; Stevenson, R.D. (Department of Haematology, Royal Infirmary, Glasgow (Scotland))

    1991-06-01

    Pulmonary function results pre- and post-transplant, to a maximum of 4 years, were analyzed in 98 patients with haematological disorders undergoing allogeneic (N = 53) or autologous bone marrow transplantation (N = 45) between 1982 and 1988. All received similar total body irradiation based regimens ranging from 9.5 Gy as a single fraction to 14.4 Gy fractionated. FEV1/FVC as a measure of airway obstruction showed little deterioration except in patients experiencing graft-versus-host disease in whom statistically significant obstructive ventilatory defects were evident by 6 months post-transplant (p less than 0.01). These defects appeared to be permanent. Restrictive ventilatory defects, as measured by reduction in TLC, and defects in diffusing capacity (DLCO and KCO) were also maximal at 6 months post-transplant (p less than 0.01). Both were related, at least in part, to the presence of GVHD (p less than 0.01) or use of single fraction TBI with absorbed lung dose of 8.0 Gy (p less than 0.05). Fractionated TBI resulted in less marked restricted ventilation and impaired gas exchange, which reverted to normal by 2 years, even when the lung dose was increased from 11.0 Gy to between 12.0 and 13.5 Gy. After exclusion of patients with GVHD (30% allografts) there was no significant difference in pulmonary function abnormalities between autograft and allograft recipients.

  4. Autologous grafting of extraocular muscles: experimental study in rabbits Transplante autólogo de musculatura ocular extrínseca: estudo experimental em coelhos

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    Jorge Meireles-Teixeira

    2005-06-01

    Full Text Available PURPOSE: To evaluate the feasibility of autologous extraocular muscle grafting as a type of muscle expansion surgery. METHODS: The left superior rectus muscle of twenty-nine rabbits was resected and this fragment was attached to the endpoint of the respective right superior rectus (test group. Thereafter, the superior rectus of the left eye was reattached to the sclera (control group. Both groups were examined during different postoperative periods in order to assess their outcomes. RESULTS: The presence of hyperemia was slightly more frequent in the grafted group. Secretion and muscle atrophy were negligible in both groups. Fibrosis was greater in grafted animals. These muscles were weaker than the control muscles, although the force required to split muscular parts was always greater than the physiological one. CONCLUSIONS: This surgical technique was reliable and useful if one intends to achieve muscle expansion without the intrinsic risks of dealing with heterologous/artificial materials.OBJETIVO: Avaliar a viabilidade do uso de segmentos de músculos oculares extrínsecos como expansores de tendões musculares. MÉTODOS: Vinte e nove coelhos tiveram seu músculo reto superior esquerdo ressecado e o fragmento de cada um foi transplantado para o reto superior contralateral (grupo-teste. Então, o reto superior esquerdo foi reinserido na esclera (grupo-controle. Os animais foram então examinados em diversos períodos pós-operatórios, até os seus sacrifícios, para que se avaliasse o desenrolar dessa técnica cirúrgica. RESULTADOS: A hiperemia foi maior entre os testes. A secreção e a atrofia muscular foram mínimas nos dois grupos. Houve maior presença de fibrose no grupo-teste, mas não tão expressiva a ponto de inviabilizar os efeitos da cirurgia. Esses músculos também se romperam mais facilmente do que os do grupo-controle, porém, a força de rompimento foi sempre bem maior do que aquela presente numa contração muscular normal

  5. Melatonin promotes survival of nonvascularized fat grafts and enhances the viability and migration of human adipose-derived stem cells via down-regulation of acute inflammatory cytokines.

    Science.gov (United States)

    Tan, Shaun S; Zhan, Weiqing; Poon, Christopher J; Han, Xiaolian; Marre, Diego; Boodhun, Sholeh; Palmer, Jason A; Mitchell, Geraldine M; Morrison, Wayne A

    2018-02-01

    Nonvascularized fat grafting is a valuable technique for soft tissue reconstruction but poor survival of fat in the host environment remains a problem. A process known as cell-assisted transfer is used to enhance fat graft retention by adding stromal vascular fraction, an adipose-derived stem cell (ASC) rich content to lipoaspirate. We have recently shown that the use of melatonin, a reactive oxygen species scavenger, protects human ASCs from hydrogen peroxide-induced oxidative stress and cell death in vitro but its role as a pharmacological adjunct in clinical fat grafting has not been studied. Herein, the effect of melatonin was examined on human ASCs in vitro using survival and functional assays including the MTT assay, CellTox Green assay, monolayer scratch assay as well as a human cytokine chemoluminescence, and tumour necrosis factor-α assay. Further, the effect of melatonin-treated fat grafts was tested in vivo with a murine model. Haematoxylin and eosin staining, perilipin and CD31 immunostaining were performed with morphometric analysis of adipose tissue. The results demonstrate that, in vitro, the addition of melatonin to ASCs significantly improved their cell-viability, promoted cell migration and preserved membrane integrity as compared to controls. In addition, it induced a potent anti-inflammatory response by downregulating acute inflammatory cytokines particularly tumour necrosis factor-α. For the first time, it is demonstrated in vivo that melatonin enhances fat graft volume retention by reducing inflammation and increasing the percentage of adipose volume within fat grafts with comparable volumes to that of cell-assisted lipotransfer. Based on these novel findings, melatonin may be a useful pharmacological adjunct in clinical fat grafting. Copyright © 2017 John Wiley & Sons, Ltd.

  6. Autologous stem cell transplantation as post-remission therapy in adult acute myelogenous leukemia: does platelet contamination of peripheral blood mobilized stem cell grafts influence the risk of leukemia relapse?

    Science.gov (United States)

    Bruserud, O; Foss, B; Abrahamsen, J F; Gjertsen, B T; Ernst, P

    2000-08-01

    Conventional chemotherapy of acute myelogenous leukemia (AML) results in an overall long-term disease-free survival of less than 50%, but for selected subsets of younger patients the prognosis can be improved by allogeneic stem cell transplantation. The use of autologous stem cell transplantation is now investigated as an alternative to allotransplantation due to its lower risk of serious complications. However, autotransplantation is associated with a relatively high risk of post-transplant AML relapse that can be derived from contaminating leukemia cells in the autograft. Peripheral blood mobilized stem cell (PBSC) grafts usually contain a higher number of platelets. The degree of platelet contamination is determined by the peripheral blood platelet count at the time of harvesting, and the platelets become activated and release soluble mediators during the ex vivo handling of PBSC grafts. Many of these platelet-derived mediators can bind to specific receptors expressed by AML blasts, and the platelet contamination may then alter AML blast survival and thereby influence the risk of post-transplant leukemia relapse. Therefore, we conclude that the platelet contamination of autologous stem cell grafts is possibly of clinical importance, but the effect of this nonstandardized parameter is difficult to predict in individual patients because the number of graft-contaminating platelets, the degree of platelet activation, and the effects of platelet-derived mediators on AML blasts differ between patients.

  7. The Role of Antibiotic Prophylaxis in Reducing Bacterial Contamination of Autologous Bone Graft Collected from Implant Site

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    Rodolfo Mauceri

    2017-01-01

    Full Text Available The aim of this study was to evaluate if antibiotic prophylaxis reduces the bacterial contamination of bone particles collected directly from the burs used for implant site preparation. Thirty-four patients underwent the surgical procedures for a total of 34 implant sites. One 1 gr. tablet of amoxicillin + clavulanic acid was given to the test group 12 hours and 1 hour before the surgery. The control group did not take antibiotic prophylaxis. Bone particles were collected and centrifuged. The suspensions were subjected to serial dilutions and each dilution was examined twice using a spatulation technique in Trypticase Soy Agar (TSA, in Sabouraud Dextrose Agar, and in Mitis Salivarius Agar (MSA. The number of colonies was calculated and the identification of various microorganisms was made. The most represented species, in both groups of patients, belonged to the “oral Streptococci.” For TSA, the test and control groups differed significantly (p = 0.018. Conversely, there was no significant difference for MSA (p = 0.201 and for the number of bacterial species isolated in the samples of the two groups of patients (p = 0.898. The antibiotic prophylaxis reduced, but did not cancel, the risk of infection of the autogenous particulate bone graft. This trial is registered with IRCT2017102537002N1.

  8. The Role of Antibiotic Prophylaxis in Reducing Bacterial Contamination of Autologous Bone Graft Collected from Implant Site.

    Science.gov (United States)

    Mauceri, Rodolfo; Campisi, Giuseppina; Matranga, Domenica; Mauceri, Nicola; Pizzo, Giuseppe; Melilli, Dario

    2017-01-01

    The aim of this study was to evaluate if antibiotic prophylaxis reduces the bacterial contamination of bone particles collected directly from the burs used for implant site preparation. Thirty-four patients underwent the surgical procedures for a total of 34 implant sites. One 1 gr. tablet of amoxicillin + clavulanic acid was given to the test group 12 hours and 1 hour before the surgery. The control group did not take antibiotic prophylaxis. Bone particles were collected and centrifuged. The suspensions were subjected to serial dilutions and each dilution was examined twice using a spatulation technique in Trypticase Soy Agar (TSA), in Sabouraud Dextrose Agar, and in Mitis Salivarius Agar (MSA). The number of colonies was calculated and the identification of various microorganisms was made. The most represented species, in both groups of patients, belonged to the "oral Streptococci." For TSA, the test and control groups differed significantly ( p = 0.018). Conversely, there was no significant difference for MSA ( p = 0.201) and for the number of bacterial species isolated in the samples of the two groups of patients ( p = 0.898). The antibiotic prophylaxis reduced, but did not cancel, the risk of infection of the autogenous particulate bone graft. This trial is registered with IRCT2017102537002N1.

  9. Long-term animal implantation study of biotube-autologous small-caliber vascular graft fabricated by in-body tissue architecture.

    Science.gov (United States)

    Watanabe, Taiji; Kanda, Keiichi; Yamanami, Masashi; Ishibashi-Ueda, Hatsue; Yaku, Hitoshi; Nakayama, Yasuhide

    2011-07-01

    A mold for the preparation of an in-body tissue architecture-induced autologous vascular graft, termed "biotube," was prepared by covering a main silicone rod (outer diameter, 3 mm; length, 30 mm) with two pieces of polyurethane sponge tubes (internal diameter, 3 mm; length, 3 mm) at both ends. The molds were embedded into the dorsal subcutaneous pouch of rabbits (weighing ca. 2 kg) for 2 months. After harvesting the rods with the formed surrounding tissues, the rods were removed to create biotubes impregnated with anastomotic reinforcement cuffs at both ends. The biotubes had homogeneous, thin connective tissue wall (thickness, 76 ± 37 μm) that was primarily composed of collagen and fibroblasts. One biotube was loaded with argatroban and autoimplanted in the carotid artery for 26 months. Neither antiplatelet nor anticoagulant agents were administered, except for an intraoperative heparin injection. Follow-up angiography showed no aneurysm formation, rupturing, or stenosis during implantation. At the end of implantation, the wall thickness of biotube (212 ± 24 μm at the anastomosis portion and 150 ± 14 μm at the midportion) was similar to that of native artery (189 ± 23 μm). The luminal surface was completely covered with endothelial cells on the formed lamina elastica interna-like layer. The regenerated vascular walls comprised multilayered smooth muscle cells and dense collagen fibers with regular circumferential orientation. A remarkable multilayered elastin fiber network was observed near the anastomosis portion. Biotubes could thus be used as small-caliber vascular prostheses that greatly facilitate the healing process and exhibit excellent biocompatibility. Copyright © 2011 Wiley Periodicals, Inc.

  10. Use of autologous fat grafting in reconstruction following mastectomy and breast conserving surgery: An updated systematic review protocol

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    Riaz A. Agha

    2017-01-01

    Ethics and dissemination: The systematic review will be published in a peer-reviewed journal and presented at national and international meetings within fields of plastic, reconstructive and aesthetic surgery, and surgical oncology. The work will be disseminated electronically and in print. Brief reports of the review and findings will be disseminated to interested parties through email and direct communication. The review aims to guide healthcare practice and policy.

  11. Safety of intramedullary autologous peripheral nerve grafts for post-rehabilitated complete motor spinal cord injuries: a phase I study.

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    Nazi Derakhshanrad

    2013-12-01

    Full Text Available Many experimental studies have reported behavioral improvement after transplantation of peripheral nerve tissue into the contused spinal cord, even in large animals. The safety of this treatment in human remains unknown. In this translational phase 1 study, safety of peripheral nerve grafting for chronic spinal cord injuries and possible outcomes are being reported. Twelve complete motor spinal cord injury patients, who had finished their rehabilitation program, were enrolled. There were 4 thoracic and 8 cervical cases. Patients underwent sural nerve preconditioning in the calf, followed 1 week later, by intramedullary transplantation of the harvested nerve fascicles. The patients were followed up for potential complications periodically, and final assessment by American Spinal Injury association (ASIA and Spinal Cord Independence Measure (SCIM III were reported after 2 years of follow-up. The median duration of the spinal cord injury was 31 months. At two years of follow up, out of 7 cases with ASIA Impairment Scale (AIS A, 4(57.1% cases improved to AIS B and 1 (14.3% case became AIS C. There were 1 patient with transient increased spasm, one case of transient cystitis, 3 patients with transient increased neuropathic pain and 1 case with transient episode of autonomic dysreflexia, all being managed medically. There was no case of donor site infection. The above complications were transient as they responded to temporary medical treatment. It may be deduced that after two years follow-up of patients that the procedure may be safe, however further controlled studies are needed to prove its efficacy.

  12. Radiographic evaluation of the symphysis menti as a donor site for an autologous bone graft in pre-implant surgery

    International Nuclear Information System (INIS)

    Bari, Roberto Di; Cicconetti, Andrea; Coronelli, Roberto

    2013-01-01

    This study was performed to obtain a quantitative evaluation of the cortical and cancellous bone graft harvestable from the mental and canine regions, and to evaluate the cortical vestibular thickness. This study collected cone-beam computed tomographic (CBCT) images of 100 Italian patients. The limits of the mental region were established: 5 mm in front of the medial margin of each mental foramen, 5 mm under the apex of each tooth present, and above the inferior mandibular cortex. Cortical and cancellous bone volumes were evaluated using SimPlant software (SimPlant 3-D Pro, Materialize, Leuven, Belgium) tools. In addition, the cortical vestibular thickness (minimal and maximal values) was evaluated in 3 cross-sections corresponding to the right canine tooth (3R), the median section (M), and the left canine tooth (3L). The cortical volume was 0.71±0.23 mL (0.27-1.96 mL) and the cancellous volume was 2.16±0.76 mL (0.86-6.28 mL). The minimal cortical vestibular thickness was 1.54±0.41 mm (0.61-3.25 mm), and the maximal cortical vestibular thickness was 3.14±0.75mm(1.01-5.83 mm). The use of the imaging software allowed a patient-specific assessment of mental and canine region bone availability. The proposed evaluation method might help the surgeon in the selection of the donor site by the comparison between bone availability in the donor site and the reconstructive exigency of the recipient site.

  13. Radiographic evaluation of the symphysis menti as a donor site for an autologous bone graft in pre-implant surgery

    Energy Technology Data Exchange (ETDEWEB)

    Bari, Roberto Di; Cicconetti, Andrea [Dept. of Oral and Maxillofacial Sciences, School of Dentistry, Sapienza University of Rome, Rome (Italy); Coronelli, Roberto [Dr. Coronelli Dental Clinic, Rome (Italy)

    2013-09-15

    This study was performed to obtain a quantitative evaluation of the cortical and cancellous bone graft harvestable from the mental and canine regions, and to evaluate the cortical vestibular thickness. This study collected cone-beam computed tomographic (CBCT) images of 100 Italian patients. The limits of the mental region were established: 5 mm in front of the medial margin of each mental foramen, 5 mm under the apex of each tooth present, and above the inferior mandibular cortex. Cortical and cancellous bone volumes were evaluated using SimPlant software (SimPlant 3-D Pro, Materialize, Leuven, Belgium) tools. In addition, the cortical vestibular thickness (minimal and maximal values) was evaluated in 3 cross-sections corresponding to the right canine tooth (3R), the median section (M), and the left canine tooth (3L). The cortical volume was 0.71±0.23 mL (0.27-1.96 mL) and the cancellous volume was 2.16±0.76 mL (0.86-6.28 mL). The minimal cortical vestibular thickness was 1.54±0.41 mm (0.61-3.25 mm), and the maximal cortical vestibular thickness was 3.14±0.75mm(1.01-5.83 mm). The use of the imaging software allowed a patient-specific assessment of mental and canine region bone availability. The proposed evaluation method might help the surgeon in the selection of the donor site by the comparison between bone availability in the donor site and the reconstructive exigency of the recipient site.

  14. Results of Use of Tissue-Engineered Autologous Oral Mucosa Graft for Urethral Reconstruction: A Multicenter, Prospective, Observational Trial.

    Science.gov (United States)

    Ram-Liebig, Gouya; Barbagli, Guido; Heidenreich, Axel; Fahlenkamp, Dirk; Romano, Giuseppe; Rebmann, Udo; Standhaft, Diana; van Ahlen, Hermann; Schakaki, Samer; Balsmeyer, Ulf; Spiegler, Maria; Knispel, Helmut

    2017-09-01

    Harvest of oral mucosa for urethroplasty due to urethral stricture is associated with donor-site-morbidity. We assessed functionality and safety of an authorized tissue-engineered oral mucosa graft (TEOMG) under routine practice in stricture recurrences of any etiology, location, length and severity (real-world data). 99 patients from eight centers with heterogenous urethroplasty experience levels were included in this prospective, non-interventional observational study. Primary and secondary outcomes were success rate (SR) and safety at 12 and 24months. All but one patient had ≥1, 77.1% (64 of 83)≥2 and 31.3% (26 of 83)≥4 previous surgical treatments. Pre- and postoperative mean±SD peak flow rate (Qmax) were 8.3±4.7mL/s (n=57) and 25.4±14.7mL/s (n=51). SR was 67.3% (95% CI 57.6-77.0) at 12 and 58.2% (95% CI 47.7-68.7) at 24months (conservative Kaplan Meier assessment). SR ranged between 85.7% and 0% in case of high and low surgical experience. Simple proportions of 12-month and 24-month SR for evaluable patients in all centers were 70.8% (46 of 65) and 76.9% (30 of 39). Except for one patient, no oral adverse event was reported. TEOMG is safe and efficient in urethroplasty. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  15. Restauração do diafragma de felino com enxerto autólogo de pericárdio Reconstruction of feline diaphragm with autologous pericardium graft

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    Saulo Tadeu Lemos Pinto Filho

    2003-10-01

    Full Text Available OBJETIVO: Avaliar o uso de enxerto autólogo de pericárdio para correção de defeitos diafragmáticos em felinos. MÉTODOS: Foram utilizados doze gatos domésticos, adultos, sem raça definida, pesando entre dois e quatro quilogramas. O procedimento cirúrgico consistiu de toracotomia no 7º espaço intercostal esquerdo, remoção de um retalho do pericárdio de, aproximadamente, 2,0 x 4,0 cm e sutura desse em um defeito de tamanho aproximado criado no diafragma. Cinco animais foram observados por um período de 30 dias de pós-operatório e o restante em 60 dias, quando foram submetidos à eutanásia para observação macroscópica e coleta de amostras para avaliação histológica. RESULTADOS: Foi observada nos animais do grupo de 30 dias, substituição parcial e no grupo de 60 dias, substituição total do enxerto de pericárdio por tecido fibrovascular, permitindo o restabelecimento completo do diafragma. Macroscopicamente, foi verificada presença de aderência na cavidade torácica, com o pulmão e pleura parietal e, na cavidade abdominal, com o fígado e omento, porém, sem comprometimento clínico das estruturas envolvidas. CONCLUSÃO: O enxerto autólogo felino pode ser utilizado para reparação de defeitos diafragmáticos, pois suporta a diferença de pressão presente, sendo substituído por tecido cicatricial, sem apresentar sinais clínicos e histológicos de rejeição.PURPOSE: Evaluate the use of feline autologous pericardium to correct diaphragmatic defects. METHODS: Twelve male and female, adult, mixed breed, domestic cats were used weighing between 2 and 4 kilogram. The surgical procedure consisted of thoracotomy of the 7th left intercostal space, removal of a pericardium graft of approximately 2,0 x 4,0 cm and the graft was sutured in a defect of the same size in the diaphragm. Six animals were observed for a period of 30 days postoperatively and six for 60 days. After this period they were submitted to euthanasia for

  16. Supplementation of fat grafts with adipose-derived regenerative cells in reconstructive surgery [Stammzellangereicherte Fetttransplantation in der rekonstruktiven Chirurgie

    Directory of Open Access Journals (Sweden)

    Herold, C.

    2012-09-01

    Full Text Available [english] Introduction: The fraction of regenerative cells in adipose tissue has been described to be even higher than in bone marrow. Adipose tissue itself is excessively available in most patients. Given that adipose tissue is abundant in majority of patients adipose derrived stem cells (ASCs have come under scrutiny for regenerative procedures in reconstructive surgery.Material and methods: ASCs were extracted by the Celution system for enrichment of fat grafts that were administered in patients with decreased wound healing, soft tissue or scar defects.Results: All patients were satisfied after reconstruction with ASCs augmented fat grafts and no side effects were observed. Discussion: The Celution system provides fast recovery of ASCs which can be immediately utilized for appropriate application. Since a high number of stem cells are harvested from fat tissue no expansion of cells is needed as described for bone marrow derived stem cells. Enrichment of fat graft with ASCs is of great interest due to their reported angiogenetic effect. The reported cases demonstrate the potential of ASCs in the field of regenerative medicine and encourage further application in reconstructive surgery.[german] Einleitung: Es konnte gezeigt werden, dass der Anteil regenerativer Zellen im Fettgewebe höher als im Knochenmark ist. Fettgewebe hingegen ist bei den meisten Patienten exzessiv vorhanden. Das legt den Einsatz von ASCs (adipose derived stem cells bei regenerativen Anwendungen in der rekonstruktiven Chirurgie nahe.Material und Methoden: Mit dem Celution System von Cytori Therapeutics Inc. prozessierte, ASC angereicherte Fetttransplantate werden an vier Patienten mit Weichteildefiziten und störenden Narben sowie Wundheilungsstörungen angewendet.Ergebnisse: Insbesondere bei Patienten mit Weichteildefiziten und Narben konnte eine suffiziente Volumenaugmentation und ansprechende Verbesserung der Narben erzielt werden. Es wurden keine Nebenwirkungen

  17. Comparative analysis of use of porous orbital implant with mucus membrane graft and dermis fat graft as a primary procedure in reconstruction of severely contracted socket

    Directory of Open Access Journals (Sweden)

    Kasturi Bhattacharjee

    2014-01-01

    Full Text Available Purpose: The purpose of our study is to present a surgical technique of primary porous orbital ball implantation with overlying mucus membrane graft (MMG for reconstruction of severely contracted socket and to evaluate prosthesis retention and motility in comparison to dermis fat graft (DFG. Study Design: Prospective comparative study. Materials and Methods: A total of 24 patients of severe socket contracture (Grade 2-4 Krishna′s classification were subdivided into two groups, 12 patients in each group. In Group I, DFG have been used for reconstruction. In Group II, porous polyethylene implant with MMG has been used as a primary procedure for socket reconstruction. In Group I DFG was carried out in usual procedure. In case of Group II, vascularized scar tissues were separated 360° and were fashioned into four strips. A scleral capped porous polyethylene implant was placed in the intraconal space and four strips of scar tissue were secured to the scleral cap and extended part overlapped the implant to make a twofold barrier between the implant and MMG. Patients were followed-up as per prefixed proforma. Prosthesis motility and retention between the two groups were measured. Results: In Group I, four patients had recurrence of contracture with fall out of prosthesis. In Group II stable reconstruction was achieved in all the patients. In terms of prosthesis motility, maximum in Group I was 39.2% and Group II, was 59.3%. The difference in prosthesis retention (P = 0.001 and motility (P = 0.004 between the two groups was significant. Conclusion: Primary socket reconstruction with porous orbital implant and MMG for severe socket contracture is an effective method in terms of prosthesis motility and prosthesis retention.

  18. Lipoestructura y relleno del polo superior de la mama frente a implantes Structural fat graft and lipofilling of mammary upper pole versus mammary implants

    Directory of Open Access Journals (Sweden)

    J.M. Cervilla Lozano

    2012-09-01

    Full Text Available La lipoestructura mamaria ofrece nuevas alternativas de tratamiento en la cirugía estética de aumento mamario, cumpliendo en algunos casos las expectativas esperadas y en otros no. Analizamos este hecho en 4 tipos de aplicación de lipoestructura mamaria que hemos venido realizando en los últimos años, centrándonos en un aspecto importante de esta cirugía que es el relleno del polo superior de la mama. Los tipos de aplicación empleados son: aumento mamario simple mediante lipoestructura en comparación con implantes; pexia más lipoestructura frente a pexia más implantes mamarios; reconstrucción de mama tuberosa mediante lipoestructura o implantes y finalmente, relleno periprotésico mediante lipoestructura en mamas sometidas a cirugía de aumento mamario con implantes. En definitiva, podríamos resumir este trabajo en una frase diciendo que la lipoestructura mamaria, a nuestro juicio, no sirve si lo que prima es conseguir el relleno del polo superior de la mama, siendo en este caso de elección la colocación de implantes mamarios. No obstante, en alguno de los casos señalados no solo es una alternativa, sino que obtiene resultados superiores a los logrados sólamente con implantes.The mammary structural fat graft offers news treatment options in breast augmentation cosmetic surgery, but it sometimes meets expectations and sometimes doesn´t. We analyze 4 different types of lipostructure mammary applications that we have been using in the last years, focused in an important aspect of this surgery as it´s the filling of the upper mammary pole. These applications are: mammary augmentation by simple structural fat compared with the use of mammary implants; structural fat graft and mastopexy versus implants and mastopexy; tuberous breast reconstruction using structural fat graft or implants and finally, periprosthetic filling in breast augmentation with mammary implants using structural fat graft. In short, we could summarize this paper

  19. Autologous mesenchymal stem cells produce concordant improvements in regional function, tissue perfusion, and fibrotic burden when administered to patients undergoing coronary artery bypass grafting: The Prospective Randomized Study of Mesenchymal Stem Cell Therapy in Patients Undergoing Cardiac Surgery (PROMETHEUS) trial.

    Science.gov (United States)

    Karantalis, Vasileios; DiFede, Darcy L; Gerstenblith, Gary; Pham, Si; Symes, James; Zambrano, Juan Pablo; Fishman, Joel; Pattany, Pradip; McNiece, Ian; Conte, John; Schulman, Steven; Wu, Katherine; Shah, Ashish; Breton, Elayne; Davis-Sproul, Janice; Schwarz, Richard; Feigenbaum, Gary; Mushtaq, Muzammil; Suncion, Viky Y; Lardo, Albert C; Borrello, Ivan; Mendizabal, Adam; Karas, Tomer Z; Byrnes, John; Lowery, Maureen; Heldman, Alan W; Hare, Joshua M

    2014-04-11

    Although accumulating data support the efficacy of intramyocardial cell-based therapy to improve left ventricular (LV) function in patients with chronic ischemic cardiomyopathy undergoing CABG, the underlying mechanism and impact of cell injection site remain controversial. Mesenchymal stem cells (MSCs) improve LV structure and function through several effects including reducing fibrosis, neoangiogenesis, and neomyogenesis. To test the hypothesis that the impact on cardiac structure and function after intramyocardial injections of autologous MSCs results from a concordance of prorecovery phenotypic effects. Six patients were injected with autologous MSCs into akinetic/hypokinetic myocardial territories not receiving bypass graft for clinical reasons. MRI was used to measure scar, perfusion, wall thickness, and contractility at baseline, at 3, 6, and 18 months and to compare structural and functional recovery in regions that received MSC injections alone, revascularization alone, or neither. A composite score of MRI variables was used to assess concordance of antifibrotic effects, perfusion, and contraction at different regions. After 18 months, subjects receiving MSCs exhibited increased LV ejection fraction (+9.4 ± 1.7%, P=0.0002) and decreased scar mass (-47.5 ± 8.1%; P<0.0001) compared with baseline. MSC-injected segments had concordant reduction in scar size, perfusion, and contractile improvement (concordant score: 2.93 ± 0.07), whereas revascularized (0.5 ± 0.21) and nontreated segments (-0.07 ± 0.34) demonstrated nonconcordant changes (P<0.0001 versus injected segments). Intramyocardial injection of autologous MSCs into akinetic yet nonrevascularized segments produces comprehensive regional functional restitution, which in turn drives improvement in global LV function. These findings, although inconclusive because of lack of placebo group, have important therapeutic and mechanistic hypothesis-generating implications. http

  20. Substitutos ósseos comparados ao enxerto ósseo autólogo em cirurgia ortopédica: revisão sistemática da literatura Bone graft substitutes compared to autologous bone graft in orthopedic surgery: systematic literature review

    Directory of Open Access Journals (Sweden)

    José Luís Amim Zabeu

    2008-03-01

    Full Text Available OBJETIVO: Identificar, a partir de revisão sistematizada da literatura, estudos clínicos com nível de evidência 1 comparando substitutos ósseos ao enxerto autólogo. MÉTODOS: Realizada busca eletrônica de artigos que comparassem o uso do enxerto ósseo autólogo a um substituto ósseo em cirurgia ortopédica. Foram considerados como critérios de elegibilidade ensaios clínicos prospectivos e randomizados em cirurgia ortopédica, com casuística mínima de 20 pacientes, envolvendo ossos da coluna vertebral ou esqueleto apendicular, publicados entre janeiro de 1990 e janeiro de 2006. RESULTADOS: Foram identificados 22 trabalhos, todos em língua inglesa, dos quais cinco compararam enxerto autólogo ao homólogo, sete envolveram uso de proteína morfogenética do tipo 2 (BMP-2, em três foi avaliada a proteína morfogenética do tipo 7 (BMP- 7 e sete utilizaram biocerâmicas, como hidroxiapatita, fosfato tricálcio e sulfato de cálcio. Os resultados mais sugestivos da equivalência com o enxerto autólogo se deram nos trabalhos com BMP-2 em cirurgia da coluna vertebral, embora diversos questionamentos possam ser feitos em relação a estes e aos demais estudos analisados, referentes a métodos e possíveis conflitos de interesses. CONCLUSÃO: Existem poucos estudos com alto nível de evidência que demonstrem a aplicabilidade clínica dos substitutos ósseos atualmente existentes.OBJECTIVE: Based on a systematic literature review, to identify studies with level of evidence 1 to compare bone graft substitutes to autologous bone grafts. METHODS: An electronic survey of papers comparing the use of autologous bone graft and a bone graft substitute in orthopedic surgery was performed. Inclusion criteria considered were prospective and randomized clinical trials in orthopedic surgery, with a minimum of 20 patients, involving spine or appendicular skeleton bones, published between January 1990 and January 2006. RESULTS: 22 papers were identified

  1. Management of Bone Gaps with Intramedullary Autologous Fibular ...

    African Journals Online (AJOL)

    ... 7 consecutive patients who presented with bone gaps that were managed with intramedullary non vascularised fibular strut graft. Method: Intramedulary Autologous fibular strut graft was used to breach the bone and the whole length augmented with cancellous graft and bridged with bone plate; external fixators or k wires.

  2. Minimal incisions vertical endoscopic lifting and fat grafting as a systematic approach to the rejuvenation of the periocular esthetic unit.

    Science.gov (United States)

    Bernardini, Francesco P; Gennai, Alessandro; Izzo, Luigi; Devoto, Martin H

    2013-01-01

    The forehead/brow complex, the temporal region, the upper eyelid, the zygomatic area, the lower eyelid, and the cheek comprise the periocular esthetic unit. The combination of variable degrees of tissue descent and fat deflation of the component parts of the unit determine its appearance with age. The authors report the results of tissue repositioning through a minimal incisions vertical endoscopic lift and volume restoration used in combination to restore the natural youthful appearance of the periocular esthetic unit. The authors retrospectively reviewed the charts of patients who underwent minimal incisions vertical endoscopic lift and fat grafting over a 12-year period in 3 different centers. Patients results were evaluated with standardized pre- and postoperative pictures graded by masked observers in a scale from poor, fair, satisfactory, to very satisfactory results. Patient satisfaction was self-graded in the same manner. The study consists of 400 patients, of whom 337 (85%) were women and 63 (14.8%) were men, with a mean age of 46 years (range 38-67) for women and mean age of 53 years (range 48-65) for men. Mean follow up was 16 months (range 6 months-8 years); in 180 patients follow up was 2 years or longer. Additional procedures included lower blepharoplasty in 205 patients (51%), neck lift in 102 patients (26%), upper blepharoplasty in 63 patients (15.7%), lateral canthoplasty in 9 patients (2.3%), and upper eyelid ptosis in 6 patients (1.5%). The results were graded as satisfactory or very satisfactory by 95% of patients and by 91% of observers. On the basis of the anatomical changes that occur in the periocular esthetic unit, tissue repositioning is indicated to address the descent of the superior complex and in minor part of the inferior complex, while volume restoration is indicated to address the volume depletion of the inferior and the lateral complexes and for refinements of the superior complex. The authors propose a systematic combination of

  3. Human regulatory T cells control xenogeneic graft-versus-host disease induced by autologous T cells in RAG2-/-gammac-/- immunodeficient mice.

    NARCIS (Netherlands)

    Mutis, T; Rijn, R.S. van; Simonetti, E.R.; Aarts-Riemens, T.; Emmelot, M.E.; Bloois, L. van; Martens, A.; Verdonck, L.F.; Ebeling, S.B.

    2006-01-01

    PURPOSE: Effective prevention of graft-versus-host disease (GvHD) is a major challenge to improve the safety of allogeneic stem cell transplantation for leukemia treatment. In murine transplantation models, administration of naturally occurring CD4+CD25+ regulatory T cells (Treg) can prevent GvHD.

  4. Technetium-99 m-MDP scintigraphy and long-term follow-up of musculo-skeletal sarcoma reconstructed with pasteurized autologous bone graft.

    Science.gov (United States)

    Ahmed, Adel Refaat

    2009-04-01

    Local bone tumor excision followed by pasteurization and reimplantation is a unique technique of reconstruction for sarcoma patients. The long-term scintigraphic findings of pasteurized bone grafts in relation to clinical patients' data were reviewed retrospectively. Twenty-two sarcoma patients (mean age, 24 years) done between April 2000 and January 2004 constituted the material of this study. One hundred and fifty-two 99 m TC-methylene diphosphonate (MDP) whole-body scans were reviewed. Initially, all autografts appeared as photon deficient areas. Diffusely increased bone uptake was present at the osteotomy sites within 4-6 months after surgery, the uptake of the grafted pasteurized bone was detected in 17 patients from about 6 months after surgery. Of 22 patients, 11 (50%) showed higher uptake than the normal bone, 6 (27%) had uptake similar to the normal bone, while 5 (23%) had less uptake than the normal bone. Radiologically, 15 patients (68%) showed complete incorporation of graft and 5 patients (23%) had partial incorporation. Oncologically, 16 patients are disease free, while 6 died of disease. No local recurrence was detected at a mean of 59 months, while fracture (13.6%) eventually healed with bone grafting and revision of internal fixation, graft collapse (9%) (needed revision arthroplasty) and infection (9%), one cured and one converted to rotationplasty, were the major complications encountered. Significantly more mechanical complications were seen when tracer uptake suggestive of revascularization occurred; thus, revascularization and partial bone ingrowth are not sufficient conditions for lower mechanical complication rate. The method of pasteurization of bone is a useful option for reconstruction after resection of malignant bone tumors.

  5. Débridement and Autologous Lipotransfer for Chronic Ulceration of the Diabetic Foot and Lower Limb Improves Wound Healing.

    Science.gov (United States)

    Stasch, Tilman; Hoehne, Julius; Huynh, Tuan; De Baerdemaeker, Randy; Grandel, Siegfried; Herold, Christian

    2015-12-01

    The application of autologous lipotransfer (fat grafting, lipofilling) in reconstructive surgery is steadily becoming more popular as evidence of the regenerative and reparative effects of fat becomes better known. The authors investigated the use of autologous lipotransfer for treatment of chronic diabetic and other foot and lower limb ulcers. Twenty-six patients with nonhealing wounds were treated with surgical débridement and autologous lipotransfer (using the débridement and autologous lipotransfer method). The mean age of the wounds before intervention was 16.7 months. Wound size after débridement averaged 5.1 ± 2.6 cm2. On average, 7.1 ± 3.3 cc of lipoaspirate was transferred into the wound area. Twenty-two of 25 wounds (88 percent) healed completely within a mean of 68.0 ± 33.0 days. A reduction of wound size by 50 percent was achieved after an average of 4 weeks. In one patient with an ulcer within particularly scarred tissues on the lower limb, a repeated session of lipotransfer led to complete wound healing after another 4 weeks. The authors describe a simple and useful technique to improve wound healing in diabetic feet and chronic lower limb ulcers with a background of peripheral vascular disease, where other interventional options to achieve wound healing have failed.

  6. Autologous Bone Marrow Mesenchymal Stem Cells Associated with Tantalum Rod Implantation and Vascularized Iliac Grafting for the Treatment of End-Stage Osteonecrosis of the Femoral Head

    Directory of Open Access Journals (Sweden)

    Dewei Zhao

    2015-01-01

    Full Text Available Tantalum rod implantation with vascularized iliac grafting has been reported to be an effective method for the treatment of young patients with osteonecrosis of the femoral head (ONFH to avert the need for total hip arthroplasty (THA. However, there have been unsatisfactory success rates for end-stage ONFH. The authors describe a modified technique using bone marrow mesenchymal stem cells (BMMSCs associated with porous tantalum rod implantation combined with vascularized iliac grafting for the treatment of end-stage ONFH. A total of 24 patients (31 hips with end-stage ONFH were treated with surgery; ARCO IIIc stage was observed in 19 hips and ARCO IV stage was observed in 12 hips. All patients were followed for a mean time of 64.35 ± 13.03 months (range 26–78. Operations on only five hips were converted to THA. The joint-preserving success rate of the entire group was 89.47% for ARCO stage IIIc and 75% for ARCO stage IV. The mean Harris hip score of the 31 hips improved significantly from 38.74 ± 5.88 points (range 22–50 to 77.23 ± 14.75 points (range 33–95. This intervention was safe and effective in delaying or avoiding total hip replacement for end-stage ONFH.

  7. Autologous Bone Marrow Mesenchymal Stem Cells Associated with Tantalum Rod Implantation and Vascularized Iliac Grafting for the Treatment of End-Stage Osteonecrosis of the Femoral Head

    Science.gov (United States)

    Zhao, Dewei; Liu, Baoyi; Wang, Benjie; Yang, Lei; Xie, Hui; Huang, Shibo; Zhang, Yao; Wei, Xiaowei

    2015-01-01

    Tantalum rod implantation with vascularized iliac grafting has been reported to be an effective method for the treatment of young patients with osteonecrosis of the femoral head (ONFH) to avert the need for total hip arthroplasty (THA). However, there have been unsatisfactory success rates for end-stage ONFH. The authors describe a modified technique using bone marrow mesenchymal stem cells (BMMSCs) associated with porous tantalum rod implantation combined with vascularized iliac grafting for the treatment of end-stage ONFH. A total of 24 patients (31 hips) with end-stage ONFH were treated with surgery; ARCO IIIc stage was observed in 19 hips and ARCO IV stage was observed in 12 hips. All patients were followed for a mean time of 64.35 ± 13.03 months (range 26–78). Operations on only five hips were converted to THA. The joint-preserving success rate of the entire group was 89.47% for ARCO stage IIIc and 75% for ARCO stage IV. The mean Harris hip score of the 31 hips improved significantly from 38.74 ± 5.88 points (range 22–50) to 77.23 ± 14.75 points (range 33–95). This intervention was safe and effective in delaying or avoiding total hip replacement for end-stage ONFH. PMID:25802840

  8. Bone grafting: An overview

    Directory of Open Access Journals (Sweden)

    D. O. Joshi

    2010-08-01

    Full Text Available Bone grafting is the process by which bone is transferred from a source (donor to site (recipient. Due to trauma from accidents by speedy vehicles, falling down from height or gunshot injury particularly in human being, acquired or developmental diseases like rickets, congenital defects like abnormal bone development, wearing out because of age and overuse; lead to bone loss and to replace the loss we need the bone grafting. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone graft. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. An ideal bone graft material is biologically inert, source of osteogenic, act as a mechanical support, readily available, easily adaptable in terms of size, shape, length and replaced by the host bone. Except blood, bone is grafted with greater frequency. Bone graft indicated for variety of orthopedic abnormalities, comminuted fractures, delayed unions, non-unions, arthrodesis and osteomyelitis. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. By adopting different procedure of graft preservation its antigenicity can be minimized. The concept of bone banking for obtaining bone grafts and implants is very useful for clinical application. Absolute stability require for successful incorporation. Ideal bone graft must possess osteogenic, osteoinductive and osteocon-ductive properties. Cancellous bone graft is superior to cortical bone graft. Usually autologous cancellous bone graft are used as fresh grafts where as allografts are employed as an alloimplant. None of the available type of bone grafts possesses all these properties therefore, a single type of graft cannot be recomm-ended for all types of orthopedic abnormalities. Bone grafts and implants can be selected as per clinical problems, the equipments available and preference of

  9. Reconstruction of Mandibular Defects Using Bone Morphogenic Protein: Can Growth Factors Replace the Need for Autologous Bone Grafts? A Systematic Review of the Literature

    Directory of Open Access Journals (Sweden)

    Alan S. Herford

    2011-01-01

    Full Text Available Autogenous bone is still considered the “gold standard” of regenerative and reconstructive procedures involving mandibular defects. However, harvesting of this material can lead to many complications like increasing morbidity, expanding of the surgical time, and incomplete healing of the donor site. In the last few years many authors looked for the development of effective reconstruction procedures using osteoinductive factors without the need for conventional bone grafting. The first-in-human study involving the use of Bone Morphongenic Proteins (rhBMP for mandibular reconstruction was performed in 2001 by Moghadam. Only few articles have been reported in the literature since then. The purpose of this study was to search and analyze the literature involving the use of rhBMP for reconstruction of mandibular defects. In all the studies reported, authors agree that the use of grown factors may represent the future of regenerative procedures with more research necessary for confirmation.

  10. Collection and composition of autologous peripheral blood stem cells graft in patients with acute myeloid leukemia: influence on hematopoietic recovery and outcome.

    Science.gov (United States)

    Raos, Mirela; Nemet, Damir; Bojanić, Ines; Sertić, Dubravka; Batinić, Drago; Dusak, Vesna; Dubravcić, Klara; Mazić, Sanja; Serventi-Seiwerth, Ranka; Mrsić, Mirando; Golubić-Cepulić, Branka; Labar, Boris

    2010-03-01

    Hematopoietic stem cell (HSC) transplantation is a standard approach in the treatment of hematological malignant diseases. For the last 15 years the main source of cells for transplantation have been peripheral blood stem cells (PBSC). With the availability of hematopoietic growth factors and understanding the advantages of treatment with PBSC, the application of bone marrow (BM) was supplanted. The aim of this survey was to explore the success of PBSC collection, the factors which influence the success of PBSC collection, the composition and the quality of graft and their influence on hematopoietic recovery and outcome after transplantation in patients with acute myeloid leukemia (AML). PBSC were collected by the method of leukapheresis after applying a combination of chemotherapy and growth factors or only growth factors. The quality of graft was determined with the clonogenic progenitor cell assay and with the flow cytometry analysis. Of the total 134 patients with AML, who were submitted to HSC mobilization, the collection was successful in 78 (58.2%) patients. The collection was more successful after the first than after the second attempt of HSC mobilization (49% vs. 11%). The criteria for effective mobilization were the number of leukocytes > 3 x 10(9)/L and the concentration of CD34+ cells > 20 x 10(3)/mL in the peripheral blood on the first day of leukapheresis. The number of CD34+ cells infused had the strongest impact on hematopoietic recovery. We noted significantly faster hematological recovery of neutrophils and platelets, fewer number of transfused units of red blood cells and platelets, shorter duration of the tranfusion support, shorter treatment with intravenous antibiotic therapy and shorter hospitalization after PBSC compared to BM transplantation. These advantages could provide their standard application in the treatment of patients with AML.

  11. Recombinant human platelet-derived growth factor-BB versus autologous bone graft in foot and ankle fusion: A systematic review and meta-analysis.

    Science.gov (United States)

    Sun, Han; Lu, Pei-Pei; Zhou, Ping-Hui; Sun, Si-Wei; Zhang, Hong-Tao; Liu, Yi-Jie; Yang, Xu; Shen, Xiao-Feng; Yang, Hui-Lin

    2017-03-01

    Today, autogenous bone graft (ABG) is still considered as the gold standard for joint fusion. Recombinant human platelet-derived growth factor-BB (rhPDGF-BB) which is of chemotactic and mitogenic to mesenchymal stem cells and possesses outstanding osteogenetic potentials has been used for ankle and foot fusion in recent years. The goal of this article is to evaluate the safety and efficacy of rhPDGF-BB versus ABG in foot and ankle fusion. The PubMed MEDLINE, EMBASE, Web of Science, and Cochrane Library were systematic searched. Finally, three randomized controlled trials (RCTs) with 634 patients were enrolled in this study. Results of radiologic effectiveness which included CT and radiographic union rates revealed that there was no significant difference between rhPDGF-BB approach and ABG approach. Analysis of clinical results held the same outcomes expect that ABG group was superior in long-term Short Form-12 physical component scores. The pooled results also demonstrated that rhPDGF-BB was as safe as ABG in foot and ankle surgery. However, autograft harvesting procedure has some drawbacks such as donor-site pain and morbidity, additional operation time, blood loss, and scarring, which can be overcome by rhPDGF-BB. Thus, rhPDGF-BB is a viable alternative to autograft in foot and ankle fusion surgery. Yet, more high-quality RCTs with long-term follow-up are still required to make the final conclusion. Copyright © 2016 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  12. Anterior cervical discectomy with fusion in patients with cervical disc degeneration: a prospective outcome study of 258 patients (181 fused with autologous bone graft and 77 fused with a PEEK cage

    Directory of Open Access Journals (Sweden)

    Roenning Paal

    2010-03-01

    Full Text Available Abstract Background Anterior cervical discectomy with fusion (ACDF is challenging with respect to both patient selection and choice of surgical procedure. The aim of this study was to evaluate the clinical outcome of ACDF, with respect to both patient selection and choice of surgical procedure: fusion with an autologous iliac crest graft (AICG versus fusion with an artificial cage made of polyetheretherketone (PEEK. Methods This was a non-randomized prospective single-center outcome study of 258 patients who underwent ACDF for cervical disc degeneration (CDD. Fusion was attained with either tricortical AICG or PEEK cages without additional anterior plating, with treatment selected at surgeon's discretion. Radicular pain, neck-pain, headache and patient satisfaction with the treatment were scored using the visual analogue scale (VAS. Results The median age was 47.5 (28.3-82.8 years, and 44% of patients were female. 59% had single-level ACDF, 40% had two level ACDF and 1% had three-level ACDF. Of the patients, 181 were fused with AICG and 77 with a PEEK-cage. After surgery, the patients showed a significant reduction in radicular pain (ΔVAS = 3.05, neck pain (ΔVAS = 2.30 and headache (ΔVAS = 0.55. Six months after surgery, 48% of patients had returned to work: however 24% were still receiving workers' compensation. Using univariate and multivariate analyses we found that high preoperative pain intensity was significantly associated with a decrease in pain intensity after surgery, for all three pain categories. There were no significant correlations between pain relief and the following patient characteristics: fusion method (AICG or PEEK-cage, sex, age, number of levels fused, disc level fused, previous neck surgery (except for neck pain, previous neck trauma, or preoperative symptom duration. Two hundred out of the 256 (78% patients evaluated the surgical result as successful. Only 27/256 (11% classified the surgical result as a failure

  13. Anterior cervical discectomy with fusion in patients with cervical disc degeneration: a prospective outcome study of 258 patients (181 fused with autologous bone graft and 77 fused with a PEEK cage)

    Science.gov (United States)

    2010-01-01

    Background Anterior cervical discectomy with fusion (ACDF) is challenging with respect to both patient selection and choice of surgical procedure. The aim of this study was to evaluate the clinical outcome of ACDF, with respect to both patient selection and choice of surgical procedure: fusion with an autologous iliac crest graft (AICG) versus fusion with an artificial cage made of polyetheretherketone (PEEK). Methods This was a non-randomized prospective single-center outcome study of 258 patients who underwent ACDF for cervical disc degeneration (CDD). Fusion was attained with either tricortical AICG or PEEK cages without additional anterior plating, with treatment selected at surgeon's discretion. Radicular pain, neck-pain, headache and patient satisfaction with the treatment were scored using the visual analogue scale (VAS). Results The median age was 47.5 (28.3-82.8) years, and 44% of patients were female. 59% had single-level ACDF, 40% had two level ACDF and 1% had three-level ACDF. Of the patients, 181 were fused with AICG and 77 with a PEEK-cage. After surgery, the patients showed a significant reduction in radicular pain (ΔVAS = 3.05), neck pain (ΔVAS = 2.30) and headache (ΔVAS = 0.55). Six months after surgery, 48% of patients had returned to work: however 24% were still receiving workers' compensation. Using univariate and multivariate analyses we found that high preoperative pain intensity was significantly associated with a decrease in pain intensity after surgery, for all three pain categories. There were no significant correlations between pain relief and the following patient characteristics: fusion method (AICG or PEEK-cage), sex, age, number of levels fused, disc level fused, previous neck surgery (except for neck pain), previous neck trauma, or preoperative symptom duration. Two hundred out of the 256 (78%) patients evaluated the surgical result as successful. Only 27/256 (11%) classified the surgical result as a failure. Patient satisfaction

  14. Effects of different concentrations of Platelet-rich Plasma and Platelet-Poor Plasma on vitality and differentiation of autologous Adipose tissue-derived stem cells.

    Science.gov (United States)

    Felthaus, Oliver; Prantl, Lukas; Skaff-Schwarze, Mona; Klein, Silvan; Anker, Alexandra; Ranieri, Marco; Kuehlmann, Britta

    2017-01-01

    Autologous fat grafts and adipose-derived stem cells (ASCs) can be used to treat soft tissue defects. However, the results are inconsistent and sometimes comprise tissue resorption and necrosis. This might be due to insufficient vascularization. Platelet-rich plasma (PRP) is a source of concentrated autologous platelets. The growth factors and cytokines released by platelets can facilitate angiogenesis. The simultaneous use of PRP might improve the regeneration potential of fat grafts. The optimal ratio has yet to be elucidated. A byproduct of PRP preparation is platelet-poor plasma (PPP). In this study we investigated the influence of different concentrations of PRP on the vitality and differentiation of ASCs. We processed whole blood with the Arthrex Angel centrifuge and isolated ASCs from the same donor. We tested the effects of different PRP and PPP concentrations on the vitality using resazurin assays and the differentiation of ASCs using oil-red staining. Both cell vitality and adipogenic differentiation increase to a concentration of 10% to 20% PRP. With a PRP concentration of 30% cell vitality and differentiation decrease. Both PRP and PPP can be used to expand ASCs without xenogeneic additives in cell culture. A PRP concentration above 20% has inhibitory effects.

  15. Improved fat transplantation survival by using the conditioned medium of vascular endothelial growth factor transfected human adipose-derived stem cells.

    Science.gov (United States)

    Zhang, Yang; Xiao, Li-Ling; Li, Jiang-Xuan; Liu, Hong-Wei; Li, Sheng-Hong; Wu, Yan-Yun; Liao, Xuan; Rao, Cong-Qiang

    2017-08-01

    Autologous fat transplantation has been applied widely in clinic. However, the low survival rate is still a problem to be solved. Studies shows that the human adipose-derived stem cells (ADSCs) transfected by vascular endothelial growth factor (VEGF) can improve the survival rate of autologous fat transplantation. Our study is to evaluate the effects of the conditioned medium of VEGF-transfected human adipose-derived stem cells (VEGF-ADSCs-CM) on fat transplantation. ADSCs were isolated and transfected with MOI = 40. The study was divided into three groups, VEGF-ADSCs-CM group, normal-ADSCs-CM group and control group. The conditioned media for VEGF-ADSCs-CM group and normal-ADSCs-CM group were collected, and then mixed with fat, with the mixtures being injected into the back of nude mice. On 4, 7, 15, 30, 60 days after transplantation, the grafts were evaluated on the wet weight, histology, ELISA and western blot. As the results revealed, the survival rate of VEGF-ADSCs-CM group was highest with the best fat cell morphology, and the VEGF secretion of VEGF-ADSCs-CM group was also highest. Therefore, our study demonstrates that VEGF-ADSCs-CM can improve the survival rate of fat transplantation effectively, and VEGF-ADSCs-CM can be regarded as an effective assisted method for fat transplantation. Copyright © 2017 Kaohsiung Medical University. Published by Elsevier Taiwan. All rights reserved.

  16. Estudo comparativo da neoformação óssea utilizando-se o enxerto autógeno e três substitutos: defeitos ósseos em ratos Comparative study of bone neoformation using autologous grafting and three replacements: bone defects in rats

    Directory of Open Access Journals (Sweden)

    Rodrigo Steffen Stein

    2009-01-01

    Full Text Available OBJETIVO: Comparar a percentagem de neoformação óssea promovida pelo enxerto ósseo autógeno e três tipos de materiais de substituição de características distintas em cavidades em fêmures de ratos. MÉTODOS: Foram realizadas duas cavidades de 5,4 x 2,7mm, em cada fêmur (direito e esquerdo, de 14 ratos Wistar isogênicos. Cada um dos quatro defeitos criados foi preenchido com o osso autógeno ou com um dos três materiais testados - hidroxiapatita (HA, Genphos® (HA+ β-TCP e GenMix® (um enxerto ósseo bovino composto. Ao final dos períodos de seis semanas (n = 6 e 12 semanas (n = 8, os animais foram sacrificados. As lâminas (coradas com Picro-Sirius foram analisadas por microscopia óptica normal e software específico. RESULTADOS: Os grupos com o osso autógeno se mostraram muito superiores aos demais nos dois tempos analisados, tendo média de neoformação óssea ± DP de 90,6 ± 10,8% em seis semanas, e 98 ± 9,2% em 12 semanas (p > 0,0001 em ambos os tempos analisados. Em seis semanas, os resultados para os demais grupos foram os seguintes: Genphos®, 46 ± 7,1%; HA, 43,1 ± 8,4%; e GenMix®, 57,3 ± 4,5%. Em 12 semanas: Genphos®, 47,8 ± 11,1%; HA, 39,9 ± 5,4%; GenMix®, 59,7 ± 4,8%, significativa (p = 0,007. CONCLUSÕES: Em ambos os tempos analisados, os três materiais de substituição óssea testados se mostraram inferiores ao osso autógeno quanto à percentagem de neoformação óssea.OBJECTIVE: Compare the percentage of bone neoformation promoted by autologous bone grafting and three kinds of replacement materials with different characteristics in rats' femoral holes. METHODS: Two holes measuring 5.4 x 2.7mm, were produced on each femur (right and left of 14 isogenic Wistar rats. Each of the four defects produced was filled by autologous bone or by one of three tested materials - hydroxyapatite (HA, Genphos® (HA+ β-TCP and GenMix® (a combined bovine bone graft. In the end of the 6-week (n = 6 and 12-week (n = 8

  17. Survival and regeneration of deep-freeze preserved autologous cranial bones after cranioplasty.

    Science.gov (United States)

    Lu, Yi; Hui, Guozhen; Liu, Fengqiang; Wang, Zhengan; Tang, Yuming; Gao, Shuxing

    2012-04-01

    After decompressive craniectomy, a deep-freeze-preserved autologous cranial bone graft can be used for cranioplasty to avoid immunoreaction against an artificial patch material. Autologous cranial bone grafts not only have better physical properties, such as heat conduction, compared to artificial patch materials, but they also have the advantages of a lower medical cost and satisfactory physical flexibility. The discussion over (99)Tc(m)-MDP SPECT static cranial bone tomography in the diagnosis of survival and regeneration in deep-freeze preservation autologous cranial bones after cranioplasty is valuable. Objective. To investigate whether deep-freeze-preserved autologous cranial bone grafts could survive and regenerate after autologous reimplantation. The method of cranial bone preservation involved removing the cranial graft and sealing it in a double-layer sterile plastic bag under sterile surgical conditions. On the day of the cranioplasty operation, the cranial bone graft was disinfected by immersing it in 3% povidone-iodine for 30 minutes. At short-term (2 weeks), medium-term (3 months), and long-term (12 months) postoperative follow-up visits, (99)Tc(m)-MDP SPECT static cranial bone tomography was used to examine the reimplanted cranial bone. Results. There were no postoperative infections or seromas in all 16 cases. Two weeks following cranial bone graft reimplantation, the SPECT tomography showed some radioactivity uptake in the reimplanted cranial bone graft, which was lower than that in the cranial bone on the healthy side. At 3 months and 12 months after the operation, the radioactivity uptake in the reimplanted cranial bone graft was the same as that in the cranial bone on the healthy side. X-ray films showed blurred sutures in the reimplanted cranial bone graft at 12 months after surgery. Reimplanted deep-freeze-preserved autologous cranial bone can survive in the short term and regenerate in the medium and long terms.

  18. Experimental results and clinical impact of using autologous rectus fascia sheath for vascular replacement

    NARCIS (Netherlands)

    Kobori, Laszlo; Nemeth, Tibor; Nagy, Peter; Dallos, Gabor; Sotonyi, Peter; Fehervari, Imre; Nemes, Balazs; Gorog, Denes; Patonai, Attila; Monostory, Katalin; Doros, Attila; Sarvary, Enikoe; Fazakas, Janos; Gerlei, Zsuzsanna; Benkoe, Tamas; Piros, Laszlo; Jaray, Jeno; De Jong, Koert P.

    Vascular complications are major causes of graft failure in liver transplantation. The use of different vascular grafts is common but the results are controversial. The aim of this study was to create an 'ideal' arterial interponate for vascular replacements in the clinical field. An autologous,

  19. Epidermal grafting versus split-thickness skin grafting for wound healing (EPIGRAAFT): study protocol for a randomised controlled trial

    OpenAIRE

    Kanapathy, Muholan; Hachach-Haram, Nadine; Bystrzonowski, Nicola; Harding, Keith; Mosahebi, Afshin; Richards, Toby

    2016-01-01

    Background Split-thickness skin grafting (SSG) is an important modality for wound closure. However, the donor site becomes a second, often painful wound, which may take more time to heal than the graft site itself and holds the risk of infection and scarring. Epidermal grafting (EG) is an alternative method of autologous skin grafting that harvests only the epidermal layer of the skin by applying continuous negative pressure on the normal skin to raise blisters. This procedure has minimal don...

  20. Differential fat harvesting

    Directory of Open Access Journals (Sweden)

    Sebastian Torres Farr

    2014-12-01

    Full Text Available Aim: Volume replacement with fillers is regularly performed with the use of diverse volumetric materials to correct different structures around the face, depending on the volume enhancement required and the thickness of the soft tissue envelope. Differential fat harvesting and posterior grafting is performed to place the correct fat parcel size for each target area, expanding the potential applications of fat. Methods: Sixty patients consecutively recruited on a first come basis undergone a facial fat grafting procedure, in private practice setting between March 2012 and October 2013. Fat grafting quantity and quality was predicted for each case. Differential harvesting was performed, with 2 fat parcels size. Processing was performed through washing. Fat infiltration was carried out through small cannulas or needles depending on the treated area. Outcomes were analysed both by the physicians and the patients at 7 days, 1 month, 3 months and 6 months through a perceived satisfaction questionnaire. Parameters considered were downtime or discomfort, skin benefits, volume restoration, reabsorption rate estimated and overall improvement. Results: Full facial differential fat grafting procedure lasted an average of 1.5-2.5 h. Average downtime was 3-4 days. Follow-up was performed to a minimum of 6 months. Both patient and physician overall satisfaction rates were mostly excellent. Adverse events like lumps or irregularities were not encountered. Conclusion: Differential fat harvesting and posterior grafting is a valid alternative, to expand the repertoire of fat use, allow a more homogeneous effect, reduce the potential complications, speed up the process, improve graft survival, and to enhance overall aesthetic outcome.

  1. Fat injection to correct contour deformities of the reconstructed breast: a single surgeon experience

    Directory of Open Access Journals (Sweden)

    Youssef Tahiri

    2015-06-01

    Full Text Available Aim: Autologous fat grafting has gained acceptance as a technique to improve aesthetic outcomes in breast reconstruction. The purpose of this study was to share our clinical experience using autologous fat injection to correct contour deformities during breast reconstruction. Methods: A single surgeon, prospectively maintained database of patients who underwent autologous fat injection during breast reconstruction from January 2008 to November 2013 at McGill University Health Center was reviewed. Patient characteristics, breast history, type of breast reconstruction, volume of fat injected, and complications were analyzed. Results: One hundred and twenty-four patients benefited from autologous fat injection from January 2008 to November 2013, for a total of 187 treated breasts. The patients were on average 49.3 years old (΁ 8.9 years. Fat was harvested from the medial thighs (20.5%, flanks (39.1%, medial thighs and flanks (2.9%, trochanters (13.3%, medial knees (2.7%, and abdomen (21.9%. An average of 49.25 mL of fat was injected into each reconstructed breast. A total of 187 breasts in 124 patients were lipo-infiltrated during the second stage of breast reconstruction. Thirteen breasts (in 12 separate patients were injected several years after having undergone lumpectomy and radiotherapy. Of the 187 treated breasts, 118 were reconstructed with expanders to implants, 45 with deep inferior epigastric perforator flaps, 9 with latissimus dorsi flaps with implants, 4 with transverse rectus abdominis myocutaneous flaps, and 13 had previously undergone lumpectomy and radiotherapy. Six complications were noted in the entire series, for a rate of 3.2%. All were in previously radiated breasts. Average follow-up time was 12 months (range: 2-36 months. Conclusion: Fat injection continues to grow in popularity as an adjunct to breast reconstruction. Our experience demonstrates a low complication rate as compared to most surgical interventions of the breast

  2. Novel expansion techniques for skin grafts

    Science.gov (United States)

    Kadam, Dinesh

    2016-01-01

    The quest for skin expansion is not restricted to cover a large area alone, but to produce acceptable uniform surfaces, robust engraftment to withstand mechanical shear and infection, with a minimal donor morbidity. Ease of the technique, shorter healing period and reproducible results are essential parameters to adopt novel techniques. Significant advances seen in four fronts of autologous grafting are: (1) Dermal–epidermal graft expansion techniques, (2) epidermal graft harvests technique, (3) melanocyte-rich basal cell therapy for vitiligo and (4) robust and faster autologous cell cultures. Meek's original concept that the sum of perimeter of smaller grafts is larger than the harvested graft, and smaller the graft size, the greater is the potential for regeneration is witnessed in newer modification. Further, as graft size becomes smaller or minced, these micrografts can survive on the wound bed exudate irrespective of their dermal orientation. Expansion produced by 4 mm × 4 mm sized Meek micrografts is 10-folds, similarly 0.8 mm × 0.8 mm size micrografts produce 100-fold expansion, which becomes 700-fold with pixel grafts of 0.3 mm × 0.3 mm size. Fractional skin harvest is another new technique with 700 μ size full thickness graft. These provide instant autologous non-cultured graft to cover extensive areas with similar quality of engraftment surface as split skin grafts. Newer tools for epidermal blister graft harvest quickly, with uniform size to produce 7-fold expansions with reproducible results. In addition, donor area heals faster with minimal scar. Melanocyte-rich cell suspension is utilised in vitiligo surgery tapping the potential of hair root melanocytes. Further advances in the cell culture to reduce the cultivation time and provide stronger epidermal sheets with dermal carrier are seen in trials. PMID:27274117

  3. Síndrome da angústia respiratória do adulto por embolia gordurosa no período pós-operatório de lipoaspiração e lipoenxertia Adult respiratory distress syndrome due to fat embolism in the postoperative period following liposuction and fat grafting

    Directory of Open Access Journals (Sweden)

    André Nathan Costa

    2008-08-01

    Full Text Available A embolia gordurosa é definida como a ocorrência de bloqueio mecânico da luz vascular por gotículas circulantes de gordura. Acomete principalmente o pulmão, podendo afetar também o sistema nervoso central, a retina e a pele. A síndrome da embolia gordurosa é uma disfunção desses órgãos causada pelos êmbolos gordurosos. As causas mais comuns de embolia gordurosa e síndrome da embolia gordurosa são as fraturas de ossos longos, mas há relatos de sua ocorrência após procedimentos estéticos. O diagnóstico é clínico, e o tratamento ainda se restringe a medidas de suporte. Apresentamos o caso de uma paciente que evoluiu com síndrome da angústia respiratória do adulto por embolia gordurosa no período pós-operatório de lipoaspiração e lipoenxertia e respondeu bem às manobras de recrutamento alveolar e à ventilação mecânica protetora.Apresentamos também uma análise epidemiológica e fisiopatológica da síndrome da embolia gordurosa após procedimentos estéticos.Fat embolism is defined as mechanical blockage of the vascular lumen by circulating fat globules. Although it primarily affects the lungs, it can also affect the central nervous system, retina, and skin. Fat embolism syndrome is a dysfunction of these organs caused by fat emboli. The most common causes of fat embolism and fat embolism syndrome are long bone fractures, although there are reports of its occurrence after cosmetic procedures. The diagnosis is made clinically, and treatment is still restricted to support measures. We report the case of a female patient who developed adult respiratory distress syndrome due to fat embolism in the postoperative period following liposuction and fat grafting. In this case, the patient responded well to alveolar recruitment maneuvers and protective mechanical ventilation. In addition, we present an epidemiological and pathophysiological analysis of fat embolism syndrome after cosmetic procedures.

  4. Uso de factores de crecimiento plaquetar unidos a injertos de grasa para lipofiling facial en ritidectomía Use of fat grafts enriched with platelet growth factors for facial lipofiling in ritidectomy

    Directory of Open Access Journals (Sweden)

    J.M. Serra Renom

    2006-09-01

    Full Text Available Presentamos una serie de pacientes a los que hemos realizado infiltraciones de grasa enriquecida con Factores de Crecimiento Plaquetario (F.C.P. como único procedimiento. Igualmente presentamos casos donde las infiltraciones van acompañadas con otros procedimientos (lifting temporal, lifting cérvico-frontal, etc.. También usamos el plasma rico en F.C.P. en forma de coágulo para rellenar el surco de la cuenca orbitaria (“Tear Through”, y como mesoterapia facial enriquecida con nutrientes. El objetivo de este trabajo es presentar una revisión detallada de los pasos a seguir para la realización de éste procedimiento, que van desde la simple extracción de sangre para la posterior obtención de F.C.P. hasta la técnica de infiltración de grasa enriquecida con dichos factores a nivel facial. Con esta técnica de enriquecimiento de la grasa hemos logrado tener mejores resultados y con mayor permanencia. Evaluando los postoperatorios de pacientes sometidos a este procedimiento, hemos observado que el volumen infiltrado en áreas como la región malar, se mantiene entre un 90% a 95%. En otras áreas como labios y surcos nasogenianos (áreas de gran movilidad, solo permanece entre el 50% a 60% del volumen infiltrado.We present a serie of patients with facial fat infiltration enriched with platelet-derived growth factors, some of them associated to other surgical procedures (temporal lifting, cervico-frontal lifting, etc. We explain how to use this platelet - rich plasma to fill the tear - through and as a facial mesotherapy. Our purpose is to present a detailled review of our method: since blood extraction to the last obtention of the platelet - derived growth factors and the use of this plasma combined with fat infiltration in the facial area. With this methodology we have got better and more permanent results. We have evaluated 90-95 % fat grafts survival in malar region. In other facial areas such as lips or nasogenian folds (big movement

  5. Clinical application and histological properties of autologous tissue-engineered skin equivalents using an acellular dermal matrix.

    Science.gov (United States)

    Takami, Yoshihiro; Yamaguchi, Ryo; Ono, Shimpei; Hyakusoku, Hiko

    2014-01-01

    We developed a transplantable tissue-engineered skin equivalent composed of autologous cultured keratinocytes, fibroblasts, and a decellularized allogeneic dermis (acellular allogeneic dermal matrix; ADM) obtained from cadavers. In a process taking 3 weeks, cultured autologous keratinocytes from burn patients were expanded and then grown on ADMs. The tissue-engineered autologous skin equivalents (TESEs) were then transplanted in a one-stage procedure to the debrided third-degree burn wounds of 4 patients. The mean graft survival rate was 96%. Delayed graft loss and graft fragility were not observed. Histological and immunohistological findings indicated that the transplanted TESE had similar characteristics to normal human split-thickness skin grafts. These results suggest that the TESE using ADM can be used for permanent repair of full-thickness skin defects.

  6. Repair of a large congenital frontal bone defect with autologous exchange cranioplasty.

    Science.gov (United States)

    Ropper, Alexander E; Rogers, Gary F; Ridgway, Emily B; Proctor, Mark R

    2010-11-01

    The authors report the case of a large idiopathic frontal bone defect and concomitant sagittal synostosis corrected by autologous exchange cranioplasty by using a corticocancellous bone graft and cranial vault expansion. An otherwise healthy, developmentally normal 6-year-old girl presented to our clinic with a large frontal bone defect. The osseous defect was midline and inferior to the coronal sutures, and the underlying dura was slightly tense. She had no signs or symptoms of increased intracranial pressure, and her head circumference and cephalic index were normal. Imaging demonstrated fusion of the sagittal synostosis. The defect was repaired using full-thickness autologous bone harvested from the bilateral parietal regions, which were widened using barrel-stave osteotomies to reduce pressure on the graft site in the setting of sagittal synostosis and mild cranial narrowing. The donor sites were covered with autologous particulate bone graft harvested from the endocortical surface of the grafted segments and the ectocortical surface of the intact parietal bones. The donor and recipient sites healed. Imaging revealed that the particulate bone healed with a thickness similar to the surrounding bone. This bony defect is analogous to parietal foramina and may have a similar etiopathogenesis. The technique of autologous exchange cranioplasty using corticocancellous particulate bone graft provides a simple and reliable method to repair large structural calvarial defects.

  7. The effect of lipoaspirates vs. dissected abdominal fat on breast cancer cells in vitro.

    Science.gov (United States)

    Almarzouqi, Faris; Rennekampff, Hans-Oliver; Stromps, Jan-Philipp; Alharbi, Ziyad; Pallua, Norbert

    2017-03-21

    Cancer cells are typically surrounded by stromal cells and embedded in extracellular matrix (ECM). The stromal compartment interacts with cancer cells to promote growth and metastasis. For decades, autologous fasciocutaneous flaps have been safely applied for breast reconstruction after mastectomy. In contrast, the safety of fat grafting (lipofilling) procedure has been under debate regarding the risk of cancer recurrence. Harvested fat tissue (lipoaspirates) and dissected abdominal fat (DAF) were co-cultured with MCF-7 breast cancer cells. The vitality of MCF-7 cells was measured using AlamarBlue ® consecutively for 5 days. ECM degradation was determined by detection of matrix metalloproteinase-1 (MMP-1) expression in MCF-7 cells. Integrin α2 was measured by Western blot to assess the degree of adhesion and motility of MFC-7 cells. The MCF-7 proliferation increased substantially when co-cultured with fat tissue. However, there was no significant difference between the proliferation stimulating effects of lipoaspirates and DAF. Similarly, MMP-1 protein expression was equally elevated in MCF-7 cells by both lipoaspirates and DAF. Importantly, MCF-7 cells showed an increased level of integrin α2 once co-cultured with either lipoaspirates or DAF. Fat tissue increases the proliferation of MCF-7 cells in vitro. Our data suggest that lipoaspirates as well as DAF might possess a considerable potency to promote tumorigenic growth of breast cancer cells. Thus, clinical trials are needed to address the safety of lipofilling by breast reconstruction surgery after mastectomy.

  8. Autologous Stem Cell Transplantation in Patients with Acute Myeloid Leukemia: a Single-Centre Experience

    Directory of Open Access Journals (Sweden)

    Kakucs Enikő

    2013-04-01

    Full Text Available Introduction: Autologous haemopoietic stem cell transplantation (SCT is an important treatment modality for patients with acute myeloid leukemia with low and intermediate risk disease. It has served advantages over allogenic transplantation, because it does not need a matched donor, there is no graft versus host disease, there are less complications and a faster immune reconstitution than in the allo-setting. The disadvantage is the lack of the graft versus leukaemia effect.

  9. beta-TCP Versus Autologous Bone for Repair of Alveolar Clefts in a Goat Model.

    NARCIS (Netherlands)

    Ruiter, A. de; Meijer, G.J.; Dormaar, T.; Janssen, N.; Bilt, A. van der; Slootweg, P.J.; Bruijn, J. de; Rijn, L. van; Koole, R.A.

    2011-01-01

    Objective : The aim of this study in goats was to test the hypothesis that a novel synthetic bone substitute beta tricalcium phosphate (beta-TCP) can work as well as autologous bone harvested from the iliac crest for grafting and repair of alveolar clefts. Design : Ten adult Dutch milk goats ( Capra

  10. Autologous epidermal cell suspension: A promising treatment for chronic wounds.

    Science.gov (United States)

    Zhao, Hongliang; Chen, Yan; Zhang, Cuiping; Fu, Xiaobing

    2016-02-01

    Chronic wounds have become an increasing medical and economic problem of aging societies because they are difficult to manage. Skin grafting is an important treatment method for chronic wounds, which are refractory to conservative therapy. The technique involving epidermal cell suspensions was invented to enable the possibility of treating larger wounds with only a small piece of donor skin. Both uncultured and cultured autologous epidermal cell suspensions can be prepared and survive permanently on the wound bed. A systematic search was conducted of EMBASE, Cochrane Library, PubMed and web of science by using Boolean search terms, from the establishment of the database until May 31, 2014. The bibliographies of all retrieved articles in English were searched. The search terms were: (epithelial cell suspension OR keratinocyte suspension) and chronic and wound. From the included, 6 studies are descriptive interventions and discussed the use of autologous keratinocyte suspension to treat 61 patients' chronic wound. The various methods of preparation of epidermal cell suspension are described. The advantages and shortcomings of different carriers for epidermal cell suspensions are also summarised. Both uncultured and cultured autologous epidermal cell suspensions have been used to treat chronic wounds. Although the limitations of these studies include the small number of patient populations with chronic wounds and many important problems that remain to be solved, autologous epidermal cell suspension is a promising treatment for chronic wounds. Copyright © 2015 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  11. Comparative Study Using Autologous Fat Grafts Plus Platelet-Rich Plasma With or Without Fractional CO2 Laser Resurfacing in Treatment of Acne Scars: Analysis of Outcomes and Satisfaction With FACE-Q.

    Science.gov (United States)

    Tenna, S; Cogliandro, A; Barone, M; Panasiti, Vincenzo; Tirindelli, M; Nobile, Carolina; Persichetti, Paolo

    2017-06-01

    A multitude of options are traditionally used for the treatment of acne scars; however, newer treatment modalities are emerging to decrease the propensity for post-inflammatory hyperpigmentation and upregulate new collagen production. The aim of this study was to evaluate the efficacy of nanofat and platelet-rich plasma (PRP) infiltration alone and combined with fractional CO 2 laser resurfacing to improve atrophic scars of the face. From March 2014 to June 2015, 30 patients with atrophic acne scars on the cheeks were selected for this study. Patients were evaluated pre- and postoperatively by physical examination, photographs and ultrasound with a 22-MHz probe to measure subcutaneous tissue thickness. All patients were treated with infiltration of nanofat plus PRP. The production of PRP was achieved using the RegenLab THT tube ® method. In 15 randomly chosen patients, a fractional CO 2 laser resurfacing at 15 W was also performed right after the infiltration. An Italian version of the FACE-Q postoperative module was administered to analyze each patient's satisfaction and aesthetic perception of the result. The average preoperative thickness of subcutaneous tissue of patients from group A was 0.532 cm, while the average preoperative thickness of subcutaneous tissue of patients from group B was 0.737 cm. The average postoperative thickness of subcutaneous tissue was 1.201 cm in group A and 1.367 cm in group B. The improvement of thickness of subcutaneous tissue was 0.668 cm in group A and 0.63 cm in group B. We applied a t test on unpaired data, comparing the difference in thickness obtained with the treatment in both group A and in group B, with a p value =0.7289 (not significant). All patients in both groups had a treatment benefit, confirmed with FACE-Q postoperative module, but without a significant difference between the two groups. Subcutaneous infiltration with nanofat and PRP seems to be effective to improve atrophic scars, either alone or combined with fractional CO 2 laser resurfacing. The FACE-Q module confirmed the impact of treatment of facial acne scars in social life and relationships. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  12. Autologous bone marrow transplantation following chemotherapy and irradiation in dogs with spontaneous lymphomas

    International Nuclear Information System (INIS)

    Bowles, C.A.; Bull, M.; McCormick, K.; Kadin, M.; Lucas, D.

    1980-01-01

    Thirty dogs with spontaneous lymphomas were administered two to six cycles of chemotherapy and were randomized into 3 groups to receive 800 rads of total body irradiation and autologous bone marrow transplantation. Of 10 dogs irradiated after chemotherapy-induced remission and infused with remission marrow (group 1), 8 (80%) had successful grafts and experienced remissions lasting 62 to 1024 days. Of 9 dogs irradiated during remission and infused with remission marrow mixed with autologous tumor cells (group 2), 6 (66%) had remission lasting 15 to 45 days. Eleven dogs with progressive tumor growth (relapse) following chemotherapy were irradiated and infused with remission marrow (group 3). Tumor remission lasting 39 to 350 days was observed in 5 dogs (45%) in this group, and 6 dogs died in less than 30 days. Dogs in groups 1 to 3 had median survival times of 216, 60, and 45 days, respectively. The prolonged survival times for dogs in group 1 compared to dogs in groups 2 and 3 suggest that protocols involving irradiation and autologous marrow grafting in this model would be most effective when these protocols are applied to animals having a minimum tumor burden at the time of irradiation and when the grafting is done with tumor-free autologous marrow

  13. Indirect MR-arthography in the fellow up of autologous osteochondral transplantation; Indirekte MR-Arthrographie zur Verlaufskontrolle nach autologer osteochondraler Transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Herber, S.; Pitton, M.B.; Kalden, P.; Thelen, M.; Kreitner, K.F. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Radiologie; Runkel, M. [Mainz Univ. (Germany). Klinik und Poliklinik fuer Unfallchirurgie

    2003-02-01

    Purpose: To evaluate the spectrum of findings in indirect MR-arthrography following autologous osteochondral transplantation. Patients and Methods: 10 patients with autogenous osteochondral homografts underwent indirect MR-arthrography at three, 6 and 12 months postoperatively. The MR protocol at 1.5T comprised unenhanced imagings with PD- and T{sub 2}-weighted TSE-sequences with and without fat-suppression as well as T{sub 1}-weighted fat-suppressed SE-sequences before and after iv. contrast administration and after active joint exercise. Image analysis was done by two radiologists in conference and comprised the evaluation of signal intensity (SI) and integrity of the osseous plug and the cartilage surface, as well as the presence of joint effusion or bone marrow edema. Results: At three months, all cases demonstrated a significant bone marrow edema at the recipient and donor site that corresponded to a significant enhancement after iv. contrast administration. The interface between the transplant and the normal bone showed an increased SI at three and 6 months in T{sub 2}-weighted images as well as in indirect MR-arthrography. The marrow signal normalized in most cases after 6 to 12 months, indicating vitality and healing of the transplanted osteochondral graft. The SI of the interface decreased in the same period, demonstrating the stability of the homograft at the recipient site. The osteochondral plugs were well-seated in 9/10 cases. Indirect MR-arthrography was superior to unenhanced imaging in the assessment of the cartilage surface. Cartilage coverage was complete in every case. The transplanted hyaline cartilage as well as the original cartilage showed a significant increase of the SI in indirect MR-arthrography, that did not change in follow up studies. There were no pathological alterations of signal and thickness alterations of the transplanted cartilage in follow up investigations. Conclusion: Indirect MR-arthrography is a useful diagnostic tool

  14. Bone graft extenders and substitutes in the thoracolumbar spine.

    Science.gov (United States)

    Arner, Justin W; Daffner, Scott D

    2012-05-01

    Autologous iliac crest bone graft remains the gold standard for lumbar fusion. The potential for complications has led to the development of alternative bone graft materials and enhancers, including autologous growth factors, demineralized bone matrix products, osteoinductive agents, and ceramic products. The current literature centers mainly on preclinical studies, which, further complicating the situation, evaluate these products in different clinical scenarios or surgical techniques. Autologous growth factors and demineralized bone matrix products have had promising results in preclinical studies, but few strong clinical studies have been conducted. Ceramic extenders were evaluated with other substances and had good but often inconsistent results. Bone morphogenetic proteins have been extensively studied and may have benefits as osteoinductive agents. Category comparisons are difficult to make, and there are differences even between products within the same category. The surgeon must be knowledgeable about products and their advantages, disadvantages, indications, contraindications, and possible applications so that they can make the best choice for each patient.

  15. Grafting of venous leg ulcers. An intraindividual comparison between cultured skin equivalents and full-thickness skin punch grafts

    NARCIS (Netherlands)

    Mol, M. A.; Nanninga, P. B.; van Eendenburg, J. P.; Westerhof, W.; Mekkes, J. R.; van Ginkel, C. J.

    1991-01-01

    Skin equivalents that consisted of a noncontracted collagen gel populated with allogeneic fibroblasts and covered with autologous cultured keratinocytes were used for grafting venous leg ulcers. The results were compared in the same patient with those obtained with a routinely used standard method

  16. Skin grafting in severely contracted socket with the use of ′Compo′

    Directory of Open Access Journals (Sweden)

    Betharia S

    1990-01-01

    Full Text Available The results of split thickness autologous skin grafting along with the use of a dental impression material (Compo, a thermoplastic substance are presented in a series of 11 patients of acquired, severely contracted, anophthalmic sockets. Only the fornix fixation sutures and the central tarsorrhaphy were employed for the proper placement of graft without the use of retention devices. Artificial eyes were successfully fitted and retained subsequently after 6 weeks of grafting.

  17. [Platelet-rich plasma combined with autologous cancellous bone : An alternative therapy for persistent non-union?].

    Science.gov (United States)

    Hakimi, M; Jungbluth, P; Thelen, S; Betsch, M; Linhart, W; Flohé, S; Windolf, J; Wild, M

    2011-11-01

    In addition to a stabile osteosynthesis autologous cancellous bone graft remains an essential therapy option in persistent non-union. Despite this therapy regimen persistent non-union can occasionally occur. The aim of this study was to evaluate the treatment of persistent non-union with a combination of platelet-rich plasma (PRP) and autologous cancellous bone. In this prospective study 17 patients with persistent non-union of long bones were treated by a combination of PRP and autologous iliac crest bone. Inclusion criteria were a minimum of one previously failed cancellous bone transplantation and an atrophic non-union persisting for 6-14 months (mean 9 months). The patients were examined clinically and radiologically at intervals of 3, 6 and 9 months postoperatively. After an average time of 17 months (range 15-23 months) the patients were treated by a combination of PRP and autologous cancellous bone. In all cases the non-union was successfully treated and osseous bridging was found radiologically after an average of 5 months (range 4-7 months) without any complications. The combination of PRP and autologous cancellous bone appears to be a safe and effective method for treatment of persistent non-union. The use of PRP does not result in substantial additional costs. Allergies and graft versus host reactions are not expected because of the autologous origin.

  18. Thrombosis of the internal mammary artery during delayed autologous breast reconstruction: A manifestation of occult residual cancer

    OpenAIRE

    Alexandra Bucknor; Mobinulla Syed; Gerald Gui; Stuart James

    2016-01-01

    A prothombotic state may be a manifestation of malignancy, either primary or recurrent. In this report we present a case of thrombosis of the internal mammary artery during delayed autologous breast reconstruction occurring in association with, and as a possible manifestation of, occult recurrent breast cancer. We discuss salvage of the microsurgical anastomosis using a vein graft and microvascular anastomotic coupler device.

  19. Rebooting autoimmunity with autologous HSCT.

    Science.gov (United States)

    Snowden, John A

    2016-01-07

    Autologous hematopoietic stem cell transplantation (HSCT) is increasingly used for severe autoimmune and inflammatory diseases, but the mechanisms involved have yet to be elucidated. In this issue of Blood, Delemarre et al report their findings in both animal and human models which provide insights into restoration of functionality and diversity within the regulatory T-cell (Treg) compartment following HSCT.

  20. Fresh-frozen bone: case series of a new grafting material for sinus lift and immediate implants.

    LENUS (Irish Health Repository)

    Viscioni, A

    2010-08-01

    Although autologous bone is considered to be the gold standard grafting material, it needs to be harvested from patients, a process that can be off-putting and can lead to donor site morbidity. For this reason, homologous fresh-frozen bone (FFB) was used in the current study as an alternative graft material.

  1. [Construction of a capsular tissue-engineered ureteral stent seeded with autologous urothelial cells].

    Science.gov (United States)

    Tan, Haisong; Fu, Weijun; Li, Jianqiang; Wang, Zhongxin; Li, Gang; Ma, Xin; Dong, Jun; Gao, Jiangping; Wang, Xiaoxiong; Zhang, Xu

    2013-01-01

    To investigate the feasibility of constructing a capsular poly L-lactic acid (PLLA) ureteral stent seeded with autologous urothelial cells using tissue engineering methods. The capsular ureteral stent was constructed by subcutaneously embedding PLLA ureteral stent in the back of beagles for 3 weeks to induce the formation of connective tissue on the surfaces. After decellularization of the stent, the expanded autologous urothelial cells were seeded on the stent. The surface structure and cell adhesion of the stent were observed using HE staining, scanning electron microscope (SEM) and immunocytochemical staining. MTT assay was used to evaluate urothelial cell proliferation on the capsular PLLA ureteral stent and on circumferential small intestinal submucosa graft. HE staining and VIII factor immunohistochemistry revealed numerous capillaries in the connective tissue encapsulating the stent without obvious local inflammatory response. The results of SEM and immunocytochemical staining showed that the capsule contained rich collagenic fibers forming three-dimensional structures, and the seeded autologous urothelial cells could adhere and well aligned on the surface. MTT assay showed normal growth of the cells on the stent as compared with the cells grown on circumferential small intestinal submucosa graft. The capsular PLLA ureteral stent allows adhesion and proliferation of autologous urothelial cells and shows a potential in applications of constructing tissue-engineered ureter.

  2. Harvest of autologous clavipectoral fascia for use in duraplasty: cadaveric feasibility study.

    Science.gov (United States)

    Louis, Robert G; Tubbs, R Shane; Mortazavi, Martin M; Shoja, Mohammadali M; Loukas, Marios; Cohen-Gadol, Aaron A

    2013-03-01

    Techniques and materials for repair of dural defects following neurosurgical procedures vary. Given higher complication rates with nonautologous duraplasty materials, most authors strongly recommend autologous grafts. To expand the arsenal of possible materials available to the neurosurgeon, we propose the use of autologous clavipectoral fascia as an alternative donor for duraplasty. Eight embalmed adult cadavers underwent dissection of the pectoral region. A 12-cm curvilinear skin incision was made 2 cm inferior to the nipple in males and along the inferior breast edge in females. Dissection was continued until the clavipectoral fascia was encountered, and a tissue plane was developed between this fascia and the deeper pectoralis major muscle. Sections of clavipectoral fascia were used for duraplasty in the same specimens. In all specimens, removal of clavipectoral fascia was easily performed with tissue separation between the overlying fascia and underlying muscle. Only small adhesions were found between the fascia and underlying muscle, and these were easily transected. No obvious gross neurovascular injuries were identified. Large portions of clavipectoral fascia were available, and at least a 10 × 10-cm piece (average thickness, 1.2 mm) was easily harvested for all specimens. Clavipectoral fascia shares characteristics with materials such as pericranium and fascia lata that have been used successfully in duraplasty, and most importantly, it is autologous. Theoretically, using clavipectoral fascia would reduce the risk of muscle herniation. It offers an alternative source for autologous dural grafting when other sources are unavailable or exhausted. Clinical experience with this fascia is warranted.

  3. Comparação entre os resultados obtidos na reconstrução do ligamento cruzado anterior do joelho utilizando dois tipos de enxertos autólogos: tendão patelar versus semitendíneo e grácil Comparison between the results achieved in anterior cruciate ligament reconstruction with two kinds of autologous grafts: patellar tendon versus semitendinous and gracilis

    Directory of Open Access Journals (Sweden)

    Rene Jorge Abdalla

    2009-06-01

    Full Text Available OBJETIVO: O objetivo deste trabalho é comparar os resultados da artrometria e do exame isocinético entre dois tipos de enxertos autólogos: o terço central do ligamento patelar e o formado pelos tendões dos músculos semitendíneo e grácil, dentro de um mesmo protocolo de reabilitação no sexto mês pós-operatório. MATERIAIS E MÉTODOS: Foram analisados os resultados obtidos dos exames realizados em 63 pacientes divididos em dois grupos. Em um grupo de 30 pacientes, utilizou-se o tendão patelar como enxerto e em outro grupo de 33 pacientes, utilizou-se o tendão dos músculos semitendíneo e grácil. Ambos os enxertos foram fixados da mesma forma, com EndobuttonTM para fixação suspensória no fêmur e um parafuso de interferência bioabsorvível para fixação no túnel tibial. RESULTADOS: A artrometria 30 não apresentou diferença estatística entre os dois grupos observados. Já na avaliação isocinética, constatou-se que o grupo de tendão patelar possui em média maior pico de torque de flexão e maior déficit de extensão e o grupo de flexores possui, em média, melhor relação flexão/extensão e maior déficit de flexão percentual. Não há diferença estatística significante entre os grupos quanto à medida de pico de torque de extensão. CONCLUSÃO: portanto, no presente estudo, quando o tendão patelar é utilizado, há maior déficit extensor e quando são utilizados os tendões flexores, há maior déficit flexor.OBJECTIVE: this study aims to compare the arthrometric and isokinetic examination results from two types of autologous grafts: the central third of the patellar ligament and a graft formed by the tendons of the semitendinosus and gracilis muscles, within the same rehabilitation protocol, six months after the surgery. METHODS: the results from examinations carried out on 63 patients were analyzed. These patients were divided in two groups: one group of 30 patients who received a patellar tendon graft and

  4. The Relationship of a Combination of Human Adipose Tissue-Derived Stem Cells and Frozen Fat with the Survival Rate of Transplanted Fat.

    Science.gov (United States)

    Ha, Ki-Young; Park, Hojin; Park, Seung-Ha; Lee, Byung-Il; Ji, Yi-Hwa; Kim, Tae-Yeon; Yoon, Eul-Sik

    2015-11-01

    The survival rate of grafted fat is difficult to predict, and repeated procedures are frequently required. In this study, the effects of the freezing period of harvested adipose tissue and the addition of human adipose tissue-derived stem cells (ASCs) on the process of fat absorption were studied. Adipose tissue was obtained from patients who underwent a lipoaspirated fat graft. The fat tissue was cryopreserved at -20℃ in a domestic refrigerator. A total of 40 nude mice were used. The mice in the experimental group received three different subcutaneous injections in the back: an injection of fresh fat and ASCs, an injection of fat that had been frozen for one month and ASCs, and an injection of fat that had been frozen for two months and ASCs. The control mice received fat grafts without ASCs. The mice were sacrificed at four or eight weeks after the procedure, and the grafted fat tissues were harvested. The extracted fat was evaluated using photographic analysis, volume measurements, and histological examination. In the control group, the fat resorption rates four weeks after transplantation in the grafts of fresh fat, fat that had been frozen for one month, and fat that had been frozen for two months were 21.14%, 22.46%, and 42.56%, respectively. In the experimental group, the corresponding resorption rates were 6.68%, 13.0%, and 33.9%, respectively. ASCs can increase the fat graft survival rate. The use of ASCs in fat grafting can reduce the need for repeated fat grafts and provide good long term results.

  5. Trimming the fat: obesity and hematopoietic cell transplantation.

    Science.gov (United States)

    Weiss, B M; Vogl, D T; Berger, N A; Stadtmauer, E A; Lazarus, H M

    2013-09-01

    Obesity, increasing worldwide, is common in patients undergoing hematopoietic cell transplantation (HCT). This complex physiological state may alter the outcome of cancer therapies by many mechanisms including direct effects on pathogenesis, host responses to disease and altered pharmacology of chemotherapy. Obesity has been associated with multiple adverse health outcomes. Reports of obese patients undergoing HCT are challenging to interpret because of the heterogeneity of obesity definitions, underlying diseases, graft sources and chemotherapy regimens employed. Compared with normal-weight patients, it appears that obese patients undergoing allogeneic HCT have a higher risk of non-relapse mortality and inferior survival whereas those receiving autologous HCT appear to have equivalent outcomes. These findings are also difficult to interpret because there is no consistent standard for calculating chemotherapy dose in this group and future studies on specific regimens in this population are urgently needed. Patients who have undergone bariatric surgery may be at risk for unexpected events because of impaired nutritional state and altered pharmacokinetics of oral drugs. We recommend that future studies utilize more consistent and biologically relevant definitions of obesity and that the pharmacokinetics and pharmacodynamics of specific conditioning regimens be studied. Until more evidence is available, a rationale is presented for dosing based on adjusted body weight. Moreover, recommendations are provided to guide future research efforts based on more definitive measurements of body fat and its distribution available through modern quantitative imaging techniques using dual energy X-ray absorptiometry or magnetic resonance imaging scanning.

  6. Maxillary sinus augmentation procedures through equine-derived biomaterial or calvaria autologous bone: immunohistochemical evaluation of OPG/RANKL in humans

    Directory of Open Access Journals (Sweden)

    S. Tetè

    2013-02-01

    Full Text Available Autologous bone is considered the gold standard for bone regeneration, even if different heterologous bone substitutes have been proposed to overcome the limits related to its use. The aim of this study was to analyze and to compare the molecular events switched on by autologous or heterologous bone graft insertion, focusing on TGFβ1 expression and OPG/RANKL ratio, to analyze resorption process, and estimating graft vascularization, new bone tissue deposition and its mineralization, through VEGF, BSP and SPARC expression evaluation, respectively. Patients needing pre-prosthetic rehabilitation of the posterior maxilla were treated using an equine-derived biomaterial (Group 1 or calvaria autologous bone (Group 2, according to the morphology of the bone defect. Bone graft integration was evaluated on bone samples obtained from the treated areas at the moment of dental implant insertion, by morphological and immunohistochemical analyses for TGFβ1, OPG, RANKL, VEGF, BSP, and SPARC expression. Morphological analysis shows the presence of biomaterial residual granules in Group 1, in parallel to a good integration between graft and host tissue. Moderate TGFβ1 expression is seen in both Group 1 and Group 2. OPG/RANKL ratio appear higher in Group 1; VEGF expression appears very strong in Group 1 and strong in Group 2, while BSP and SPARC expression results weak in Group 1 and moderate in Group 2. Results reveal the good integration between both types of graft and the host tissue, even though autologous graft seems to produce a faster regenerative process, as evidenced by the different expression of the investigated molecules. According to these observations, the clinical use of heterologous particulate equine-derived biomaterial may ensure long-term predictability of implant-prosthetic rehabilitation, comparable to that obtained with autologous bone graft.

  7. Contemporary Review of Grafting Techniques for the Surgical Treatment of Peyronie's Disease.

    Science.gov (United States)

    Hatzichristodoulou, Georgios; Osmonov, Daniar; Kübler, Hubert; Hellstrom, Wayne J G; Yafi, Faysal A

    2017-10-01

    Peyronie's disease (PD) is a benign fibrotic disorder of the tunica albuginea of the penis, which can cause penile pain, curvature, shortening, erectile dysfunction, and psychological distress. Surgery is indicated when penile curvature prevents satisfactory sexual intercourse. Plaque incision or excision with grafting has been suggested as an option in patients with a penile curvature greater than 60°, a shortened penis, and/or an hourglass or complex deformity. To provide an overview of recent studies reporting outcomes of grafting techniques and to report advances in the development of new grafting materials for PD surgery. A literature review was performed through PubMed from 2011 through 2016 regarding grafting techniques for PD. Key words used for the search were grafting techniques, grafts, graft materials, Peyronie's disease, surgical outcomes, and surgical therapy. To report on novel and promising graft materials for PD and to discuss surgical techniques, outcomes, and limitations. Discussed outcomes include postoperative penile straightening, shortening, erectile function, glans sensation, and patient satisfaction. Various surgical techniques and grafting materials can be used for the coverage of the tunica albuginea defect after partial plaque excision or incision. Autologous and non-autologous grafts have been used in this setting. A major advantage of the available "off-the-shelf" grafts is that they do not require donor site harvesting, thus decreasing morbidity and operative time. Tissue-engineered grafts represent the future, but more research is needed to further improve surgical handling and postoperative outcomes. Patients opting for grafting techniques should have sufficient erectile rigidity preoperatively. Surgeon experience, careful patient selection, patient preference, and type of penile deformity affect the choice of graft and surgical approach used. Hatzichristodoulou G, Osmonov D, Kübler H, et al. Contemporary Review of Grafting

  8. Stent graft placement for dysfunctional arteriovenous grafts

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Gyeong Sik [Dept. of Radiology, CHA Bundang Medical Center, College of Medicine, CHA University, Seongnam (Korea, Republic of); Shin, Byung Seok; Ohm, Joon Young; Ahn, Moon Sang [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2015-07-15

    This study aimed to evaluate the usefulness and outcomes of stent graft use in dysfunctional arteriovenous grafts. Eleven patients who underwent stent graft placement for a dysfunctional hemodialysis graft were included in this retrospective study. Expanded polytetrafluoroethylene covered stent grafts were placed at the venous anastomosis site in case of pseudoaneurysm, venous laceration, elastic recoil or residual restenosis despite the repeated angioplasty. The patency of the arteriovenous graft was evaluated using Kaplan-Meier analysis. Primary and secondary mean patency was 363 days and 741 days. Primary patency at 3, 6, and 12 months was 82%, 73%, and 32%, respectively. Secondary patency at the 3, 6, 12, 24, and 36 months was improved to 91%, 82%, 82%, 50%, and 25%, respectively. Fractures of the stent graft were observed in 2 patients, but had no effect on the patency. Stent graft placement in dysfunctional arteriovenous graft is useful and effective in prolonging graft patency.

  9. Dynamic, nondestructive imaging of a bioengineered vascular graft endothelium.

    Directory of Open Access Journals (Sweden)

    Bryce M Whited

    Full Text Available Bioengineering of vascular grafts holds great potential to address the shortcomings associated with autologous and conventional synthetic vascular grafts used for small diameter grafting procedures. Lumen endothelialization of bioengineered vascular grafts is essential to provide an antithrombogenic graft surface to ensure long-term patency after implantation. Conventional methods used to assess endothelialization in vitro typically involve periodic harvesting of the graft for histological sectioning and staining of the lumen. Endpoint testing methods such as these are effective but do not provide real-time information of endothelial cells in their intact microenvironment, rather only a single time point measurement of endothelium development. Therefore, nondestructive methods are needed to provide dynamic information of graft endothelialization and endothelium maturation in vitro. To address this need, we have developed a nondestructive fiber optic based (FOB imaging method that is capable of dynamic assessment of graft endothelialization without disturbing the graft housed in a bioreactor. In this study we demonstrate the capability of the FOB imaging method to quantify electrospun vascular graft endothelialization, EC detachment, and apoptosis in a nondestructive manner. The electrospun scaffold fiber diameter of the graft lumen was systematically varied and the FOB imaging system was used to noninvasively quantify the affect of topography on graft endothelialization over a 7-day period. Additionally, results demonstrated that the FOB imaging method had a greater imaging penetration depth than that of two-photon microscopy. This imaging method is a powerful tool to optimize vascular grafts and bioreactor conditions in vitro, and can be further adapted to monitor endothelium maturation and response to fluid flow bioreactor preconditioning.

  10. MR appearance of autologous chondrocyte implantation in the knee: correlation with the knee features and clinical outcome

    International Nuclear Information System (INIS)

    Takahashi, Tomoki; Tins, Bernhard; McCall, Iain W.; Ashton, Karen; Richardson, James B.; Takagi, Katsumasa

    2006-01-01

    To relate the magnetic resonance imaging (MRI) appearance of autologous chondrocyte implantation (ACI) in the knee in the 1st postoperative year with other knee features on MRI and with clinical outcome. Forty-nine examinations were performed in 49 patients at 1 year after ACI in the knee. Forty-one preoperative magnetic resonance (MR) examinations were also available. The grafts were assessed for smoothness, thickness in comparison with that of adjacent cartilage, signal intensity, integration to underlying bone and adjacent cartilage, and congruity of subchondral bone. Presence of overgrowth and bone marrow appearance beneath the graft were also assessed. Presence of osteophyte formation, further cartilage defects, appearance of the cruciate ligaments and the menisci were also recorded. An overall graft score was constructed, using the graft appearances. This was correlated with the knee features and the Lysholm score, a clinical self-assessment score. The data were analysed by a Kruskal-Wallis H test followed by a Mann-Whitney U test with Bonferroni correction as post-hoc test. Of 49 grafts, 32 (65%) demonstrated complete defect filling 1 year postoperatively. General overgrowth was seen in eight grafts (16%), and partial overgrowth in 13 grafts (26%). Bone marrow change underneath the graft was seen; oedema was seen in 23 grafts (47%), cysts in six grafts (12%) and sclerosis in two grafts (4%). Mean graft score was 8.7 (of maximal 12) (95% CI 8.0-9.5). Knees without osteophyte formation or additional other cartilage defects (other than the graft site) had a significantly higher graft score than knees with multiple osteophytes (P=0.0057) or multiple further cartilage defects (P=0.014). At 1 year follow-up improvement in the clinical scores was not significantly different for any subgroup. (orig.)

  11. Bone grafting simultaneous to implant placement. Presentation of a case.

    Science.gov (United States)

    Peñarrocha-Diago, Miguel; Gómez-Adrián, Maria Dolores; García-Mira, Berta; Ivorra-Sais, Mariola

    2005-01-01

    Bone defects at mandibular alveolar crest level complicate the placement of dental implants in the ideal location. Surgical reconstruction using autologous bone grafts allows implant fixation in an esthetic and functional manner. We describe a patient with large mandibular bone loss secondary to periodontal inflammatory processes. Reconstruction of the mandibular alveolar process was carried out using onlay block bone grafts harvested from the mandible. The grafts were stabilized by positioning the dental implants through them--a procedure that moreover afforded good primary implant fixation. After two years of follow-up the clinical and radiological outcome is good. In the lower jaw, where bone regeneration is complicated, we were able to achieve good results in this patient--minimizing the corresponding waiting time by grafting and placing the implants in the same surgical step.

  12. Autopoiesis: Autology, Autotranscendence and Autonomy

    DEFF Research Database (Denmark)

    , to the prospects of imagination, not least because imagination is driven by such paradoxes. The depth of the imagination is all surface, and all of its surfaces are deep structures. Schiltz’s exploration of autology grows out of one of a number (a growing number) of programmes that deal seriously with the idea......¿ning) problem of modernity. Castoriadis suggests a mutual and complementary relation between subjective and collective autonomy. Bouchet’s interpretation of this is very  radical and in certain respects quite startling. He considers how in modernity emerge spontaneous social orders (like markets or publics...

  13. Specific allogeneic unresponsiveness in irradiated dogs reconstituted with autologous bone marrow

    International Nuclear Information System (INIS)

    Rapaport, F.T.; Bachvaroff, R.J.; Akiyama, N.; Sato, T.; Ferrebee, J.W.

    1980-01-01

    Hemopoietic reconstitution of supralethally irradiated adult dogs of the Cooperstown colony with their own stored bone marrow can produce long-term unresponsiveness to DLA-identical kidney allografts with no need for any additional immunosuppression. Eleven of 18 kidneys transplanted 12 h after replacement of autologous marrow into irradiated recipients currently survive with normal function for as long as 1417 d; 8 of 13 organs transplanted 28 h after marrow replacement, and 8 of 13 organs transplanted 36 h after marrow injection, currently survive up to 502 d, with no further treatment. Alterations in the timing and sequence of each procedure decrease the incidence of unresponsiveness. Survival and function of the kidney allografts were not affected by the rejection of successive skin grafts from the kidney donor. Skin grafts from other DLA-identical donors and DLA-incompatible skin grafts were rejected by the same recipients in uniform fashion

  14. Punch Grafting In Chronic Stable Vitiligo : A Preliminary Report

    Directory of Open Access Journals (Sweden)

    Sirka C. S

    1997-01-01

    Full Text Available Eleven patients of stable vitiligo (7 segmental, 2 focal, 2 contact depigmentation having localized lesions were treated with autologous punch skin grafts. The cosmetic improvement at 5th month was good in 3, fair in 7 and poor in 1. However, at 7th month the improvement was excellent in 4, good in 6 and poor in 1. Complications in the form of variegated colour â€" 9 patients, cobblestoning â€" 8 patients, depigmentation â€"1 patient and graft loss in 1 patient were noted in this study. The role of adjuvant therapy (topical steroid and topical psoralen is highlighted.

  15. Osseous-Cartilaginous Spreader Graft and Nasal Framework Reconstruction.

    Science.gov (United States)

    Ors, Safvet

    2017-10-01

    Revision rhinoplasties and saddle nose deformities usually require grafting for reconstruction. Between January 1, 2000, and January 1, 2017, autologous rib grafts were used in 127 secondary and tertiary rhinoplasty patients [(57/127 females) and (70/127 males)]. Osseous-cartilaginous rib grafts (OCRGs) were divided into three parts (i.e., 1/3 upper peripheral, 1/3 central, and 1/3 lower peripheral). The harvested OCRGs were also shaped as vertical strips using a number 11 scalpel blade. These OCRGs were shaped to form the L-strut cartilaginous graft (LSCGs), osseous-cartilaginous spreader grafts (OCSGs), osseous-cartilaginous onlay grafts, nasal valve grafts (NVGs), and lower lateral cartilaginous grafts (LLCGs). The upper peripheral portion of the rib was usually used as an onlay graft for dorsal reshaping. The shape of this part was minimally convex after being cut from the main graft, and the convex shape was very appropriate for use as an onlay graft. The middle portion of the graft that consisted of the osseous and cartilaginous structure was used for the OCSGs. The middle portion of the graft that contained only cartilage was used for the LSCGs, NVGs, and LLCGs. OCRGs were used for the dorsal, alar, septal, upper lateral, and columellar struts for all patients. OCSGs were used for all of the septal grafts to provide further stability. In the nasal valve failure patients, the rib cartilage was fixed onto the lower lateral and upper lateral cartilage and was sutured using polyglactin to improve nasal valve function. One edge of the graft was sutured over the septum, and the other edge was positioned against the maxillary crest to allow for air flow at the nasal valve. After an OCSG was sutured to the septum, a flat and smooth dorsum was shaped before the dorsal onlay graft was placed and fixed. The bone fragments of the grafts that consisted of spreader and onlay grafts were tied to the radix nasi bone without any space. After 6 months of follow-up, a

  16. Epidermal grafting versus split-thickness skin grafting for wound healing (EPIGRAAFT): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Kanapathy, Muholan; Hachach-Haram, Nadine; Bystrzonowski, Nicola; Harding, Keith; Mosahebi, Afshin; Richards, Toby

    2016-05-17

    Split-thickness skin grafting (SSG) is an important modality for wound closure. However, the donor site becomes a second, often painful wound, which may take more time to heal than the graft site itself and holds the risk of infection and scarring. Epidermal grafting (EG) is an alternative method of autologous skin grafting that harvests only the epidermal layer of the skin by applying continuous negative pressure on the normal skin to raise blisters. This procedure has minimal donor site morbidity and is relatively pain-free, allowing autologous skin grafting in an outpatient setting. We plan to compare EG to SSG and to further investigate the cellular mechanism by which each technique achieves wound healing. EPIGRAAFT is a multicentre, randomised, controlled trial that compares the efficacy and wound-healing mechanism of EG with SSG for wound healing. The primary outcome measures are the proportion of wounds healed in 6 weeks and the donor site healing time. The secondary outcome measures include the mean time for complete wound healing, pain score, patient satisfaction, health care utilisation, cost analysis, and incidence of adverse events. This study is expected to define the efficacy of EG and promote further understanding of the mechanism of wound healing by EG compared to SSG. The results of this study can be used to inform the current best practise for wound care. Clinicaltrials.gov identifier, NCT02535481 . Registered on 11 August 2015.

  17. PCR-positivity in harvested bone marrow predicts relapse after transplantation with autologous purged bone marrow in children in second remission of precursor B-cell acute leukaemia

    NARCIS (Netherlands)

    Vervoordeldonk, S. F.; Merle, P. A.; Behrendt, H.; Steenbergen, E. J.; van den Berg, H.; van Wering, E. R.; von dem Borne, A. E.; van der Schoot, C. E.; van Leeuwen, E. F.; Slaper-Cortenbach, I. C.

    1997-01-01

    Purging of autologous bone marrow (BM) grafts of children in second remission after a relapse of precursor B acute lymphoblastic leukaemia (ALL) in the BM has been carried out in our laboratory since 1987, initially by complement mediated cell lysis. This protocol was extended by performing an

  18. Screening for autologous blood transfusions

    DEFF Research Database (Denmark)

    Mørkeberg, J; Belhage, B; Ashenden, M

    2009-01-01

    The ratio between the amount of hemoglobin in the mature erythrocyte population and the reticulocytes (RBCHb:RetHb ratio) has previously been suggested as a marker to screen for EPO-abuse. We speculated that the reinfusion of blood would lead to a marked increase in this ratio, making it a valuable...... parameter in the screening for autologous blood doping. Three bags of blood (approximately 201+/-11 g of Hb) were withdrawn from 16 males and stored at either -80 degrees C (-80 T, n=8) or +4 degrees C (+4 T, n=8) and reinfused 10 weeks or 4 weeks later, respectively. Seven subjects served as controls...... week wash-out period were identified as 'suspicious', and 18.8% (-80 T) and 4.3% (+4 T) as 'positive'. In total, 7 out of 16 (43.8%) subjects had at least one sample exceeding 182.9. Compared to the currently used indirect parameters, the RBCHb:RetHb ratio is the best indicator of autologous blood...

  19. Evolution of Autologous Chondrocyte Repair and Comparison to Other Cartilage Repair Techniques

    Directory of Open Access Journals (Sweden)

    Ashvin K. Dewan

    2014-01-01

    Full Text Available Articular cartilage defects have been addressed using microfracture, abrasion chondroplasty, or osteochondral grafting, but these strategies do not generate tissue that adequately recapitulates native cartilage. During the past 25 years, promising new strategies using assorted scaffolds and cell sources to induce chondrocyte expansion have emerged. We reviewed the evolution of autologous chondrocyte implantation and compared it to other cartilage repair techniques. Methods. We searched PubMed from 1949 to 2014 for the keywords “autologous chondrocyte implantation” (ACI and “cartilage repair” in clinical trials, meta-analyses, and review articles. We analyzed these articles, their bibliographies, our experience, and cartilage regeneration textbooks. Results. Microfracture, abrasion chondroplasty, osteochondral grafting, ACI, and autologous matrix-induced chondrogenesis are distinguishable by cell source (including chondrocytes and stem cells and associated scaffolds (natural or synthetic, hydrogels or membranes. ACI seems to be as good as, if not better than, microfracture for repairing large chondral defects in a young patient’s knee as evaluated by multiple clinical indices and the quality of regenerated tissue. Conclusion. Although there is not enough evidence to determine the best repair technique, ACI is the most established cell-based treatment for full-thickness chondral defects in young patients.

  20. Esterified hyaluronic acid and autologous bone in the surgical correction of the infra-bone defects.

    Science.gov (United States)

    Ballini, Andrea; Cantore, Stefania; Capodiferro, Saverio; Grassi, Felice Roberto

    2009-01-01

    We study the osteoinductive effect of the hyaluronic acid (HA) by using an esterified low-molecular HA preparation (EHA) as a coadjuvant in the grafting processes to produce bone-like tissue in the presence of employing autologous bone obtained from intra-oral sites, to treat infra-bone defects without covering membrane. We report on 9 patients with periodontal defects treated by EHA and autologous grafting (4 males and 5 females, all non smokers, with a mean age of 43.8 years for females, 40.0 years for males and 42 years for all the group, in good health) with a mean depth of 8.3 mm of the infra-bone defects, as revealed by intra-operative probes. Data were obtained at baseline before treatment and after 10 days, and subsequently at 6, 9, and 24 months after treatment. Clinical results showed a mean gain hi clinical attachment (gCAL) of 2.6mm of the treated sites, confirmed by radiographic evaluation. Such results suggest that autologous bone combined with EHA seems to have good capabilities in accelerating new bone formation in the infra-bone defects.

  1. An overview on autologous fibrin glue in bone tissue engineering of maxillofacial surgery

    Directory of Open Access Journals (Sweden)

    Azizollah Khodakaram-Tafti

    2017-01-01

    Full Text Available The purpose of this review is to have an overview on the applications on the autologous fibrin glue as a bone graft substitute in maxillofacial injuries and defects. A search was conducted using the databases such as Medline or PubMed and Google Scholar for articles from 1985 to 2016. The criteria were “Autograft,” “Fibrin tissue adhesive,” “Tissue engineering,” “Maxillofacial injury,” and “Regenerative medicine.” Bone tissue engineering is a new promising approach for bone defect reconstruction. In this technique, cells are combined with three-dimensional scaffolds to provide a tissue-like structure to replace lost parts of the tissue. Fibrin as a natural scaffold, because of its biocompatibility and biodegradability, and the initial stability of the grafted stem cells is introduced as an excellent scaffold for tissue engineering. It promotes cell migration, proliferation, and matrix making through acceleration in angiogenesis. Growth factors in fibrin glue can stimulate and promote tissue repair. Autologous fibrin scaffolds are excellent candidates for tissue engineering so that they can be produced faster, cheaper, and in larger quantities. In addition, they are easy to use and the probability of viral or prion transmission may be decreased. Therefore, autologous fibrin glue appears to be promising scaffold in regenerative maxillofacial surgery.

  2. Biological Properties and Therapeutic Value of Cryopreserved Fat Tissue.

    Science.gov (United States)

    Mashiko, Takanobu; Wu, Szu-Hsien; Kanayama, Koji; Asahi, Rintaro; Shirado, Takako; Mori, Masanori; Sunaga, Ataru; Sarukawa, Shunji; Uda, Hirokazu; Yoshimura, Kotaro

    2018-01-01

    Fat grafting frequently requires multiple treatments and thus repeated liposuction to achieve treatment goals. The purpose of this study was to evaluate whether cryopreservation of adipose tissue may facilitate future fat grafting. Lipoaspirates were harvested from six women and preserved using two cryopreservation methods: (1) simple cooling to -80°C (cryo-1); or (2) programmed cooling to -196°C (cryo-2). Fresh fat, cryo-1 fat, and cryo-2 fat were analyzed both in vitro and in vivo. Immunohistochemistry of both types of cryopreserved adipose tissue revealed that most adipocytes were necrotic. The cell number and viability of stromal vascular fraction cells were significantly decreased in cryo-1 fat (1.7 × 10 cells, 42.6 percent viable) and cryo-2 fat (2.0 × 10 cells, 55.4 percent viable), compared with fresh fat (3.9 × 10 cells, 90.6 percent viable). Although adipose-derived stem cells were cultured successfully from all fats, functional adipose-derived stem cells from cryopreserved fats were much fewer, with comparable multilineage differentiating capacity. In vivo studies using human fat grafted into immunocompromised mice revealed that, 3 months after transplantation, all of the cryopreserved fats maintained their volume to some extent; however, the cryopreserved fats were mostly filled with dead tissue and produced significantly lower engraftment scores than fresh fat. Most adipocytes were killed in the process of cryopreservation and thawing. Adipose-derived stem cells were isolated from cryopreserved fat, but the number of functional adipose-derived stem cells was very limited in both cryopreservation methods. After grafting, cryopreserved fat was retained as dead and fibrous tissue, suggesting a risk of clinical complications such as oil cysts.

  3. Treatment of the Infection after Fat Injection

    Directory of Open Access Journals (Sweden)

    Seok-Kwun Kim

    2015-01-01

    Full Text Available For recent years, use of autologous fat injection has increased significantly in facial contouring surgery. Along with such increase in use, complications like atypical mycoplasma infection have been also on the increasing trend. The authors report two cases of Mycobacterium chelonae infection that occurred after autologous fat injection. Patients were treated as infection that resistant to common antibiotics and results were negative to routine culture and Gram staining. Acid-fast bacillus stain, polymerase chain reaction (PCR test and mycobacterial cultures were conducted for diagnosis under suspicion of atypical mycoplasma infection. Then, combination antibiotics therapy, surgical treatment, and steroid injection were performed for treatment. Both patients were diagnosed with Mycobacterium chelonae in PCR test. They were positive to mycobacterial cultures. Combination antibiotics therapy was repeated to improvement of symptom. However, they could not be free from side effects such as deformation in facial contour, scar and pigmentation even after full recovery. When chronic wound infections after autologous fat injection, we must suspect atypical or mycobacterial infection and conduct examinations for a early diagnosis and proper antibiotic therapy that is effective to the nontuberculous mycobacteria.

  4. High dose ACNU and radiation therapy with autologous bone marrow rescue for a patient with cerebellar medulloblastoma

    International Nuclear Information System (INIS)

    Matsumoto, Masahito; Yamashita, Junkoh; Okamoto, Shin-ichiro; Handa, Hajime; Sawada, Hitoshi; Abe, Mitsuyuki

    1984-01-01

    High dose ACNU and radiation therapy with auto-logous bone marrow rescue was performed in a 3-year-old boy suffering from cerebellar medulloblastoma, whose main mass had been removed at operation when widespread subarachnoid tumor dissemination was already present. The myelosuppression, which is a major side effect of high dose chemotherapy, was successfully prevented by the autologous bone marrow grafting and the serial CT scans showed complete dissappearance of the tumor. However, the patient died on the 53rd day after the administration of ACNU of respiratory complication which was most likely due to pulmonary fibrosis. Although the autologous bone marrow rescue therapy is a technical advance to cope with myelosuppression secondary to chemotherapy, side effects of the other organs, particularly of the respiratory system, remain to be solved. The optimal treatment schedule should be established as soon as possible. (author)

  5. Specific Factors Influence the Success of Autologous and Allogeneic Hematopoietic Stem Cell Transplantation

    Directory of Open Access Journals (Sweden)

    Thissiane L. Gonçalves

    2009-01-01

    Full Text Available Successful hematopoietic stem cell transplantation (HSCT, both autologous and allogeneic, requires a rapid and durable engraftment, with neutrophil (>500/µL and platelet (>20,000/µL reconstitution. Factors influencing engraftment after autologous or allogeneic HSCT were investigated in 65 patients: 25 autologous peripheral stem cell transplantation (PBSCT and 40 allogeneic bone marrow transplantation (BMT patients. The major factor affecting engraftment was the graft source for HSCT. Neutrophil and platelet recovery were more rapid in autologous PBSCT than in allogeneic BMT [neutrophil occurring in median on day 10.00 (09.00/11.00 and 19.00 (16.00/23.00 and platelet on day 11.00 (10.00/13.00 and 21.00 (18.00/25.00, respectively; p < 0.0001]. The type of disease also affected engraftment, where multiple myeloma (MM and lymphoma showed faster engraftment when compared with leukemia, syndrome myelodysplastic (SMD and aplastic anemia (AA and MM presented the best overall survival (OS in a period of 12 months. Other factors included the drug used in the conditioning regimen (CR, where CBV, melphalan (M-200 and FluCy showed faster engraftment and M-200 presented the best OS, in a period of 12 months and age, where 50–59 years demonstrated faster engraftment. Sex did not influence neutrophil and platelet recovery.

  6. Autologous stem cell transplantation versus alternative allogeneic donor transplants in adult acute leukemias.

    Science.gov (United States)

    Claude Gorin, Norbert

    2016-04-01

    The availability of alternative sources of stem cells including most recently T-replete haploidentical marrow or peripheral blood, and the increasing use of reduced-intensity conditioning (RIC), renders feasible an allogeneic transplant to almost all patients with acute leukemia up to 70 years of age. Autologous stem cell transplantation (ASCT) for consolidation of complete remission (CR), however, offers in some circumstances an alternative option. Although associated with a higher relapse rate, autologous transplant benefits from a lower non-relapse mortality, the absence of graft-versus-host disease (GVHD), and a better quality of life for long-term survivors. The recent use of intravenous busulfan (IVBU) with high-dose melphalan, better monitoring of minimal residual disease (MRD), and maintenance therapy post autografting bring new interest. Few retrospective studies compared the outcome following alternative donor versus autologous transplants for remission consolidation. Genoidentical and phenoidentical allogeneic stem cell transplantations are undisputed gold standards, but there are no data showing the superiority of alternative allogeneic donor over autologous transplantation, at the time of undetectable MRD, in patients with good- and intermediate-1 risk acute myelocytic leukemia (AML) in first complete remission (CR1), acute promyelocytic leukemia in second complete remission (CR2), and Philadelphia chromosome-positive (Ph(+)) acute lymphocytic leukemia (ALL). Copyright © 2016. Published by Elsevier Inc.

  7. Physiological problems in patients undergoing autologous and allogeneic hematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Sevgisun Kapucu

    2014-01-01

    Full Text Available Objective: Stem cell transplantation is usually performed in an effort to extend the patient′s life span and to improve their quality of life. This study was conducted to determine the postoperative physiological effects experienced by patients who had undergone autologous and allogeneic stem cell transplantation. Methods: The research is a descriptive study conducted with a sample of 60 patients at Stem Cell Transplantation Units in Ankara. Percentile calculation and chi-square tests were used to evaluate the data. Results: When a comparison was made between patients who had undergone allogeneic Hematopoietic stem cell transplantation (HSCT and those who had undergone autologous HSCT, results indicated that problems occurred more often for the allogeneic HSCT patients. The problems included: Digestion (94.3%, dermatological (76.7%, cardiac and respiratory (66.7%, neurological (66.7%, eye (56.7%, infections (26.7% and Graft Versus Host Disease (5 patients. Furthermore, the problems with pain (50%, numbness and tingling (40%, and speech disorders (3 patients were observed more often in autologous BMT patients. Conclusion: Autologous and allogeneic patients experienced most of physical problems due to they receive high doses of chemotherapy. Therefore, it is recommended that an interdisciplinary support team approach should be usedtohelp reduce and manage the problems that may arise during patient care.

  8. Electrospun vascular grafts with anti-kinking properties

    Directory of Open Access Journals (Sweden)

    Bode M.

    2015-09-01

    Full Text Available One of the major challenges in developing appropriate vascular substitutes is to produce a graft that adapts to the biological and mechanical conditions at the application or implantation site. One approach is the use of tissue engineered electrospun grafts pre-seeded with autologous cells. However, bending stresses during in vivo applications could lead to kinking of the graft which may result in life-threatening stenosis. The aim of this study was to develop an electrospun vascular graft consisting of biodegradable polymers which can reduce or prevent kinking, due to their higher flexibility. In order to improve the bendability of the grafts, various electrospinning collectors were designed using six different patterns. Subsequently, the grafts were examined for scaffold morphology, mechanical strength and bendability. Scaffolds spun on a collector structured with a v-shaped thread (flank angle of 120° showed a homogenous and reproducible fiber deposition as compared to the unstructured reference sample. The results of the tensile tests were comparable to the unstructured reference sample, supporting the first observation. Studies on bendability were performed using a custom made flow-bending test setup. It was shown that the flow through the v-shaped grafts was reduced to less than 45 % of the reference value even after bending the graft to an angle of 140°. In contrast, the flow through an unstructured graft was reduced to more than 50 % after bending to an angle of 55°. The presented data demonstrate the need for optimizing the bendability of the commonly used electrospun vascular grafts. Using of macroscopic v-shaped collectors is a promising solution to overcome the issue of graft kinking.

  9. Histomorphometric Evaluation of Superovulation Effect on Follicular Development after Autologous Ovarian Transplantation in Mice

    Directory of Open Access Journals (Sweden)

    Amin Tamadon

    2015-01-01

    Full Text Available The effect of superovulation by pregnant mare serum gonadotropin (PMSG on autologous transplanted ovaries in the lumbar muscles of mice was histomorphometrically evaluated using the indices of number and volume of different kind of follicles and volume of corpora lutea, ovary, and stroma. Angiogenesis was observed after mouse ovarian transplantation on days 14 and 21 after ovarian grafting. After transplantation, the total number and volume of primary and secondary follicles reduced, while PMSG superovulation increased the total number and total volume of tertiary follicles and also the ovarian volume after transplantation. Transplantation increased the average size of primary, secondary, and tertiary follicles. Therefore, primary and secondary follicles can survive after autologous transplantation but their reservations diminished by increasing the time of transplantation. However, number of tertiary follicles and their response to superovulation increased over time after transplantation.

  10. Thrombosis of the internal mammary artery during delayed autologous breast reconstruction: A manifestation of occult residual cancer

    Directory of Open Access Journals (Sweden)

    Alexandra Bucknor

    2016-06-01

    Full Text Available A prothombotic state may be a manifestation of malignancy, either primary or recurrent. In this report we present a case of thrombosis of the internal mammary artery during delayed autologous breast reconstruction occurring in association with, and as a possible manifestation of, occult recurrent breast cancer. We discuss salvage of the microsurgical anastomosis using a vein graft and microvascular anastomotic coupler device.

  11. Saturated fat (image)

    Science.gov (United States)

    ... saturated fat. Sources of saturated fat include whole-milk dairy products, like cheese, ice cream and butter. Animal fats ... saturated fat. Sources of saturated fat include whole-milk dairy products, like cheese, ice cream and butter. Animal fats ...

  12. Intraurethral Injection of Autologous Minced Skeletal Muscle

    DEFF Research Database (Denmark)

    Gräs, Søren; Klarskov, Niels; Lose, Gunnar

    2014-01-01

    PURPOSE: Intraurethral injection of in vitro expanded autologous skeletal muscle derived cells is a new regenerative therapy for stress urinary incontinence. We examined the efficacy and safety of a simpler alternative strategy using freshly harvested, minced autologous skeletal muscle tissue...... noted. CONCLUSIONS: Intraurethral injection of minced autologous muscle tissue is a simple surgical procedure that appears safe and moderately effective in women with uncomplicated stress urinary incontinence. It compares well to a more complicated regenerative strategy using in vitro expanded muscle...... with its inherent content of regenerative cells. MATERIALS AND METHODS: A total of 20 and 15 women with uncomplicated and complicated stress urinary incontinence, respectively, received intraurethral injections of minced autologous skeletal muscle tissue and were followed for 1 year. Efficacy was assessed...

  13. Proximal Tibia Bone Graft: An alternative Donor Source especially for Foot and Ankle Procedures

    Directory of Open Access Journals (Sweden)

    Jia TY

    2015-03-01

    Full Text Available Among the many donor sites for harvesting autologous bone graft, the iliac crest has been the most commonly used. However, for foot and ankle procedures the proximal tibia has gained popularity as an alternative donor site due to its anatomic proximity to the primary surgical site. In this article we evaluated the possible complications associated with harvesting proximal tibia bone graft. Our study showed the low incidence of morbidity in harvesting proximal tibia bone graft, thereby providing a good alternative donor for foot and ankle procedures.

  14. Comparison of a microsliced modified chondroperichondrium shield graft and a temporalis fascia graft in primary type I tympanoplasty: A prospective randomized controlled trial.

    Science.gov (United States)

    Bhattacharya, Shambhu Nath; Pal, Sudipta; Saha, Somnath; Gure, Prasanta Kumar; Roy, Anupam

    2016-07-01

    We conducted a prospective, randomized, controlled trial to compare outcomes in type I tympanoplasty patients who received an autologous microsliced modified cartilage perichondrium shield graft (cartilage group) and those who received an autologous temporalis muscle fascia graft (fascia group). Our three outcomes measures were (1) anatomic success rates at 3 months, (2) hearing results at 6 months, and (3) rates of morphologic success (i.e., the absence of reperforation, retraction, and graft displacement) at 2 years among those in each group who had an intact graft at 3 months. Of 56 patients who were initially enrolled and who underwent one of these type I tympanoplasty procedures, 51 completed the study-28 in the cartilage group and 23 in the fascia group. The former was made up of 11 males and 17 females, aged 15 to 48 years (mean: 27.4), and the latter included 9 males and 14 females, aged 15 to 52 years (mean: 31.7). The overall graft take rate at 3 months with respect to perforation closure (anatomic success) was 93.3% in the cartilage group and 91.7% in the fascia group, which was not a statistically significant difference. The mean hearing gain at 6 months was 11.7 ± 7.6 dB in the cartilage group and 12.6 ± 6.0 dB in the fascia group-again, not statistically significant. At 2 years, morphologic success rates were 92.3 and 81.0%, respectively-again, not statistically significant. We conclude that autologous microsliced modified cartilage perichondrium shield graft tympanoplasty is as effective as conventional temporalis fascia tympanoplasty in terms of graft take rates and functional results. Indeed, medium-term outcomes (2-yr follow-up) revealed that sustainable morphologic success was actually better with the cartilage technique than with the fascia technique because it was associated with fewer revision surgeries.

  15. Anterior cruciate ligament reconstruction in a rabbit model using canine small intestinal submucosa and autologous platelet-rich plasma.

    Science.gov (United States)

    Lee, A-Jin; Chung, Wook-Hun; Kim, Dae-Hyun; Lee, Kyung-Pil; Chung, Dai-Jung; Do, Sun Hee; Kim, Hwi-Yool

    2012-11-01

    The bone-ligament interface is the main point of failure after anterior cruciate ligament reconstruction. Synthetic ligament materials have problems such as a greater failure rate of the bone-ligament insertion than autografts. Small intestinal submucosa (SIS) is a biologic scaffold that has been used to repair musculoskeletal tissue and has been shown to promote cell migration and enhance collagen fiber regeneration. Autologous platelet-rich plasma (PRP) has also been investigated as a potential promoter of tendon healing. We investigated SIS and PRP as biomaterials that might strengthen the bone-tunnel interface and improve tendon structure formation. Anterior cruciate ligament grafts were formed of braid-twist canine SIS. These canine SIS ligament grafts were used for anterior cruciate ligament reconstruction in 20 New Zealand white rabbits. The rabbits were divided into 2 treatment groups. In 1 group (SIS group; n = 10), we only implanted the canine SIS grafts. In the second group (PRP group; n = 10), we applied autologous PRP to the surgical area after implantation of canine SIS grafts. We determined the cytokine level of the autologous PRP using a transforming growth factor-β1 enzyme-linked immunosorbent assay kit. At 1 and 4 wk after surgery, magnetic resonance imaging was performed to evaluate the grafts. The femur-graft-tibia complex was assessed histologically and biomechanically at 8 wk after surgery. At 1 wk after surgery, the magnetic resonance imaging scans of the PRP group showed high signal-intensity lesions. In biomechanical tests, the SIS group had a significantly greater maximum load, maximum stress, and ultimate load and strain than the PRP group. The histologic findings of the PRP group revealed a greater cellular response, fibrotic tissue regeneration around the graft, broad chondrocyte cell infiltration, and collagen fibers that were loosely attached to the bone. The PRP group had significantly lower tension load values than the SIS group

  16. Toward a patient-specific tissue engineered vascular graft.

    Science.gov (United States)

    Best, Cameron; Strouse, Robert; Hor, Kan; Pepper, Victoria; Tipton, Amy; Kelly, John; Shinoka, Toshiharu; Breuer, Christopher

    2018-01-01

    Integrating three-dimensional printing with the creation of tissue-engineered vascular grafts could provide a readily available, patient-specific, autologous tissue source that could significantly improve outcomes in newborns with congenital heart disease. Here, we present the recent case of a candidate for our tissue-engineered vascular graft clinical trial deemed ineligible due to complex anatomical requirements and consider the application of three-dimensional printing technologies for a patient-specific graft. We 3D-printed a closed-disposable seeding device and validated that it performed equivalently to the traditional open seeding technique using ovine bone marrow-derived mononuclear cells. Next, our candidate's preoperative imaging was reviewed to propose a patient-specific graft. A seeding apparatus was then designed to accommodate the custom graft and 3D-printed on a commodity fused deposition modeler. This exploratory feasibility study represents an important proof of concept advancing progress toward a rationally designed patient-specific tissue-engineered vascular graft for clinical application.

  17. Grafting and curing

    International Nuclear Information System (INIS)

    Garnett, J.L.; Loo-Teck Ng; Visay Viengkhou

    1998-01-01

    Progress in radiation grafting and curing is briefly reviewed. The two processes are shown to be mechanistically related. The parameters influencing yields are examined particularly for grafting. For ionising radiation grafting systems (EB and gamma ray) these include solvents, substrate and monomer structure, dose and dose-rate, temperature and more recently role of additives. In addition, for UV grafting, the significance of photoinitiators is discussed. Current applications of radiation grafting and curing are outlined. The recent development of photoinitiator free grafting and curing is examined as well as the potential for the new excimer laser sources. The future application of both grafting and curing is considered, especially the significance of the occurrence of concurrent grafting during cure and its relevance in environmental considerations

  18. Magnetizable stent-grafts enable endothelial cell capture

    Energy Technology Data Exchange (ETDEWEB)

    Tefft, Brandon J. [Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (United States); Uthamaraj, Susheil [Division of Engineering, Mayo Clinic, Rochester, MN (United States); Harburn, J. Jonathan [School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees (United Kingdom); Hlinomaz, Ota [Department of Cardioangiology, St. Anne' s University Hospital, Brno (Czech Republic); Lerman, Amir [Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (United States); Dragomir-Daescu, Dan [Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN (United States); Sandhu, Gurpreet S., E-mail: sandhu.gurpreet@mayo.edu [Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (United States)

    2017-04-01

    Emerging nanotechnologies have enabled the use of magnetic forces to guide the movement of magnetically-labeled cells, drugs, and other therapeutic agents. Endothelial cells labeled with superparamagnetic iron oxide nanoparticles (SPION) have previously been captured on the surface of magnetizable 2205 duplex stainless steel stents in a porcine coronary implantation model. Recently, we have coated these stents with electrospun polyurethane nanofibers to fabricate prototype stent-grafts. Facilitated endothelialization may help improve the healing of arteries treated with stent-grafts, reduce the risk of thrombosis and restenosis, and enable small-caliber applications. When placed in a SPION-labeled endothelial cell suspension in the presence of an external magnetic field, magnetized stent-grafts successfully captured cells to the surface regions adjacent to the stent struts. Implantation within the coronary circulation of pigs (n=13) followed immediately by SPION-labeled autologous endothelial cell delivery resulted in widely patent devices with a thin, uniform neointima and no signs of thrombosis or inflammation at 7 days. Furthermore, the magnetized stent-grafts successfully captured and retained SPION-labeled endothelial cells to select regions adjacent to stent struts and between stent struts, whereas the non-magnetized control stent-grafts did not. Early results with these prototype devices are encouraging and further refinements will be necessary in order to achieve more uniform cell capture and complete endothelialization. Once optimized, this approach may lead to more rapid and complete healing of vascular stent-grafts with a concomitant improvement in long-term device performance. - Highlights: • Magnetic stent-grafts were made from 2205 steel stents and polyurethane nanofibers. • Stent-grafts remained patent and formed a thin and uniform neointima when implanted. • Stent-grafts captured endothelial cells labeled with magnetic nanoparticles.

  19. The Effect of Platelet-Rich Plasma on Survival of the Composite Graft and the Proper Time of Injection in a Rabbit Ear Composite Graft Model

    Directory of Open Access Journals (Sweden)

    Hyun Nam Choi

    2014-11-01

    Full Text Available BackgroundAdministration of growth factors has been associated with increased viability of composite grafts greater than 1-cm in diameter. Platelet-rich plasma (PRP contains many of the growth factors studied. In this study, we evaluate the effect of PRP injection on composite graft viability and the proper time for injection.MethodsA total of 24 New Zealand White rabbits were divided into four groups. Autologous PRP was injected into the recipient sites three days before grafting in group 1, on the day of grafting in group 2, and three days after grafting in group 3. Group 4 served as control without PRP administration. Auricular composite grafts of 3-cm diameter were harvested and grafted back into place after being rotated 180 degrees. Median graft viability and microvessel density were evaluated at day 21 of graft via macroscopic photographs and immunofluorescent staining, respectively.ResultsThe median graft survival rate was 97.8% in group 1, 69.2% in group 2, 55.7% in group 3, and 40.8% in the control group. The median vessel counts were 34 (per ×200 HPF in group 1, 24.5 in group 2, 19.5 in group 3, and 10.5 in the control group.ConclusionsThis study demonstrates that PRP administration is associated with increased composite graft viability. All experimental groups showed a significantly higher survival rate and microvessel density, compared with the control group. Pre-administration of PRP was followed by the highest graft survival rate and revascularization. PRP treatments are minimally invasive, fast, easily applicable, and inexpensive, and offer a potential clinical pathway to larger composite grafts.

  20. Recipient Wound Bed Characteristics Affect Scarring and Skin Graft Contraction

    Science.gov (United States)

    2015-02-13

    presence of myofibroblasts and leukocytic infiltration. Injuries resulting in loss of dermal coverage are typically treated by means of eschar excision or...hypodermis is usually dictated by the severity of injury and may not always be possible, restoration of the hypodermis through tissue engineering, before or...in leukocyte infiltra- tion between grafts on fat and grafts on fascia by staining for CD45, the leukocyte common antigen ( LCA ) (Figure 6). Although

  1. A COMPARATIVE STUDY OF POSTOPERATIVE OUTCOME AFTER PTERYGIUM EXCISION USING AUTOLOGOUS BLOOD AND SUTURES

    Directory of Open Access Journals (Sweden)

    Harpal Singh

    2017-12-01

    Full Text Available BACKGROUND Pterygium is a degenerative and hyperplastic condition of conjunctiva. In this, subconjunctival tissue proliferates as vascularised granulation tissue, thus invading the cornea and destroying the superficial stroma and Bowman’s membrane. It varies from small asymptomatic lesion to large, rapidly growing lesion, thus leading to impairment of vision. Pterygium occurs more frequently between 30 degrees latitude north and south of the equator called as “pterygium belt.” The most challenging situation after pterygium excision is the recurrence of the pterygium. Many techniques had been used, but none of them is universally accepted due to variable recurrence rate. The aim of the study is to compare the two modalities of treatment in pterygium excision with postoperative outcomes. MATERIALS AND METHODS A comparative study was conducted from July 2016 to August 2017 in the Department of Ophthalmology, People’s College of Medical Sciences and Research Centre, Bhopal (M.P.. Total 50 patients with primary nasal pterygium of grade 2 or more were enrolled from eye outpatient department. The patients were randomly divided into two groups for pterygium excision with conjunctival autografting using either autologous blood (group A or sutures (group B. Two groups were compared for postoperative discomfort, recurrence and graft displacement. RESULTS Out of 50 patients, 28 were in group A and 22 were in group B. Maximum numbers of patients were involved in outdoor activities. In comparison to autologous blood technique, postoperative discomfort was more in suture group after pterygium excision. In group A, the graft displacement was found in 2 (7.1% patients, whereas in group B, there was no graft displacement seen. While in group B2 (9.1% patients had granuloma formation. The recurrence of pterygium was high (22.7% in group B as compared to group A (3.6%. There was a significant correlation between rate of recurrence and type of surgery (P

  2. Postoperative Autologous Reinfusion in Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    A. Crescibene

    2015-01-01

    Full Text Available Surgeries for total knee replacement (TKR are increasing and in this context there is a need to develop new protocols for management and use of blood transfusion therapy. Autologous blood reduces the need for allogeneic blood transfusion and the aim of the present study was to verify the safety and the clinical efficacy. An observational retrospective study has been conducted on 124 patients, undergoing cemented total knee prosthesis replacement. Observed population was stratified into two groups: the first group received reinfusion of autologous blood collected in the postoperative surgery and the second group did not receive autologous blood reinfusion. Analysis of data shows that patients undergoing autologous blood reinfusion received less homologous blood bags (10.6% versus 30%; p=0.08 and reduced days of hospitalization (7.88 ± 0.7 days versus 8.96 ± 2.47 days for the control group; p=0.03. Microbiological tests were negative in all postoperatively salvaged and reinfused units. Our results emphasize the effectiveness of this procedure and have the characteristics of simplicity, low cost (€97.53 versus €103.79; p<0.01, and easy reproducibility. Use of autologous drainage system postoperatively is a procedure that allows reducing transfusion of homologous blood bags in patients undergoing TKR.

  3. Bone grafts in dentistry

    Directory of Open Access Journals (Sweden)

    Prasanna Kumar

    2013-01-01

    Full Text Available Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing. These grafts are bioresorbable and have no antigen-antibody reaction. These bone grafts act as a mineral reservoir which induces new bone formation.

  4. Dietary fats explained

    Science.gov (United States)

    ... Some vegetable oils, such as coconut, palm, and palm kernel oil, also contain saturated fats. These fats are solid ... acids are unhealthy fats that form when vegetable oil hardens in a process ... Hydrogenated fats, or "trans fats," are often used ...

  5. Alveolar ridge preservation with autologous particulated dentin-a case series.

    Science.gov (United States)

    Valdec, Silvio; Pasic, Pavla; Soltermann, Alex; Thoma, Daniel; Stadlinger, Bernd; Rücker, Martin

    2017-12-01

    Ridge preservation can be performed with autologous bone, alloplastic bone substitute material or a combination of both. Dentin is similar to bone in its chemical composition. In its use as bone substitute material, it undergoes a remodelling process and transforms to bone. The presented case report introduces a technique in which the extraction socket is augmented with autologous, particulated dentin. The fractured, non-savable mesial incisor of the upper jaw was carefully extracted in axial direction. After the extraction, the tooth was cleared from remaining periodontal tissue. The vital pulp tissue or a root canal filling, enamel and cementum were also removed. Following the particulation of the remaining dentin in a bone mill, the dentin particles were immediately filled orthotope into the alveolar socket. The soft tissue closure was performed with a free gingival graft of the palate. After an observation period of 4 months, an implant was placed in the augmented area, which osseointegrated successfully and could be restored prosthodontically in the following. The results of this method showed a functional and aesthetic success. The pre-implantological, autologous ridge preservation with dentin could be performed successfully. For the establishment of dentin as augmentation material for jaw augmentation procedures, a prospective, clinical trial is now necessary.

  6. Autologous blood transfusion - a review | Charles | South African ...

    African Journals Online (AJOL)

    The discovery of HIV and other transfusion-transmissible infections has increased the demand for alternatives to allogeneic blood transfusion. One such alternative is autologous transfusion. This review presents an analysis of autologous transfusion. We conclude that autologous transfusion should form part of a strategy to ...

  7. Autologous fibrin adhesive in experimental tubal anastomosis.

    Science.gov (United States)

    Rajaram, S; Rusia, U; Agarwal, S; Agarwal, N

    1996-01-01

    To evaluate autologous fibrin in rabbit oviduct anastomosis versus 7-0 vikryl, a conventional suture material used in tubal anastomosis. Thrombin was added to the autologous fibrinogen at the site of anastomosis to obtain a tissue adhesive. The anastomotic time, pregnancy rate, and litter size were evaluated. Three months later, a relaparotomy was done to evaluate patency and degree of adhesions, and a tubal biopsy was taken from the site of anastomosis. Analysis of results showed a statistically significant (P < .001) shortened anastomotic time and superior histopathological union in the tissue adhesive group. Patency rate, pregnancy rate, and degree of adhesions were comparable in both groups.

  8. Autologous adipocyte derived stem cells favour healing in a minipig model of cutaneous radiation syndrome.

    Directory of Open Access Journals (Sweden)

    Fabien Forcheron

    Full Text Available Cutaneous radiation syndrome (CRS is the delayed consequence of localized skin exposure to high doses of ionizing radiation. Here we examined for the first time in a large animal model the therapeutic potential of autologous adipose tissue-derived stroma cells (ASCs. For experiments, Göttingen minipigs were locally gamma irradiated using a (60Co source at the dose of 50 Gy and grafted (n = 5 or not (n = 8. ASCs were cultured in MEM-alpha with 10% fetal calf serum and basic fibroblast growth factor (2 ng.mL(-1 and post irradiation were intradermally injected on days 25, 46, 67 and finally between days 95 and 115 (50 × 10(6 ASCs each time into the exposed area. All controls exhibited a clinical evolution with final necrosis (day 91. In grafted pigs an ultimate wound healing was observed in four out of five grafted animals (day 130 +/- 28. Immunohistological analysis of cytokeratin expression showed a complete epidermis recovery. Grafted ASCs accumulated at the dermis/subcutis barrier in which they attracted numerous immune cells, and even an increased vasculature in one pig. Globally this study suggests that local injection of ASCs may represent a useful strategy to mitigate CRS.

  9. Revision surgery after third generation autologous chondrocyte implantation in the knee.

    Science.gov (United States)

    Niethammer, Thomas R; Niethammer, Thomas; Valentin, Siegfried; Ficklscherer, Andreas; Gülecyüz, Mehmet F; Gülecyüz, Mehmet; Pietschmann, Matthias F; Pietschmann, Matthias; Müller, Peter E; Müller, Peter

    2015-08-01

    Third generation autologous chondrocyte implantation (ACI) is an established treatment for full thickness cartilage defects in the knee joint. However, little is known about cases when revision surgery is needed. The aim of the present study is to investigate the complication rates and the main reasons for revision surgery after third generation autologous chondrocyte implantation in the knee joint. It is of particular interest to examine in which cases revision surgery is needed and in which cases a "wait and see" strategy should be used. A total of 143 consecutive patients with 171 cartilage defects were included in this study with a minimum follow-up of two years. All defects were treated with third generation ACI (NOVACART®3D). Clinical evaluation was carried out after six months, followed by an annual evaluation using the International Knee Documentation Committee (IKDC) subjective score and the visual analogue scale (VAS) for rest and during activity. Revision surgery was documented. The revision rate was 23.4 % (n = 36). The following major reasons for revision surgery were found in our study: symptomatic bone marrow edema (8.3 %, n = 3), arthrofibrosis (22.2 %, n = 8) and partial graft cartilage deficiency (47.2 %, n = 17). The following revision surgery was performed: retrograde drilling combined with Iloprost infusion therapy for bone marrow oedema (8.4 %, n = 3), arthroscopic arthrolysis of the suprapatellar recess (22.2 %, n = 8) and microfracturing/antegrade drilling (47.3 %, n = 17). Significant improvements of clinical scores after revision surgery were observed. Revision surgery after third generation autologous chondrocyte implantation is common and is needed primarily in cases with arthrofibrosis, partial graft cartilage deficiency and symptomatic bone marrow oedema resulting in a significantly better clinical outcome.

  10. Qualitative and quantitative differences of adipose-derived stromal cells from superficial and deep subcutaneous lipoaspirates: a matter of fat.

    Science.gov (United States)

    Di Taranto, Giuseppe; Cicione, Claudia; Visconti, Giuseppe; Isgrò, Maria A; Barba, Marta; Di Stasio, Enrico; Stigliano, Egidio; Bernardini, Camilla; Michetti, Fabrizio; Salgarello, Marzia; Lattanzi, Wanda

    2015-08-01

    Subcutaneous fat represents a valuable reservoir of adipose-derived stem cells (ASCs) in the stromal vascular fraction (SVF), widely exploited in regenerative medicine applications, being easily harvested through lipoaspiration. The lack of standardized procedures for autologous fat grafting guided research efforts aimed at identifying possible differences related to the harvesting site, which may affect cell isolation yield, cell growth properties and clinical outcomes. Subcutaneous fat features a complex architecture: the superficial fascia separates superficial adipose tissue (SAT) from deep layer tissue (DAT). We aimed to unravel the differences between SAT and DAT, considering morphological structure, SVF composition, and ASC properties. SAT and DAT were collected from female donors and comparatively analyzed to evaluate cellular yield and viability, morphology, immunophenotype and molecular profile. ASCs were isolated in primary culture and used for in vitro differentiation assays. SAT and DAT from cadaver donors were also analyzed through histology and immunohistochemistry to assess morphology and cell localization within the hypoderm. Liposuctioned SAT contained a higher stromal tissue compound, along with a higher proportion of CD105-positive cells, compared with DAT from the same harvesting site. Also, cells isolated from SAT displayed increased multipotency and stemness features. All differences were mainly evidenced in specimens harvested from the abdominal region. According to our results, SAT features overall increased stem properties. Given that subcutaneous adipose tissue is currently exploited as the gold standard source for high-yield isolation of adult stem cells, these results may provide precious hints toward the definition of standardized protocols for microharvesting. Copyright © 2015 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  11. The Use of Platelet-Rich Plasma for Storage of Surplus Harvested Skin Grafts.

    Science.gov (United States)

    Keskin, Ilknur; Ayturk, Nilufer; Sutcu, Mustafa; Keskin, Mustafa; Mudok, Tangul

    2017-02-01

    There is a need for improved methods and storage media to sustain the tissue viability of autologous skin grafts. To compare histological changes in human skin grafts stored in platelet-rich plasma (PRP) with those of grafts stored in saline. Eight circular, 3-mm full-thickness skin graft samples were harvested from the abdominal skin of each of 5 patients scheduled to undergo an abdominoplasty procedure. Four of these graft samples were stored in saline, and the other 4 were stored in saline mixed with PRP prepared from the patient's own venous blood. Histological assessment of the microscopic appearance of the samples was performed on days 5, 8, 11, and 14. The integrity of the epidermal-dermal junction, number of keratinocytes with perinuclear halos, collagen organization, and number of fibroblasts per field were assessed. The cellular apoptosis rate was also measured on these same days. On day 5, significant differences were observed microscopically between the PRP- and saline-stored grafts ( P < .05). The grafts preserved in saline exhibited early marked cellular and nuclear swelling with pleomorphism, as well as early nuclear halo formation. The cell viability rate of the PRP group was significantly higher than that of the saline-stored group on day 8 ( P < .05). Platelet-rich plasma and its inherent growth factors supported longer graft survival; however, its effect lasted only until day 8. Platelet-rich plasma may be beneficial if grafts need to be stored for delayed application(s).

  12. Retrospective review of a tertiary adult burn centre's experience with modified Meek grafting.

    Science.gov (United States)

    Munasinghe, Namal; Wasiak, Jason; Ives, Andrew; Cleland, Heather; Lo, Cheng Hean

    2016-01-01

    Autologous split skin grafting is the gold standard in treating patients with massive burns. However, the limited availability of donor sites remains a problem. The aim of this study is to present our experience with the modified Meek technique of grafting, outcomes achieved and recommendations for optimized outcomes. We retrospectively reviewed patient records from our tertiary referral burn centre and the Bi-National Burns Registry to identify all patients who had modified Meek grafting between 2010 and 2013. Patient records were reviewed individually and information regarding patient demographics, mechanism of injury and surgical management was recorded. Outcome measures including graft take rate, requirement for further surgery and complications were also recorded. Eleven patients had modified Meek grafting procedures. The average age of patients was 46 years old (range 23 - 64). The average total body surface area (TBSA) burnt was 56.75 % (range 20-80 %). On average, 87 % of the grafted areas healed well and did not require regrafting. In the regrafted areas, infection was the leading cause of graft failure. Modified Meek grafting is a useful method of skin expansion. Similar to any other grafting technique, infection needs to be sought and treated promptly. It is recommended for larger burns where donor sites are not adequate or where it is desirable to limit their extent.

  13. 111 In-labeled leukocytes in the detection of prosthetic vascular graft infections

    International Nuclear Information System (INIS)

    Williamson, M.R.; Boyd, C.M.; Read, R.C.; Thompson, B.W.; Barnes, R.W.; Shah, H.R.; Balachandran, S.; Ferris, E.J.

    1986-01-01

    Making a clinical diagnosis of infection in prosthetic vascular grafts is difficult but when undiagnosed, this condition has a high mortality rate. Using Indium-111-labeled white-blood cells, 30 scans were performed in 21 patients suspected of having a prosthetic graft infection. The diagnosis of infected graft was confirmed by surgery in all cases, and lack of infection was established by resolution of symptoms with conservative therapy. Twenty-four hour scans of autologous Indium-111 leukocytes were obtained, and correlative CT studies were done in 11 cases. There were 13 infected grafts at surgery (purulent material present), and scans were positive in all (100% sensitivity); of 17 scans, there were 15 true negatives and two false positives (88% specificity). Using the criteria of gas or fluid around the graft, the sensitivity of CT was only 37% in a small subset of these patients. One-half of the cases in which infection was suspected clinically had no infection and had negative scans. Various types of grafts and graft materials were used, and there was no correlation with presence or absence of infection on the basis of the type of graft. Extragraft infection sites were found in five patients. In conclusion, use of Indium-111 leukocytes has been found to be an accurate and valuable diagnostic method for evaluation of suspected prosthetic vascular graft infection, and to have higher diagnostic accuracy than CT

  14. Macro fat and micro fat

    DEFF Research Database (Denmark)

    Li, Yanjun; Gaillard, Jonathan R; McLaughlin, Tracey

    2015-01-01

    of body fat is unknown. In this study, we investigate adipose tissue dynamics in response to various isocaloric diet compositions, comparing gender- and insulin sensitivity-dependent differences. A body composition model is used to predict fat mass changes in response to changes in diet composition for 28...... the relative change of fat mass for each diet composition, respectively. We find that adipose cell-size dynamics are associated with different modulations dependent on gender and insulin resistance. Larger turnover and growth/shrinkage rates in insulin resistant individuals suggest they may be more sensitive......The adipose cell-size distribution is a quantitative characterization of adipose tissue morphology. At a population level, the adipose cell-size distribution is insulin-sensitivity dependent, and the observed correlation between obesity and insulin resistance is believed to play a key role...

  15. Cord Blood Banking Standards: Autologous Versus Altruistic

    Science.gov (United States)

    Armitage, Sue

    2016-01-01

    Cord blood (CB) is either donated to public CB banks for use by any patient worldwide for whom it is a match or stored in a private bank for potential autologous or family use. It is a unique cell product that has potential for treating life-threatening diseases. The majority of CB products used today are for hematopoietic stem cell transplantation and are accessed from public banks. CB is still evolving as a hematopoietic stem cell source, developing as a source for cellular immunotherapy products, such as natural killer, dendritic, and T-cells, and fast emerging as a non-hematopoietic stem cell source in the field of regenerative medicine. This review explores the regulations, standards, and accreditation schemes that are currently available nationally and internationally for public and private CB banking. Currently, most of private banking is under regulated as compared to public banking. Regulations and standards were initially developed to address the public arena. Early responses from the medical field regarding private CB banking was that at the present time, because of insufficient scientific data to support autologous banking and given the difficulty of making an accurate estimate of the need for autologous transplantation, private storage of CB as “biological insurance” should be discouraged (1, 2, 3). To ensure success and the true realization of the full potential of CB, whether for autologous or allogeneic use, it is essential that each and every product provided for current and future treatments meets high-quality, international standards. PMID:26779485

  16. Cord Blood Banking Standards: Autologous Versus Altruistic.

    Science.gov (United States)

    Armitage, Sue

    2015-01-01

    Cord blood (CB) is either donated to public CB banks for use by any patient worldwide for whom it is a match or stored in a private bank for potential autologous or family use. It is a unique cell product that has potential for treating life-threatening diseases. The majority of CB products used today are for hematopoietic stem cell transplantation and are accessed from public banks. CB is still evolving as a hematopoietic stem cell source, developing as a source for cellular immunotherapy products, such as natural killer, dendritic, and T-cells, and fast emerging as a non-hematopoietic stem cell source in the field of regenerative medicine. This review explores the regulations, standards, and accreditation schemes that are currently available nationally and internationally for public and private CB banking. Currently, most of private banking is under regulated as compared to public banking. Regulations and standards were initially developed to address the public arena. Early responses from the medical field regarding private CB banking was that at the present time, because of insufficient scientific data to support autologous banking and given the difficulty of making an accurate estimate of the need for autologous transplantation, private storage of CB as "biological insurance" should be discouraged (1, 2, 3). To ensure success and the true realization of the full potential of CB, whether for autologous or allogeneic use, it is essential that each and every product provided for current and future treatments meets high-quality, international standards.

  17. Predonated autologous blood transfusion in elective orthopaedic ...

    African Journals Online (AJOL)

    Background: The use of homologous blood carries significant risk of viral infections and immune-mediated reactions. Preoperative autologous blood donation is an attractive alternative to homologous transfusion and has become common in elective orthopaedic surgery. Objective: To present our experience with the use of ...

  18. Autologous granulation tissue tubes for replacement of urethral defects: An experimental study in male rabbits.

    Science.gov (United States)

    Jiang, Shi-Wei; Xu, Zhong-Hua; Zhao, Yuan-Yuan; Yan, Lei; Zhou, Zun-Lin; Gu, Gang-Li

    2017-10-31

    Tubularized urethroplasty is commonly performed in clinical practice using genital skin flaps, bladder mucosa, and buccal mucosa. However, the long-term effects are not satisfying, and donor site morbidities remain a problem. Besides, those grafts are unavailable with malignant conditions of the urinary tract, a history of lichen sclerosis, or oral disease. An autologous granulation tissue tube of any required length and diameter can be produced by implanting foreign objects subcutaneously (Summary Fig.). The current study aimed to investigate to what extent of length this fully autologous tissue could be used for tubularized urethroplasty, satisfying urethral patency and tissue regeneration, in male rabbits. Twenty-seven New Zealand male rabbits were randomly divided into three groups. Silastic tubes were implanted subcutaneously in Group 1 and Group 2. By 2 weeks the granulation tissue encapsulating the tubes was harvested. In Group 1, pendulous urethral segments of 1 cm were excised, and urethroplasty was performed with the granulation tissue tube in an end-to-end fashion. In Group 2, a pendulous urethral segment of 1.5 cm was replaced with the tissue tube. In Group 3, a pendulous urethral defect of 1 cm was repaired by re-anastomosis as control. Serial urethrograms were performed at 1, 2 and 6 months postoperatively. Meanwhile, the neo-urethra were harvested and analyzed grossly and histologically. The urethrograms showed that all animals in Group 1 maintained a wide urethral caliber. In contrast, animals in Group 2 and Group 3 developed progressive strictures. Histologically, an intact urothelium with one to two cell layers lined the graft by 1 month, which was surrounded by increasing organized smooth muscle in Group 1. By 6 months, the grafts were completely integrated into native urethra. Nevertheless, extensive fibrosis occurred in Group 2 and Group 3. The tissue successfully maintained patency and guided urethral regeneration across a distance of 1

  19. Pedicled fat flap to increase lateral fullness in upper blepharoplasty.

    Science.gov (United States)

    Sozer, Sadri O; Agullo, Francisco J; Palladino, Humberto; Payne, Phileemon E; Banerji, Soumo

    2010-03-01

    The eyelid of a young person can be distinguished by the lateral fullness of the upper eyelid. With aging, lateral fullness decreases. Volume restoration in the periorbital area has been previously addressed by fat draping and grafting. More recently, techniques for regaining lateral fullness of the upper eyelid have focused on fat grafting, although effective graft take, reabsorption, and irregularities have been a concern. To address these issues, the concept of pedicled fat draping in the upper eyelid was explored. In a retrospective study from June 2006 to August 2008, 31 patients underwent upper blepharoplasty with augmentation of the lateral fullness with a pedicled fat flap from the central fat pad. The fat from the central compartment was elevated, dissected, and then transposed to the lateral upper eyelid below the orbicularis muscle. All patients were women ranging in age from 43 to 68 years. Pre- and postoperative picture comparison demonstrated a more youthful appearance with increased lateral fullness of the upper eyelids. There were no cases of fat necrosis encountered. Increased volume remained stable over an average of one-year follow-up. No complications were recorded. Transposing a pedicled fat pad from the central compartment laterally has proven to be an effective technique for achieving predictable upper lateral eyelid fullness and thus achieving a long-lasting, more youthful appearance.

  20. Bone graft substitutes for the treatment of traumatic fractures of the extremities.

    Science.gov (United States)

    Hagen, Anja; Gorenoi, Vitali; Schönermark, Matthias P

    2012-01-01

    were calculated in a patient subgroup with high-grade open fractures (Gustilo-Anderson grade IIIB). Cost-effectiveness for BMP-2 versus standard care with autologous bone grafts as well as for other bone graft substitutes in fracture treatment has not been determined yet. Although there were some significant differences in favour of BMP-2, due to the overall poor quality of the studies the evidence can only be interpreted as suggestive for efficacy. In the case of CaP cements and bone marrow-based bone substitute materials, the evidence is only weakly suggestive for efficacy. From an overall economic perspective, the transferability of the results of the health economic evaluations to the current situation in Germany is limited. The current evidence is insufficient to evaluate entirely the use of different bone graft substitutes for fracture treatment. From a medical point of view, BMP-2 is a viable alternative for treatment of open fractures of the tibia, especially in cases where bone grafting is not possible. Autologous bone grafting is preferable comparing to the use of OP-1. Possible advantages of CaP cements and composites containing bone marrow over autogenous bone grafting should be taken into account in clinical decision making. The use of the hydroxyapatite material and allograft bone chips compared to autologous bone grafts cannot be recommended. From a health economic perspective, the use of BMP-2 in addition to standard care without bone grafting is recommended as cost-saving in patients with high-grade open fractures (Gustilo-Anderson grade IIIB). Based on the current evidence no further recommendations can be made regarding the use of bone graft substitutes for the treatment of fractures. To avoid legal implications, use of bone graft substitutes outside their approved indications should be avoided.

  1. Engineered vascularized bone grafts

    OpenAIRE

    Tsigkou, Olga; Pomerantseva, Irina; Spencer, Joel A.; Redondo, Patricia A.; Hart, Alison R.; O’Doherty, Elisabeth; Lin, Yunfeng; Friedrich, Claudia C.; Daheron, Laurence; Lin, Charles P.; Sundback, Cathryn A.; Vacanti, Joseph P.; Neville, Craig

    2010-01-01

    Clinical protocols utilize bone marrow to seed synthetic and decellularized allogeneic bone grafts for enhancement of scaffold remodeling and fusion. Marrow-derived cytokines induce host neovascularization at the graft surface, but hypoxic conditions cause cell death at the core. Addition of cellular components that generate an extensive primitive plexus-like vascular network that would perfuse the entire scaffold upon anastomosis could potentially yield significantly higher-quality grafts. W...

  2. Bilateral maxillary sinus floor augmentation with tissue-engineered autologous osteoblasts and demineralized freeze-dried bone

    Directory of Open Access Journals (Sweden)

    Aashish Deshmukh

    2015-01-01

    Full Text Available The pneumatization of the maxillary sinus often results in a lack of sufficient alveolar bone for implant placement. In the last decades, maxillary sinus lift has become a very popular procedure with predictable results. Sinus floor augmentation procedures are generally carried out using autologous bone grafts, bone substitutes, or composites of bone and bone substitutes. However, the inherent limitations associated with each of these, have directed the attention of investigators to new technologies like bone tissue engineering. Bone marrow stromal cells have been regarded as multi-potent cells residing in bone marrow. These cells can be harvested from a person, multiplied outside his body using bioengineering principles and technologies and later introduced into a tissue defect. We present a case where tissue-engineered autologous osteoblasts were used along with demineralized freeze-dried bone for sinus floor augmentation.

  3. [Effect of T-cell depletion of the graft on graft survival and graft vs host disease].

    Science.gov (United States)

    Irlé, C; Aapro, M; Chapuis, B; Kaestli, M; Marin, P; Jeannet, M

    1986-11-29

    A limiting dilution culture method has been developed which allows the detection of small numbers of residual marrow T cells following their depletion with the monoclonal antibody Campath-I and autologous complement. In seven consecutive patients the degree of T cell depletion obtained was 1.82 (1.27-2.82) log. The number of nucleated cells per kg decreased by 50% and the number of CFU-GM per kg decreased by 60%. In all except one case marrow cellularity was found to be satisfactory 3 weeks after the transplant. Peripheral engraftment of granulocytes (greater than 500/mm3 on day 20, greater than 1000/mm3 on day 27), lymphocytes (greater than 500 on day 39, greater than 1000 on day 66), platelets (greater than 20,000 and self-sustained after day 24) and red blood cells (day to last infusion = 19) indicated a delay in recovery of lymphocytes and possibly granulocytes, but not platelets or red blood cells, compared to the engraftment seen in non-T depleted patients. No correlation between nucleated cells infused, GFU-GM and engraftment was found. However, the extent of T cell depletion apparently affects lymphocyte, and possibly granulocyte, recovery. The delay in lymphoid engraftment is also reflected by nonresponsiveness to alloantigens during the first 6-9 months following marrow grafting in the absence of graft vs. host disease.

  4. Maxillary sinus lift with intraoral autologous bone and B--tricalcium phosphate: histological and histomorphometric clinical study.

    Science.gov (United States)

    Aguirre Zorzano, Luis Antonio; Rodríguez Tojo, María José; Aguirre Urizar, José Manuel

    2007-11-01

    Rehabilitation with implants in the upper maxilla often implies a challenge due to the shortage and quality of the remaining bone. Different kinds of grafts have been described in an endeavour to solve these problems. The purpose of this study was to assess the osteoconduction potential of an autogenous bone and B-Tricalcium Phosphate mixture, in the treatment of atrophic upper maxillae. 22 patients were treated using the "sinus lift" technique. All patients had residual bone equal to or greater than 5 mm, the sinus was lifted, bone grafted and implants installed during the same surgical procedure (autologous bone and B- Tricalcium Phospahate). During the implant exposure after the osseointegration period, samples of regenerated bone were taken using a trephine from 5 patients. Paraffin-embedded sections were analysed the structure and tissues percentages. Data were estimated statistically. Clinical results showed integration of the 42 fixtures installed. Histological analysis showed good integration of the B-Tricalcium Phosphate in the newly formed bone likewise absence of inflammation. Histomorphometric analysis showed a mean bone proportion of 30.7% (range 22.8%-50.6%). Results suggest the osteoconductive material B-Tricalcium Phosphate associated with autologous bone obtained through filtration is an appropriate graft for implant treatment of atrophic maxillae, in combination with the sinus lift procedure.

  5. Remoção da cartilagem articular associada ou não a implante homógeno ou enxerto autógeno de osso esponjoso em cães submetidos à artrodese atlantoaxial Joint cartilage removal associated or not to homologous implant or autologous cancellous bone graft in dogs submitted to atlantoaxial arthrodesis

    Directory of Open Access Journals (Sweden)

    Rafael Festugatto

    2013-03-01

    same amount. Group III (GIII: this was the same procedure as GI, however, was used autogenous cancellous bone graft at the given location. Radiographic examinations were performed on all animals at 30, 60 and 90 days postoperatively. At 90 days of PO was carried out euthanasia of animals for testing of manual palpation and CT evaluation and histological. Samples were kept in solution in 10% buffered formaldehyde for fixation for a minimum of 72 hours and after, decalcified in formic acid and sodium citrate for subsequent processing and included in paraffin. Sections were stained with hematoxylin-eosin for light microscopy evaluation. Statistical analysis of the association between the degree of joint fusion assessed by manual palpation, the digitized radiographic images and CT scans and treatment groups, we applied the Chi-square test of independence. The test results were evaluated by the exact significance and considered statistically significant at 5% significance (P<0.05. By manual palpation test and by the CT images can be seen that there was no statistically significant difference between groups at 90 days postoperatively. Radiographic analysis of the atlantoaxial joint showed that the degree of fusion was similar among treatments, no statistical difference at 30, 60 and 90 days postoperatively. Regarding the histopathological study of atlantoaxial joint of dogs after 90 days postoperatively was found that bone formation in group I had 25% of each intensity (absent, mild, moderate, severe in group II, 75% lighter and 25% sharp and in group III, 25% moderate and 75% severe. It can be concluded that the use of graft homogenous preserved in 98% glycerin in dogs undergoing atlantoaxial fusion method is a viable alternative for treatment of atlantoaxial instability. There is no difference in the degree of joint fusion and bone formation when the technique of atlantoaxial arthrodesis in dogs is associated with autogenous cancellous bone graft or implant homogenous. The

  6. Osseous scintigraphy and auxiliary graft

    International Nuclear Information System (INIS)

    Khelifa, F.; Siles, S.; Puech, B.

    1992-01-01

    The scintigraphy could be a good way to survey the osseous graft: three cases are studied in which were recognized the presence of a graft, surinfection, graft lysis, pseudo-arthrosis, algodystrophy. 8 refs., 5 figs

  7. Meniscal allograft transplantation. Part 1: systematic review of graft biology, graft shrinkage, graft extrusion, graft sizing, and graft fixation.

    Science.gov (United States)

    Samitier, Gonzalo; Alentorn-Geli, Eduard; Taylor, Dean C; Rill, Brian; Lock, Terrence; Moutzouros, Vasilius; Kolowich, Patricia

    2015-01-01

    To provide a systematic review of the literature regarding five topics in meniscal allograft transplantation: graft biology, shrinkage, extrusion, sizing, and fixation. A systematic literature search was conducted using the PubMed (MEDLINE), ScienceDirect, and EBSCO-CINAHL databases. Articles were classified only in one topic, but information contained could be reported into other topics. Information was classified according to type of study (animal, in vitro human, and in vivo human) and level of evidence (for in vivo human studies). Sixty-two studies were finally included: 30 biology, 3 graft shrinkage, 11 graft extrusion, 17 graft size, and 6 graft fixation (some studies were categorized in more than one topic). These studies corresponded to 22 animal studies, 22 in vitro human studies, and 23 in vivo human studies (7 level II, 10 level III, and 6 level IV). The principal conclusions were as follows: (a) Donor cells decrease after MAT and grafts are repopulated with host cells form synovium; (b) graft preservation alters collagen network (deep freezing) and causes cell apoptosis with loss of viable cells (cryopreservation); (c) graft shrinkage occurs mainly in lyophilized and gamma-irradiated grafts (less with cryopreservation); (d) graft extrusion is common but has no clinical/functional implications; (e) overall, MRI is not superior to plain radiograph for graft sizing; (f) graft width size matching is more important than length size matching; (g) height appears to be the most important factor influencing meniscal size; (h) bone fixation better restores contact mechanics than suture fixation, but there are no differences for pullout strength or functional results; and (i) suture fixation has more risk of graft extrusion compared to bone fixation. Systematic review of level II-IV studies, Level IV.

  8. Bioreactor activated graft material for early implant fixation in bone

    DEFF Research Database (Denmark)

    Snoek Henriksen, Susan; Ding, Ming; Overgaard, Søren

    2011-01-01

    Introduction The combined incubation of a composite scaffold with bone marrow stromal cells in a perfusion bioreactor could make up a novel hybrid graft material with optimal properties for early fixation of implant to bone. The aim of this study was to create a bioreactor activated graft (BAG...... in each sheep. The concentric gap (2 mm) surrounding the implant was filled with 1) BAG (autogenous), 2) granules, 3) granules+bone marrow aspirate (BMA, autologous) or 4) allograft. The sheep were euthanized after 6 weeks. Distal femurs were removed and implant-bone samples were divided in two parts...... calculated to assess implant fixation. Results were assessed by One-way ANOVA. P-values less than 0.05 were considered significant. Results One sheep in group 1 had to be euthanized after 4 weeks (excluded). One implant in each group was loosened and could not undergo push-out test (excluded). Group 1...

  9. FAT MYRINGOPLASTY IN A TERTIARY CARE GOVERNMENT HOSPITAL

    Directory of Open Access Journals (Sweden)

    Paidi Ramesh Chandra

    2017-12-01

    Full Text Available BACKGROUND Myringoplasty is the surgical procedure performed for the closure of perforations of pars tensa of the tympanic membrane. Various graft materials are used such as temporalis fascia, periosteum, perichondrium, vein, dura and adipose tissue (fat. Fat myringoplasty is a simple, cost effective and outpatient procedure. This study is performed to evaluate the operative outcome of fat myringoplasty in patients with Chronic Suppurative Otitis Media (CSOM. The aim of the study is to assess graft uptake to assess hearing improvement and to assess the operative outcome in relation to the site of perforation after fat myringoplasty. MATERIALS AND METHODS This study was performed in Government ENT Hospital, Andhra Medical College, Visakhapatnam. A total of 20 patients between the age group of 18-50 years suffering from tubotympanic type of chronic suppurative otitis media were taken up for study. The study period was for 18 months from October 2015 to March 2017. RESULTS Results were analysed in terms of graft uptake and hearing improvement. Average audiometric gain after 6 months was 10.58 dB. Successful closure of perforation was achieved in 90% cases. Perforations involving posterior quadrant showed 100% graft uptake, compared to anterior quadrant perforations, which showed 75% graft uptake. No major postoperative complications were noted. CONCLUSION Fat myringoplasty can be safely performed in dry, small central perforations of tympanic membrane especially belonging to posterior quadrant. Ear lobule constitutes convenient source of fat graft. The procedure can be performed as a day care surgery. Proper selection of cases is necessary to obtain good results.

  10. Advances in radiation grafting

    International Nuclear Information System (INIS)

    Hegazy, El-Sayed A.; AbdEl-Rehim, H.A.; Kamal, H.; Kandeel, K.A.

    2001-01-01

    Graft copolymerization is an attractive means for modifying base polymers because grafting frequently results in the superposition of properties relating to the backbone and pendent chains. Among the various methods for initiating the grafting reaction, ionizing radiation is the cleanest and most versatile method of grafting available. Ion-exchange membranes play an important role in modern technology, especially in separation and purification of materials. The search for improved membrane composition has considered almost every available polymeric material because of its great practical importance. Grafting of polymers with a mixture of monomers is important since different types of chains containing different functional groups are included. A great deal is focused on the waste treatment of heavy and toxic metals from wastewater because of the severe problems of environmental pollution. Functionalized polymers suitable for metal adsorption with their reactive functional groups such as carboxylic and pyridine groups suitable for waste treatment were prepared by radiation grafting method. More reactive chelating groups were further introduced to the grafted copolymer through its functional groups by chemical treatments with suitable reagents. The advances of radiation grafting and possible uses are briefly discussed

  11. Calcar bone graft

    Energy Technology Data Exchange (ETDEWEB)

    Bargar, W.L.; Paul, H.A.; Merritt, K.; Sharkey, N.

    1986-01-01

    A canine model was developed to investigate the use of an autogeneic iliac bone graft to treat the calcar deficiency commonly found at the time of revision surgery for femoral component loosening. Five large male mixed-breed dogs had bilateral total hip arthroplasty staged at three-month intervals, and were sacrificed at six months. Prior to cementing the femoral component, an experimental calcar defect was made, and a bicortical iliac bone graft was fashioned to fill the defect. Serial roentgenograms showed the grafts had united with no resorption. Technetium-99 bone scans showed more uptake at three months than at six months in the graft region. Disulfine blue injection indicated all grafts were perfused at both three and six months. Thin section histology, fluorochromes, and microradiographs confirmed graft viability in all dogs. Semiquantitative grading of the fluorochromes indicated new bone deposition in 20%-50% of each graft at three months and 50%-80% at six months. Although the calcar bone graft was uniformly successful in this canine study, the clinical application of this technique should be evaluated by long-term results in humans.

  12. Advances in radiation grafting

    Science.gov (United States)

    Hegazy, El-Sayed A.; AbdEl-Rehim, H. A.; Kamal, H.; Kandeel, K. A.

    2001-12-01

    Graft copolymerization is an attractive means for modifying base polymers because grafting frequently results in the superposition of properties relating to the backbone and pendent chains. Among the various methods for initiating the grafting reaction, ionizing radiation is the cleanest and most versatile method of grafting available. Ion-exchange membranes play an important role in modern technology, especially in separation and purification of materials. The search for improved membrane composition has considered almost every available polymeric material because of its great practical importance. Grafting of polymers with a mixture of monomers is important since different types of chains containing different functional groups are included. A great deal is focused on the waste treatment of heavy and toxic metals from wastewater because of the severe problems of environmental pollution. Functionalized polymers suitable for metal adsorption with their reactive functional groups such as carboxylic and pyridine groups suitable for waste treatment were prepared by radiation grafting method. More reactive chelating groups were further introduced to the grafted copolymer through its functional groups by chemical treatments with suitable reagents. The advances of radiation grafting and possible uses are briefly discussed.

  13. Complement activated granulocytes can cause autologous tissue destruction in man

    Directory of Open Access Journals (Sweden)

    E. Löhde

    1992-01-01

    Full Text Available Activation of polymorphonuclear granulocytes (PMNs by C5a is thought to be important in the pathogenesis of multiple organ failure during sepsis and after trauma. In our experiment exposure of human PMNs to autologous zymosan activated plasma (ZAP leads to a rapid increase in chemiluminescence. Heating the ZAP at 56°C for 30 min did not alter the changes, while untreated plasma induced only baseline activity. The respiratory burst could be completely abolished by decomplementation and preincubation with rabbit antihuman C5a antibodies. Observation of human omentum using electron microscopy showed intravascular aggregation of PMNs, with capillary thrombosis and diapedesis of the cells through endothelial junctions 90 s after exposure to ZAP. PMNs caused disruption of connections between the mesothelial cells. After 4 min the mesothelium was completely destroyed, and connective tissue and fat cells exposed. Native plasma and minimum essential medium did not induce any morphological changes. These data support the concept that C5a activated PMNs can cause endothelial and mesothelial damage in man. Even though a causal relationship between anaphylatoxins and organ failure cannot be proved by these experiments C5a seems to be an important mediator in the pathogenesis of changes induced by severe sepsis and trauma in man.

  14. Tumescent mastectomy technique in autologous breast reconstruction.

    Science.gov (United States)

    Vargas, Christina R; Koolen, Pieter G L; Ho, Olivia A; Ricci, Joseph A; Tobias, Adam M; Lin, Samuel J; Lee, Bernard T

    2015-10-01

    Use of the tumescent mastectomy technique has been reported to facilitate development of a hydrodissection plane, reduce blood loss, and provide adjunct analgesia. Previous studies suggest that tumescent dissection may contribute to adverse outcomes after immediate implant reconstruction; however, its effect on autologous microsurgical reconstruction has not been established. A retrospective review was conducted of all immediate microsurgical breast reconstruction procedures at a single academic center between January 2004 and December 2013. Records were queried for age, body mass index, mastectomy weight, diabetes, hypertension, smoking, preoperative radiation, reconstruction flap type, and autologous flap weight. Outcomes of interest were mastectomy skin necrosis, complete and partial flap loss, return to the operating room, breast hematoma, seroma, and infection. There were 730 immediate autologous breast reconstructions performed during the study period; 46% with the tumescent dissection technique. Groups were similar with respect to baseline patient and procedural characteristics. Univariate analysis revealed no significant difference in the incidence of mastectomy skin necrosis, complete or partial flap loss, return to the operating room, operative time, estimated blood loss, recurrence, breast hematoma, seroma, or infection in patients undergoing tumescent mastectomy. Multivariate analysis also demonstrated no significant association between the use of tumescent technique and postoperative breast mastectomy skin necrosis (P = 0.980), hematoma (P = 0.759), or seroma (P = 0.340). Use of the tumescent dissection technique during mastectomy is not significantly associated with adverse outcomes after microsurgical breast reconstruction. Despite concern for its impact on implant reconstruction, our findings suggest that this method can be used safely preceding autologous procedures. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Autologous Stem Cell Transplant for AL Amyloidosis

    OpenAIRE

    Roy, Vivek

    2012-01-01

    AL amyloidosis is caused by clonal plasma cells that produce immunoglobulin light chains which misfold and get deposited as amyloid fibrils. Therapy directed against the plasma cell clone leads to clinical benefit. Melphalan and corticosteroids have been the mainstay of treatment for a number of years and the recent availability of other effective agents (IMiDs and proteasome inhibitors) has increased treatment options. Autologous stem cell transplant (ASCT) has been used in the treatment of ...

  16. Management of Fournier's gangrene non-healing wounds by autologous skin micrograft biotechnology: a new technique.

    Science.gov (United States)

    Bocchiotti, M A; Bogetti, P; Parisi, A; Rivarossa, F; Frenello, A; Baglioni, E A

    2017-06-02

    Fournier's gangrene is an acute bacterial infection producing necrosis of the perineum and external genitalia that generally affects elderly men. Although skin grafts and flaps are the standard procedure for reconstruction, sometimes wounds can become chronic. Rigenera Protocol is a new technique based on autologous skin micrografts that reactivates and supports wound healing. A 40-year-old male with Fournier's gangrene, due to a rectal microperforation following diarrhoea, was treated with surgical debridement, negative pressure wound therapy and subsequently coverage with skin grafts. He developed non-healing wounds treated by Rigenera protocol after two months of advanced wound dressings. This technique is based on skin micrografts obtained by mechanical dermal disgregation to provide mesenchymal stem cells and extracellular matrix to the wound. The suspension injected into the wound triggers reactivation of healing without significant residual scarring on both donor site and treated area. Non-healing wounds were reduced by 15% at day 7 and by 50% after 30 days. Wounds completely healed after seventy days. The regenerated tissue appeared closer to skin graft than to scar tissue. This report shows how the use of skin micrografts through Rigenera protocol can be a useful method to reactivate wound healing resulting from Fournier's gangrene, with no discomfort for patient in a practical, safe and easy way.

  17. Perineal hernia repair using an autologous tunica vaginalis communis in nine intact male dogs.

    Science.gov (United States)

    Pratummintra, Kittiya; Chuthatep, Suwicha; Banlunara, Wijit; Kalpravidh, Marissak

    2013-01-01

    Perineal hernia in dogs is very problematic and mostly requires surgical reconstruction of the weak pelvic diaphragm. Tissue or synthetic grafts have been used for the correction after failure of the conventional herniorrhaphy. Aim of this clinical trial was to assess the possible use of the autologous tunica vaginalis communis as a free graft for perineal hernia repair in intact male dogs. Seven unilateral and 2 bilateral perineal hernias in nine intact male dogs free from testicular and scrotal neoplasms were included in this study. The median surgical time for unilateral herniorrhaphy was 75 min. The median follow-up time was 13 months. The success of the autografting, based on no recurrence and comfort of the animals during urination and defecation, was found in ten of 11 hernias; giving a success rate of 90.91%. One hernia (9.09%) recurred 10 days after surgery. Histopathological examination of the apposing area between the graft and the adjacent tissue, taken during the repair of the recurred case at day 20, revealed neovascularization and connective tissue ingrowth. In conclusion, the tunica vaginalis autograft can be used for perineal herniorrhaphy in intact male dogs.

  18. A novel scoring system for evaluation of results of autologous transplantation methods in vitiligo

    Directory of Open Access Journals (Sweden)

    Gupta Somesh

    2002-01-01

    Full Text Available Autologous transplantation of melanocyte/melanocytes bearing epidermis for vitiligo can be done by mini-punch grafting (MPG, suction blister epidermal grafting (SBEG, thin split -thickness skin grafting (TSTG, transplantation of basal cell layer enriched suspension and cultured epithelial/melanocyte transplantation. To date no comparative study of these transplantation procedures has been published. Comparison of different studies carried out at different centers may be difficult in the absence of uniform evaluation criteria. In most of the published studies, the results were evaluated in terms of extent of pigmentation. Complictions and color match were evaluated separately. This approach, however, may not give a fair idea about the results. We have developed a scoring system with holistic approach considering the extent of pigmentation, color match and the complications of both the donor and the recipient areas, all taken together. In the scoring system, the score for individual criteria was multiplied with a factor, the value of which was decided on the basis of relative importance of each criteria. The use of this scoring system is exemplified in twelve patients who underwent TSTG, SBEG and MPG. In the scoring system the results were judged as excellent and fair in 3 patients each, as good in 4 patients and as poor in 2 patients.

  19. Efeito do enxerto autólogo de pericôndrio costal com butil-2-cianoacrilato em lesão provocada na cartilagem articular do joelho de coelhos The effect of autologous costal perichondrium graft with butyl-2-cyanoacrylate in provoked injury in the articular cartilage of rabbit’s knee

    Directory of Open Access Journals (Sweden)

    Mário Sérgio Viana Xavier

    1999-10-01

    Full Text Available A finalidade desse estudo foi verificar o efeito do enxerto autólogo de pericôndrio com butil-2-cianoacrilato em lesão provocada na cartilagem articular do joelho de coelhos. Foram utilizados animais machos, adultos, divididos em 2 grupos, denominados de Grupo A e de Grupo B, de 17 animais cada um. Os animais do Grupo A foram reoperados com 4 semanas e os do Grupo B com 8 semanas. Foi retirado um fragmento de 2 cm da 7ª cartilagem costal esquerda do qual se descolou o pericôndrio. Retiraram-se dois cilindros ósseo-cartilaginosos, um de cada côndilo femural medial do mesmo animal. De um lado a cartilagem articular do cilindro foi substituida por pericôndrio com um fina camada do adesivo tecidual na sua face externa e do outro lado só foi retirada a cartilagem articular. Os cilindros foram recolocados nos fêmures. Macroscopicamente, no Grupo A, encontrou-se a maioria das lesões com pericôndrio recobertas totalmente com tecido e todas as lesões sem pericôndrio recobertas parcialmente. No Grupo B, não se encontrou diferença macroscópica significante entre a cobertura total e parcial com tecido, das lesões. Estatisticamente, não houve diferença microscópica significante entre as lesões com pericôndrio e sem pericôndrio do Grupo A e do Grupo B e nem entre os Grupos A e B.The purpose of this study was to verify the effect of the perichondrium graft with butyl-2-cyanoacrylate in provoked injury in the articular cartilage of rabbit`s knee. Male adult animals were used, divided in 2 groups, called Group A and Group B, with 17 animals each. The Group A animals were reoperated in 4 weeks and the Group B animals in 8 weeks. A 2 cm fragment was taken out from the 7th costal cartilage from which the perichondrium was removed. Two osteo-cartilaginous cylinders were taken out from each medialis condyles of the femurs in the same animal. The articular cartilage of the cylinder was replaced in one side by the perichondrium with a thin layer

  20. Prospectively randomized clinical trial to compare in situ and reversed saphenous vein grafts for femoropopliteal bypass.

    Science.gov (United States)

    Harris, P L; How, T V; Jones, D R

    1987-04-01

    Two hundred and fifteen femoropopliteal bypass procedures using autologous saphenous vein grafts were randomly allocated to either the reversed or in situ technique. Eleven veins (5 per cent) were rejected at operation on the basis of their small size, nine in the reversed group and two in the in situ group, and there were two (2 per cent) perioperative deaths in each group, leaving 102 reversed and 98 in situ grafts for further study. The cumulative patency at 3 years of the reversed grafts was 77 per cent and that of the in situ grafts was 68 per cent (n.s.). The patency of all grafts was affected adversely by small veins (P less than 0.005), long grafts (P less than 0.05), low volume of blood flow in the grafts (P less than 0.001) and poor run-off (P less than 0.05). These factors influenced the outcome of the in situ and reversed operations to a similar degree and there was no statistically significant difference between them within any subgroup. The mean compliance of the in situ grafts measured 3 months or more after operation with an ultrasonic echo-tracking system was 0.024 +/- 0.01 per cent/mmHg (+/- s.d.) compared with 0.017 +/- 0.01 per cent/mmHg for the reversed grafts (t = 2.43, P less than 0.02). The incidence of fibrous stricture formation as shown by intravenous digital subtraction angiography was 29 per cent in both the reversed and the in situ grafts. The results of the study to date indicate that reversed and in situ vein grafts are equally effective for femoropopliteal bypass.

  1. Blood Vessel-Derived Acellular Matrix for Vascular Graft Application

    Directory of Open Access Journals (Sweden)

    Luigi Dall’Olmo

    2014-01-01

    Full Text Available To overcome the issues connected to the use of autologous vascular grafts and artificial materials for reconstruction of small diameter (<6 mm blood vessels, this study aimed to develop acellular matrix- (AM- based vascular grafts. Rat iliac arteries were decellularized by a detergent-enzymatic treatment, whereas endothelial cells (ECs were obtained through enzymatic digestion of rat skin followed by immunomagnetic separation of CD31-positive cells. Sixteen female Lewis rats (8 weeks old received only AM or previously in vitro reendothelialized AM as abdominal aorta interposition grafts (about 1 cm. The detergent-enzymatic treatment completely removed the cellular part of vessels and both MHC class I and class II antigens. One month after surgery, the luminal surface of implanted AMs was partially covered by ECs and several platelets adhered in the areas lacking cell coverage. Intimal hyperplasia, already detected after 1 month, increased at 3 months. On the contrary, all grafts composed by AM and ECs were completely covered at 1 month and their structure was similar to that of native vessels at 3 months. Taken together, our findings show that prostheses composed of AM preseeded with ECs could be a promising approach for the replacement of blood vessels.

  2. Osteoinduction of bone grafting materials for bone repair and regeneration.

    Science.gov (United States)

    García-Gareta, Elena; Coathup, Melanie J; Blunn, Gordon W

    2015-12-01

    Regeneration of bone defects caused by trauma, infection, tumours or inherent genetic disorders is a clinical challenge that usually necessitates bone grafting materials. Autologous bone or autograft is still considered the clinical "gold standard" and the most effective method for bone regeneration. However, limited bone supply and donor site morbidity are the most important disadvantages of autografting. Improved biomaterials are needed to match the performance of autograft as this is still superior to that of synthetic bone grafts. Osteoinductive materials would be the perfect candidates for achieving this task. The aim of this article is to review the different groups of bone substitutes in terms of their most recently reported osteoinductive properties. The different factors influencing osteoinductivity by biomaterials as well as the mechanisms behind this phenomenon are also presented, showing that it is very limited compared to osteoinductivity shown by bone morphogenetic proteins (BMPs). Therefore, a new term to describe osteoinductivity by biomaterials is proposed. Different strategies for adding osteoinductivity (BMPs, stem cells) to bone substitutes are also discussed. The overall objective of this paper is to gather the current knowledge on osteoinductivity of bone grafting materials for the effective development of new graft substitutes that enhance bone regeneration. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Autologous growth factor injections in chronic tendinopathy.

    Science.gov (United States)

    Sandrey, Michelle A

    2014-01-01

    de Vos RJ, van Veldhoven PLJ, Moen MH, Weir A, Tol JL. Autologous growth factor injections in chronic tendinopathy: a systematic review. Br Med Bull. 2010;95:63-77. The authors of this systematic review evaluated the literature to critically consider the effects of growth factors delivered through autologous whole-blood and platelet-rich-plasma (PRP) injections in managing wrist-flexor and -extensor tendinopathies, plantar fasciopathy, and patellar tendinopathy. The primary question was, according to the published literature, is there sufficient evidence to support the use of growth factors delivered through autologous whole-blood and PRP injections for chronic tendinopathy? The authors performed a comprehensive, systematic literature search in October 2009 using PubMed, MEDLINE, EMBASE, CINAHL, and the Cochrane library without time limits. The following key words were used in different combinations: tendinopathy, tendinosis, tendinitis, tendons, tennis elbow, plantar fasciitis, platelet rich plasma, platelet transfusion, and autologous blood or injection. The search was limited to human studies in English. All bibliographies from the initial literature search were also viewed to identify additional relevant studies. Studies were eligible based on the following criteria: (1) Articles were suitable (inclusion criteria) if the participants had been clinically diagnosed as having chronic tendinopathy; (2) the design had to be a prospective clinical study, randomized controlled trial, nonrandomized clinical trial, or prospective case series; (3) a well-described intervention in the form of a growth factor injection with either PRP or autologous whole blood was used; and (4) the outcome was reported in terms of pain or function (or both). All titles and abstracts were assessed by 2 researchers, and all relevant articles were obtained. Two researchers independently read the full text of each article to determine if it met the inclusion criteria. If opinions differed on

  4. Autologous blood cell transplantation versus HLA-identical sibling transplantation for acute myeloid leukemia in first complete remission: a registry study from the Center for International Blood and Marrow Transplantation Research

    Science.gov (United States)

    Keating, Armand; DaSilva, Gisela; Pérez, Waleska S.; Gupta, Vikas; Cutler, Corey S.; Ballen, Karen K.; Cairo, Mitchell S.; Camitta, Bruce M.; Champlin, Richard E.; Gajewski, James L.; Lazarus, Hillard M.; Lill, Michael; Marks, David I.; Nabhan, Chadi; Schiller, Gary J.; Socie, Gerald; Szer, Jeffrey; Tallman, Martin S.; Weisdorf, Daniel J.

    2013-01-01

    The optimal post-remission treatment for acute myeloid leukemia in first complete remission remains uncertain. Previous comparisons of autologous versus allogeneic hematopoietic cell transplantation noted higher relapse, but lower treatment-related mortality though using bone marrow grafts, with treatment-related mortality of 12-20%. Recognizing lower treatment-related mortality using autologous peripheral blood grafts, in an analysis of registry data from the Center for International Blood and Transplant Research, we compared treatment-related mortality, relapse, leukemia-free survival, and overall survival for patients with acute myeloid leukemia in first complete remission (median ages 36-44, range 19-60) receiving myeloablative HLA-matched sibling donor grafts (bone marrow, n=475 or peripheral blood, n=428) versus autologous peripheral blood (n=230). The 5-year cumulative incidence of treatment-related mortality was 19% (95% confidence interval, 16-23%), 20% (17-24%) and 8% (5-12%) for allogeneic bone marrow, allogeneic peripheral blood and autologous peripheral blood stem cell transplant recipients, respectively. The corresponding figures for 5-year cumulative incidence of relapse were 20% (17-24%), 26% (21-30%) and 45% (38-52%), respectively. At 5 years, leukemia-free survival and overall survival rates were similar: allogeneic bone marrow 61% (56-65%) and 64% (59-68%); allogeneic peripheral blood 54% (49-59%) and 59% (54-64%); autologous peripheral blood 47% (40-54%) and 54% (47-60%); P=0.13 and P=0.19, respectively. In multivariate analysis the incidence of treatment-related mortality was lower after autologous peripheral blood transplantation than after allogeneic bone marrow/peripheral blood transplants [relative risk 0.37 (0.20-0.69); P=0.001], but treatment failure (death or relapse) after autologous peripheral blood was significantly more likely [relative risk 1.32 (1.06-1.64); P=0.011]. The 5-year overall survival, however, was similar in patients who

  5. Effect of centrifugation and washing on adipose graft viability: a new method to improve graft efficiency.

    Science.gov (United States)

    Hoareau, Laurence; Bencharif, Karima; Girard, Anne-Claire; Gence, Lydie; Delarue, Pierre; Hulard, Olivier; Festy, Franck; Roche, Regis

    2013-05-01

    Adipose tissue grafting is a promising method in the field of surgical filling. We studied the effect of centrifugation on fat grafts, and we propose an optimised protocol for the improvement of adipose tissue viability. Adipose tissue was subjected to different centrifugations, and the volumes of interstitial liquid and oil released were measured to choose the optimal condition. Tissue from this condition was then compared to tissue obtained from two traditional techniques: strong centrifugation (commonly 3 min at 3000 rpm/900 g), and decantation, by injecting into immunodeficient mice. The cytokine interleukin-6 (IL-6) and chemokine monocyte chemotactic protein-1 (MCP-1) were assayed 24 h post-injection, and after 1 month of grafting the state of the lipografts was evaluated through macroscopic and histological analysis, with oil gap area measurement. Strong centrifugation (900 g, 1800 g) is deleterious for adipose tissue because it leads to until threefold more adipocyte death compared to low centrifugation (100 g, 400 g). In addition, mice injected with strong centrifuged and non-centrifuged adipose tissue have higher rates of blood IL-6 and MCP-1, compared to those grafted with soft centrifuged fat. Moreover, extensive lipid vacuoles were detectable on histological sections of the non-centrifuged lipografts, whereas lipografts from soft centrifugation contain a higher amount of connective tissue containing collagen fibres. It is necessary to wash and centrifuge adipose tissue before reinjection in order to remove infiltration liquid and associated toxic molecules, which in the long term are deleterious for the graft. However, strong centrifugation is not recommended since it leads very quickly to greater adipocyte death. Thus, soft centrifugation (400 g/1 min), preceded by washings, seems to be the most appropriate protocol for the reinjection of adipose tissue. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published

  6. The effect of adipose-derived stem cells on the increased survival of crushed cartilage graft in rabbits

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Ebadi

    2016-10-01

    Full Text Available Background: In recent years the use of diced cartilage grafts in reconstructive surgery particulary rhinoplasty have been considered by most plastic surgeons. However, long-term resorption usually occurs. Stem cells are a powerful tool for reconstructive surgery to rebuild and maintain tissue with reduced complications. Since the adipose tissue-derived stem cells (ADSCs can rebuild a wide variety of tissues such as skin, fat, bone and cartilage are used, this is a very good chance for cosmetic surgery. The aim of this study was to examine the effects of adipose-derived stem cells on the viability of diced cartilage grafts. Methods: This interventional study was performed on May 2014 in animal laboratory of Hazrat Fatima Hospital on 10 New Zealand white male rabbits, weighing 2000-2500 grams, approximately 12 to 16 weeks of age. Stem cells was harvested from inguinal adipose tissue of each rabbits. After completely removing the skin and perichondrium, cartilage became divided into two equal pieces using a scalpel. Then place the ear amputation was restored by nylon 4 zero. After weighing cartilages, on either side of the center line on the back of each rabbits, left and right, subcutaneous pocket created equal weight and each piece of cartilage was placed in an envelope. Stem cells were injected in one side and the other side was control. The cartilage weights were recorded both before implantation and after explantation. Evaluation of living chondrocytes was conducted 12 weeks after implantation. Results: The mean difference of cartilage weights was varied between two groups (intervention and control sides, So that the average was significantly higher in stem cell side than that in the control side (P= 0.021. The average number of live chondrocytes was significantly higher in the intervention side than the control side (P< 0.001. Conclusion: Despite the unclear mechanism, these results suggest that adipose-derived stem cells can maintain the

  7. Sarpogrelate hydrochloride reduced intimal hyperplasia in experimental rabbit vein graft.

    Science.gov (United States)

    Kodama, Akio; Komori, Kimihiro; Hattori, Keisuke; Yamanouchi, Dai; Kajikuri, Junko; Itoh, Takeo

    2009-05-01

    The selective 5-HT(2A) receptor antagonist sarpogrelate has been clinically used for treatment in atherosclerotic diseases. However, it remains unknown whether administration of sarpogrelate inhibits intimal hyperplasia seen in autologous vein grafts. Therefore, we sought to clarify this question using an experimental rabbit vein graft model. Male rabbits were divided into two groups: a control group and a sarpogrelate-treated group. The jugular vein was interposed in the carotid artery in reversed fashion for 4 weeks and intimal hyperplasia of the grafted vein was measured (n = 8, in each group). Acetylcholine (ACh)-induced endothelium-dependent relaxation was tested by precontraction with prostaglandin F(2alpha) (PGF(2alpha), 5 muM) (n = 5, in each). endothelial nitric oxide synthase (eNOS) protein expression and superoxide production of these veins were also assessed. The suppression of intimal hyperplasia was significantly greater in the sarpogrelate-treated group than in the control group. ACh induced an endothelium-dependent relaxation in the sarpogrelate-treated group (but not in the control group). In endothelium-intact strips from the sarpogrelate-treated group, the nitric oxide (NO) synthase inhibitor nitroarginine enhanced the PGF(2alpha)-induced contraction and blocked the ACh-induced relaxation. Immunoreactive eNOS protein expression was similar between the two groups but superoxide production (estimated from ethidium fluorescence) in endothelial cells was significantly smaller in the sarpogrelate-treated group. The present results indicate that in vivo blockade of 5-HT(2A) receptors leads to an inhibition of intimal hyperplasia in rabbit vein graft. It is suggested that an increased function of endothelium-derived NO through a reduction in endothelial superoxide production may be a possible underlying mechanism for this. These novel findings support the clinical usefulness of sarpogrelate for preventing intimal hyperplasia in vein graft after bypass

  8. Management of Terminal Osseous Overgrowth of the Humerus With Simple Resection and Osteocartilaginous Grafts.

    Science.gov (United States)

    Fedorak, Graham T; Cuomo, Anna V; Watts, Hugh G; Scaduto, Anthony A

    Osseous overgrowth is a common complication in children after humeral transcortical amputation. Capping tibial overgrowth with the proximal fibula has been shown to be the most effective treatment. However, best treatment practices are not clear for the humerus. We compared patients treated surgically for humeral osseous overgrowth with simple resection or autologous osteocartilaginous graft to determine if this treatment were as effective in the humerus as it has been in the tibia. A retrospective review of humeral amputees from 1987 to 2011 at a pediatric hospital was performed. Patients with 2 years follow-up who underwent surgical treatment for established humeral overgrowth were included. Patients initially managed with simple resection were compared with those managed with autologous osteocartilaginous grafts. Descriptive statistics were calculated for demographic and outcome variables. T tests and χ tests were used to compare differences between groups. Eighteen humeri in 16 patients met inclusion criteria. Mean age at surgery was 8.3 (2.6 to 13.6) years and mean follow-up was 6.3 (1.5 to 10.4) years. Thirteen humeri underwent simple resection, with recurrent overgrowth in 9, and revision surgery in 8 at a mean 2.6 years. Five humeri were primarily managed with autologous osteocartilaginous grafts. Two developed non-overgrowth-related complications at 1 and 42 months. Including revision procedures after simple resection, 10 humeri were managed with autologous osteocartilaginous grafts. Thirty percent (3/10) required revision surgery; however, there were no cases of recurrent overgrowth. χ comparison showed lower rates of complications (P=0.004) and reoperation (P=0.012) with capping as compared with simple resection. Autologous osteocartilaginous capping of the humerus has a significantly lower rate of complications and reoperation compared with simple resection. However, the capping procedure has the potential for other complications related to difficulty

  9. Autologous osteochondral mosaicplasty or TruFit plugs for cartilage repair.

    Science.gov (United States)

    Hindle, Paul; Hendry, Jane L; Keating, John F; Biant, Leela C

    2014-06-01

    Autologous osteochondral mosaicplasty and TruFit Bone graft substitute plugs are methods used to repair symptomatic articular cartilage defects in the adult knee. There have been no comparative studies of the two techniques. This retrospective study assessed functional outcome of patients using the EQ-5D, Knee Injury and Osteoarthritis Outcome Score (KOOS) and Modified Cincinnati scores at follow-up of 1-5 years. There were 66 patients in the study (35 TruFit and 31 Mosaicplasty): 44 males and 22 females with a mean age of 37.3 years (SD 12.6). The mean BMI was 26.8. Thirty-six articular cartilage lesions were due to trauma, twenty-six due to osteochondritis dissecans and three due to non-specific degenerative change or unknown. There was no difference between the two groups age (n.s.), sex (n.s.), BMI (n.s.), defect location (n.s.) or aetiology (n.s.). The median follow-up was 22 months for the TruFit cohort and 30 months for the mosaicplasty group. There was no significant difference in the requirement for re-operation (n.s). Patients undergoing autologous mosaicplasty had a higher rate of returning to sport (p = 0.006), lower EQ-5D pain scores (p = 0.048) and higher KOOS activities of daily living (p = 0.029) scores. Sub-group analysis showed no difference related to the number of cases the surgeon performed. Patients requiring re-operation had lower outcome scores regardless of their initial procedure. This study demonstrated significantly better outcomes using two validated outcome scores (KOOS, EQ-5D), and an ability to return to sport in those undergoing autologous mosaicplasty compared to those receiving TruFit plugs. IV.

  10. The increasing role of epidermal grafting utilizing a novel harvesting system in chronic wounds.

    Science.gov (United States)

    Serena, Thomas E

    2015-02-01

    Skin grafting techniques range from harvesting full-thickness to split-thickness grafts to grafts containing only epidermis. All of these autologous tissues have their place on the reconstructive ladder. However, the use of full-thickness and split-thickness grafts as coverage over chronic wounds remains limited by a number of factors, including the need for anesthesia, a surgically trained physician, and an operating room in which to perform the procedure; pain and damage associated with the donor site; and severe patient comorbidities. Epidermal grafting offers an option for autografts and uses only a minimal amount of superficial epidermis from the donor site. Although successful use of epidermal grafting has been reported in pigmentation disorders, as well as burns and chronic wounds, previous harvesting methods have been described as cumbersome and time consuming. An automated epidermal harvesting system is now commercially available and involves a tool that applies both heat and suction concurrently to normal skin to induce epidermal micrograft formation. The new tool allows quick harvest and transfer of the epidermal micrografts at the bedside without anesthesia, with minimal donor site healing time and patient discomfort. The use of epidermal grafts in chronic wounds and the harvesting technique are reviewed here.

  11. Bone Graft Alternatives

    Science.gov (United States)

    ... spinal deformity, or who have some types of disc herniations. In certain types of spinal fusion, bone grafts ... Specialist SEARCH Download Brochure ENGLISH Related Treatments Cervical Disc Herniation Fusion Lumbar Disc Herniation {1} ##LOC[OK]## {1} ## ...

  12. Melting graft wound syndrome

    Directory of Open Access Journals (Sweden)

    Shiou-Mei Chen

    2017-09-01

    Full Text Available Melting graft wound syndrome is characterized by progressive epidermal loss from a previously well-taken skin graft, healed burn, or donor site. It may result in considerable morbidity and require prolonged treatment. We report a 23-year-old flame-burned patient with second- to third-degree burns involving more than 70% of the total body surface area, whose condition was complicated with septic shock. The patient presented with erosions and ulcers occurring on previously well-taken skin graft recipient sites over both legs and progressive epidermal loss on donor sites over the back. The patient's presentation was compatible with the diagnosis of melting graft wound syndrome, and we successfully treated the patient with debridement and supportive treatment.

  13. Use of autologous blood in general surgery.

    Science.gov (United States)

    D'Amato, A; Ferrazza, G; Solinas, S; Pronio, A M; Montesani, C; Ribotta, G

    2000-01-01

    Autologous blood predonation is still not as widespread as it should be in general surgery practice, even if the method is well-known and has benefits established in international literature. Authors describe the impact of an autotransfusion program, in a general surgery university department, focusing on management and cost problems. A description of the efficacy of the program during a yearlong activity period is presented. An analysis has been made about the quantity of predonated blood/plasma units, the quantity actually transfused and use of homologous blood. The problems which occurred and the cost are discussed. The most used autotransfusion method was preoperative predeposit of autologous blood. The analysis of results focused on some organizational problems that need to be avoided in order to show the methods maximum benefits. In a large number of cases (some 50%) predeposit was not made because of several managing/technical problems. In another large number of cases (38%) the quantity of units predonated did not fully supply the needs and several patients received homologous products. In another number of cases predonated blood units were not used at all (61/34%). Predeposit, preoperative hemodilution and intraoperative recovery, are methods that should all be available in a general surgery department to manage in the best way the single patients blood/plasma needs, reducing post-transfusion complication. To optimize the program and minimize waste some guidelines must be established, with the aim of a rational and correct use of the procedure. Despite the value of the method, and the favor encountered by the patients, we must not forget that the use of autologous blood is not costless.

  14. A Rabbit Model for Testing Helper-Dependent Adenovirus-Mediated Gene Therapy for Vein Graft Atherosclerosis

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    Lianxiang Bi

    2017-12-01

    Full Text Available Coronary artery bypass vein grafts are a mainstay of therapy for human atherosclerosis. Unfortunately, the long-term patency of vein grafts is limited by accelerated atherosclerosis. Gene therapy, directed at the vein graft wall, is a promising approach for preventing vein graft atherosclerosis. Because helper-dependent adenovirus (HDAd efficiently transduces grafted veins and confers long-term transgene expression, HDAd is an excellent candidate for delivery of vein graft-targeted gene therapy. We developed a model of vein graft atherosclerosis in fat-fed rabbits and demonstrated long-term (≥20 weeks persistence of HDAd genomes after graft transduction. This model enables quantitation of vein graft hemodynamics, wall structure, lipid accumulation, cellularity, vector persistence, and inflammatory markers on a single graft. Time-course experiments identified 12 weeks after transduction as an optimal time to measure efficacy of gene therapy on the critical variables of lipid and macrophage accumulation. We also used chow-fed rabbits to test whether HDAd infusion in vein grafts promotes intimal growth and inflammation. HDAd did not increase intimal growth, but had moderate—yet significant—pro-inflammatory effects. The vein graft atherosclerosis model will be useful for testing HDAd-mediated gene therapy; however, pro-inflammatory effects of HdAd remain a concern in developing HDAd as a therapy for vein graft disease.

  15. Perivascular Mesenchymal Stem Cells in Sheep: Characterization and Autologous Transplantation in a Model of Articular Cartilage Repair.

    Science.gov (United States)

    Hindle, Paul; Baily, James; Khan, Nusrat; Biant, Leela C; Simpson, A Hamish R; Péault, Bruno

    2016-11-01

    Previous research has indicated that purified perivascular stem cells (PSCs) have increased chondrogenic potential compared to conventional mesenchymal stem cells (MSCs) derived in culture. This study aimed to develop an autologous large animal model for PSC transplantation and to specifically determine if implanted cells are retained in articular cartilage defects. Immunohistochemistry and fluorescence-activated cell sorting were used to ascertain the reactivity of anti-human and anti-ovine antibodies, which were combined and used to identify and isolate pericytes (CD34 - CD45 - CD146 + ) and adventitial cells (CD34 + CD45 - CD146 - ). The purified cells demonstrated osteogenic, adipogenic, and chondrogenic potential in culture. Autologous ovine PSCs (oPSCs) were isolated, cultured, and efficiently transfected using a green fluorescence protein (GFP) encoding lentivirus. The cells were implanted into articular cartilage defects on the medial femoral condyle using hydrogel and collagen membranes. Four weeks following implantation, the condyle was explanted and confocal laser scanning microscopy demonstrated the presence of oPSCs in the defect repaired with the hydrogel. These data suggest the testability in a large animal of native MSC autologous grafting, thus avoiding possible biases associated with xenotransplantation. Such a setting will be used in priority for indications in orthopedics, at first to model articular cartilage repair.

  16. Cost effectiveness of autologous blood transfusion – A developing ...

    African Journals Online (AJOL)

    An autologous blood donation program was set up at National Orthopaedic Hospital, Igbobi Lagos in 1992 in response to the rising sero prevalence of HIV observed in our “relative replacement” donors. A retrospective batch analysis of patients who received autologous transfusion and those who received homologous ...

  17. Review of autologous blood transfusion at the Kenyatta National ...

    African Journals Online (AJOL)

    Autologous blood transfusion refers to transfusion of blood and/or blood components that are donated by the intended recipient (1). It is considered as one of the safest methods of blood transfusion (1,2). Different types of autologous blood include: preoperative blood deposit, preoperative haemodilution,intraope.

  18. Detection of accessory spleens with indium 111-labeled autologous platelets

    International Nuclear Information System (INIS)

    Davis, H.H. II; Varki, A.; Heaton, W.A.; Siegel, B.A.

    1980-01-01

    In two patients with recurrent immune thrombocytopenia, accessory splenic tissue was demonstrated by radionuclide imaging following administration of indium 111-labeled autologous platelets. In one of these patients, no accessory splenic tissue was seen on images obtained with technetium 99m sulfur colloid. This new technique provides a simple means for demonstrating accessory spleens and simultaneously evaluating the life-span of autologous platelets

  19. Disseminated Fusarium infection in autologous stem cell transplant recipient

    OpenAIRE

    Avelino-Silva, Vivian Iida; Ramos, Jessica Fernandes; Leal, Fabio Eudes; Testagrossa, Leonardo; Novis, Yana Sarkis

    2015-01-01

    Disseminated infection by Fusarium is a rare, frequently lethal condition in severely immunocompromised patients, including bone marrow transplant recipients. However, autologous bone marrow transplant recipients are not expected to be at high risk to develop fusariosis. We report a rare case of lethal disseminated Fusarium infection in an autologous bone marrow transplant recipient during pre-engraftment phase.

  20. Disseminated Fusarium infection in autologous stem cell transplant recipient

    Directory of Open Access Journals (Sweden)

    Vivian Iida Avelino-Silva

    2015-01-01

    Full Text Available Disseminated infection by Fusarium is a rare, frequently lethal condition in severely immunocompromised patients, including bone marrow transplant recipients. However, autologous bone marrow transplant recipients are not expected to be at high risk to develop fusariosis. We report a rare case of lethal disseminated Fusarium infection in an autologous bone marrow transplant recipient during pre-engraftment phase.

  1. The effect of platelet-rich plasma on composite graft survival.

    Science.gov (United States)

    Jeon, Yeo Reum; Kang, Eun Hye; Yang, Chae Eun; Yun, In Sik; Lee, Won Jai; Lew, Dae Hyun

    2014-08-01

    Composite grafts are suitable for facial reconstruction because of good color matching, low donor-site morbidity, acceptable texture, and easy surgical techniques. However, their use is limited to small defects and by unpredictable survival rates. As platelet-rich plasma contains large numbers of growth factors and has been widely used for tissue regeneration, this study aimed to investigate platelet-rich plasma as an adjuvant to enhance composite graft survival. Twenty New Zealand White rabbits were used, and chondrocutaneous composite grafts were applied to their ears. The grafts were then returned to their original positions after rotation to block the original circulation from the base of the graft. Each of the individual ears was assigned randomly into one of two groups: experimental (n=20; platelet-rich plasma group) or control (n=20; control group). The surrounding skin of the composite graft was injected with either 1.0 ml of platelet-rich plasma derived from autologous whole blood in the platelet-rich plasma group or normal saline in the control group. Graft survival, cutaneous blood flow, CD31-stained vessels, and vascular endothelial growth factor protein levels were examined. Twelve days after surgery, graft viability in the platelet-rich plasma group was higher than in the control group. Blood perfusion was also higher in the platelet-rich plasma group. Compared with the control group, the number of CD31 blood vessels and vascular endothelial growth factor expression levels were significantly increased in the platelet-rich plasma group. The authors' results suggest that platelet-rich plasma restores the perfusion of composite grafts by enhancing revascularization and may exert therapeutic effects on the survival of composite grafts.

  2. Incidence of interstitial pneumonia after hyperfractionated total body irradiation before autologous bone marrow/stem cell transplantation

    International Nuclear Information System (INIS)

    Lohr, F.; Schraube, P.; Wenz, F.; Flentje, M.; Kalle, K. von; Haas, R.; Hunstein, W.; Wannenmacher, M.

    1995-01-01

    Purpose/Objectives Interstitial pneumonia (IP) is a severe complication after allogenic bone marrow transplantation (BMT) with incidence rates between 10 % and 40 % in different series. It is a polyetiologic disease that occurs depending on age, graft vs. host disease (GvHD), CMV-status, total body irradiation (TBI) and immunosuppressive therapy after BMT. The effects of fractionation and dose rate are not entirely clear. This study evaluates the incidence of lethal IP after hyperfractionated TBI for autologous BMT or stem cell transplantation. Materials and Methods Between 1982 and 1992, 182 patients (60 % male, 40 % female) were treated with hyperfractionated total body irradiation (TBI) before autologous bone marrow transplantation. Main indications were leukemias and lymphomas (53 % AML, 21 % ALL, 22 % NHL, 4 % others) Median age was 30 ys (15 - 55 ys). A total dose of 14.4 Gy was applied using lung blocks (12 fractions of 1.2 Gy in 4 days, dose rate 7-18 cGy/min, lung dose 9 - 9.5 Gy). TBI was followed by cyclophosphamide (200 mg/kg). 72 % were treated with bone marrow transplantation, 28 % were treated with stem cell transplantation. Interstitial pneumonia was diagnosed clinically, radiologically and by autopsy. Results 4 patients died most likely of interstitial pneumonia. For another 12 patients interstitial pneumonia was not the most likely cause of death but could not be excluded. Thus, the incidence of lethal IP was at least 2.2 % but certainly below 8.8 %. Conclusion Lethal interstitial pneumonia is a rare complication after total body irradiation before autologous bone marrow transplantation in this large, homogeously treated series. In the autologous setting, total doses of 14.4 Gy can be applied with a low risk for developing interstitial pneumonia if hyperfractionation and lung blocks are used. This falls in line with data from series with identical twins or t-cell depleted marrow and smaller, less homogeneous autologous transplant studies. Thus

  3. Correction of Sunken Upper Eyelids by Anchoring the Central Fat Pad to the Medial Fat Pad during Upper Blepharoplasty

    Directory of Open Access Journals (Sweden)

    Myeong Su Jeon

    2015-07-01

    Full Text Available BackgroundMany methods have been proposed for the correction of sunken upper eyelids. These methods include surgical treatments, such as micro-fat, dermofat, or fascia-fat grafts, or the use of alloplastic materials. Here, we present our experience of sunken upper eyelid correction involving the simple addition of anchoring the central fat pad to the medial fat pad during upper blepharoplasty.MethodsWe performed 74 cases of upper blepharoplasty with sunken upper eyelid correction between October 2013 and September 2014. The lateral portion of the central fat pad was partially dissected to facilitate anchoring. The medial fat pad was gently exposed and then pulled out to facilitate anchoring. After the rotation of the dissected lateral portion of the central fat pad by 180° to the medial side, it was anchored spreading to the medial fat pad. Photographs taken at 6 months postoperatively were presented to three physicians for objective assessment. Of the 74 patients, 54 patients followed at 6 months postoperatively were included in this retrospective, objective assessment.ResultsSunken eyelids were effectively corrected in 51 of the 54 patients, but 3 had minimal effect because preaponeurotic fat pads had been removed during previous upper blepharoplasty. In addition to correcting sunken eyelids, lateral bulging was corrected and a better definition of the lateral portion of upper lid creases was obtained.ConclusionsAnchoring the central fat pad to the medial fat pad provides an effective means of correcting sunken upper eyelids during upper blepharoplasty.

  4. Effects of human adipose-derived stem cells and stromal vascular fraction on cryopreserved fat transfer.

    Science.gov (United States)

    Bae, Yong Chan; Song, Ji Sun; Bae, Seong Hwan; Kim, Joo Hyoung

    2015-05-01

    The use of cryopreserved adipose tissue for soft tissue augmentation is common, but unpredictability of fat graft viability remains a limitation. Adipose-derived stem cell (ADSC) and stromal vascular fraction (SVF) have been introduced to enhance viability and improve the survival of transplanted fat tissue. To investigate whether supplementation with ADSC or SVF improved the survival of cryopreserved fat grafts. The cryopreserved fat grafts were treated with ADSC, SVF, or normal saline in 30 six-week-old male nude mice to test whether ADSC and SVF could improve the survival of the transplanted fat tissue. The authors examined the weight, volume, and histological features of each group (n = 10) at 8 weeks after transplantation to evaluate the survival of the fat tissue. There was no difference between the control and SVF groups with respect to weight, volume, and histological findings. However, the ADSC group showed a significant increase in weight and volume compared with the control and SVF groups. Histological examination showed that the ADSC supplementation improved the quality of the transplanted fat grafts. Taken together, these results suggest a potential clinical utility of ADSC but no advantage of SVF in facilitating cryopreserved fat transfer.

  5. The Use of Autologous Peritoneum for Complete Caval Replacement Following Resection of Major Intra-abdominal Malignancies.

    Science.gov (United States)

    Coubeau, Laurent; Rico Juri, Juan-Manuel; Ciccarelli, Olga; Jabbour, Nicolas; Lerut, Jan

    2017-04-01

    Assessment of a simple layer peritoneal tube used as an autogenous inferior vena cava replacement. Extensive en-bloc multivisceral resection including major vessels is effective in selected abdominal malignancies, but the need for vascular reconstruction represents a surgical challenge. We describe the use of autologous peritoneum for caval replacement. Autogenous parietal peritoneum without fascial backing was harvested and tubularized to replace the inferior vena cava (IVC) in four patients with complex abdominal tumors. Surgical morbidity was evaluated using the Clavien-Dindo classification, and graft patency was systematically evaluated with ultrasound. All four patients had multiorgan resections for malignancies involving the retro-hepatic IVC, and they all required the replacement of infrarenal and suprarenal IVC segments. Additionally, all four required a right nephrectomy, two had a combined major hepatectomy, and one patient needed a veno-venous bypass. All had an R0 resection. A clinical follow-up took place between 5 and 11 months after surgery for each patient. Four-month graft patency was confirmed by ultra-sound and TDM with no sign of disease recurrence. Autologous peritoneum without fascial backing is a good and safe option for circumferential replacement of IVC after extensive en-bloc tumor resection with IVC involvement.

  6. Complications Following Autologous Latissimus Flap Breast Reconstruction

    Directory of Open Access Journals (Sweden)

    Mufid Burgić

    2010-02-01

    Full Text Available Use of an autologous latissimus flap in breast reconstruction accounts for a supple and natural look of reconstructed breast. Most common postoperative complication, seroma, became more of a rule then an exception when it comes to postoperative evaluation of the patients who underwent this reconstructive procedure. A retrospective study analysing and evaluating different complication rates in 20 patients who underwent breast reconstruction by autologous latissimus flap, was conducted. All patients included in the study were operated at the Department of plastic surgery of Hôpital Civil in Strasbourg, France, between 1996 and 2008. The complication rates were noted as follows: seroma in 19 of our 20 patients (95%, late hypertrophic scarring in 3 patients (15%, postoperative surgical site hematoma in 3 patients (15%, and 2 patients (10% presented postoperative chronic back pain. Different options used in seroma treatment and prevention (subcutaneous-fascia anchor sutures of donor site, application of corticosteroids by injection into donor site postoperatively, passive drainage can reduce seroma formation and thus overall complication rates, leading to much faster patient’s recovery time and return to normal daily activities.

  7. Cartilage repair: Generations of autologous chondrocyte transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Marlovits, Stefan [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)]. E-mail: stefan.marlovits@meduniwien.ac.at; Zeller, Philip [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Singer, Philipp [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Resinger, Christoph [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Vecsei, Vilmos [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2006-01-15

    Articular cartilage in adults has a limited capacity for self-repair after a substantial injury. Surgical therapeutic efforts to treat cartilage defects have focused on delivering new cells capable of chondrogenesis into the lesions. Autologous chondrocyte transplantation (ACT) is an advanced cell-based orthobiologic technology used for the treatment of chondral defects of the knee that has been in clinical use since 1987 and has been performed on 12,000 patients internationally. With ACT, good to excellent clinical results are seen in isolated post-traumatic lesions of the knee joint in the younger patient, with the formation of hyaline or hyaline-like repair tissue. In the classic ACT technique, chondrocytes are isolated from small slices of cartilage harvested arthroscopically from a minor weight-bearing area of the injured knee. The extracellular matrix is removed by enzymatic digestion, and the cells are then expanded in monolayer culture. Once a sufficient number of cells has been obtained, the chondrocytes are implanted into the cartilage defect, using a periosteal patch over the defect as a method of cell containment. The major complications are periosteal hypertrophy, delamination of the transplant, arthrofibrosis and transplant failure. Further improvements in tissue engineering have contributed to the next generation of ACT techniques, where cells are combined with resorbable biomaterials, as in matrix-associated autologous chondrocyte transplantation (MACT). These biomaterials secure the cells in the defect area and enhance their proliferation and differentiation.

  8. Sacral Fracture Nonunion Treated by Bone Grafting through a Posterior Approach

    Directory of Open Access Journals (Sweden)

    Sang Yang Lee

    2013-01-01

    Full Text Available Nonunion of a sacral fracture is a rare but serious clinical condition which can cause severe chronic pain, discomfort while sitting, and significant restriction of the level of activities. Fracture nonunions reportedly occur most often after nonoperative initial treatment or inappropriate operative treatment. We report a case of fracture nonunion of the sacrum and pubic rami that resulted from non-operative initial treatment, which was treated successfully using bone grafting through a posterior approach and CT-guided percutaneous iliosacral screw fixation combined with anterior external fixation. Although autologous bone grafting has been the gold standard for the treatment of pelvic fracture nonunions, little has been written describing the approach. We utilized a posterior approach for bone grafting, which could allow direct visualization of the nonunion site and preclude nerve root injury. By this procedure, we were able to obtain the healing of fracture nonunion, leading to pain relief and functional recovery.

  9. Prefabrication of a vascularized nerve graft by vessel implantation: preliminary report of an experimental model.

    Science.gov (United States)

    Cavadas, P C; Vera-Sempere, F J

    1994-01-01

    Regeneration through vascularized nerve grafts (VNG) seems to be better than nonvascularized nerve grafts (NVNG), especially in hostile beds. We report on an experimental technique of prefabrication of VNG by direct vessel implantation. An arteriovenous fistula was created in the groin region with autologous vein grafts in the Wistar rat model, and implanted into the sciatic nerve. Five weeks later the sciatic VNG was elevated on the prefabricated pedicle. The flap was free-transferred orthotopically over a silicone sheet to impede plasmatic imbibition. Flap viability at 3 days was complete. India ink injection of the AV fistula resulted in capillary ink filling within the nerve and surrounding tissues. Histologic sections of the flap were examined, revealing its neovascularity. In an ongoing study, the regeneration through this prefabricated VNG is being compared to native VNG.

  10. Axillobifemoral bypass grafting

    Directory of Open Access Journals (Sweden)

    Davidović Lazar B.

    2004-01-01

    Full Text Available INTRODUCTION Axillo-femoral bypass (AxF means connecting the axillar and femoral artery with the graft that is placed subcutaneously [1]. Usually, this graft is connected with contralateral femoral artery via one accessory subcutaneous graft, and this connection is known as axillobifemoral bypass (AxFF. This extra-anatomic procedure is an alternative method to the standard reconstruction of aortoiliac region when there are contraindications for general or local reasons. OBJECTIVE The objective of this paper is to show early and late results of AxFF bypass grafting as well as to show the indications for AxFF bypass. METHODS The sample consisted of 37 patients. The procedure was performed in 28 patients who suffered from aortoiliac occlusive disease and who were at high risk due to the comorbidity- in one patient with the rupture of juxtarenal aneurysm of abdominal aorta; in five patients with aortoenteric fistula, in two patients with iatrogenic lesion of abdominal aorta and in one female patient with anus preternaturalis definitivus who was treated for rectovaginal fistula. Donor's right axillary artery was used in 26 cases (70.3%, and donor's left axillary artery was used in 9 cases (29.7%. Dacron graft was used in 34 patients and Polytetrafluo-roethlylene graft was used in three patients. Simultaneously, profundo-plastic was done in four patients and femoro-popliteal bypass was performed in three patients. In five patients who suffered from aortoenteric fistula, simultaneous intervention of gastrointerstinal system has been done, x2 test was used for statistical evaluation and life table method was used for verification of late graft patency. RESULTS The rate of early postoperative mortality was 13.5%. The causes of death were: sepsis -1, MOFS - 3, and infarct myocardium -1. The mean follow up period was 40.1 months, ranging from six months to 17 years. During the follow up period, an early graft thrombosis was identified in two and late graft

  11. Autologous fibrin membrane combined with solid platelet-rich plasma in the management of perforated corneal ulcers: a pilot study.

    Science.gov (United States)

    Alio, Jorge L; Rodriguez, Alejandra E; Martinez, Lorena M; Rio, Alvaro Luque

    2013-06-01

    The combined use of autologous fibrin membrane and the eye platelet-rich plasma (E-PRP) clot could be considered as a new surgical alternative for the closure of corneal perforations. To evaluate the use of autologous solid platelet-rich plasma in combination with an autologous fibrin membrane as a surgical alternative for wound closure in perforated corneal ulcers. Both the fibrin membrane and the E-PRP clot were prepared with the patient's own blood just before the operation. Nylon stitches were used to fixate the fibrin membrane to the conjunctiva and then the E-PRP clot was placed over the corneal perforation, underneath the fibrin membrane. A temporal partial tarsorrhaphy was performed at the end of the procedure. We conducted postoperative monitoring for 3 months. SETTING Vissum Corporacion Oftalmologica, Alicante, Spain. Eleven patients with perforated corneal ulcers. Surgical alternative for the closure of corneal perforation. Corneal biomicroscopy, fluorescein test, digital tonometry. In all cases the corneal perforation was sealed. The fibrin membrane was present over the corneal surface for the first 3 to 5 days and then gradually disappeared. No evidence of infection or inflammation was detected. Digital tonometry confirmed acceptable levels of ocular tonus in all cases from day 2 after the operation. No patients reported pain, discomfort, or other symptoms, and no complications were observed. After 3 months' follow-up, there was no evidence of relapses or perforations. Corneal grafting was eventually performed in 7 of the 11 cases. The combined use of autologous fibrin membrane and E-PRP clot is a safe and effective surgical alternative for the closure of corneal perforations. This technique can be considered as a temporary measure until the condition of the cornea permits definite intervention.

  12. Is there a role for fat grafting in nerve regeneration?

    Directory of Open Access Journals (Sweden)

    Emanuela Gal-Nădăşan1,

    2016-12-01

    Full Text Available OBJECTIVES AND BACKGROUND The digital patient is a powerful tool that permits an “offline” consultation of the patient and creates medical case studies for medical students [1]. The main objective is to create a digital representation of the scoliotic patient in order to show precise gait and posture. The digital representation can be later analyzed without the presence of the actual patient. MATERIALS AND METHODS A digital version of the real life patient is created using the Microsoft Kinect program that captures both the gait and the posture. RESULTS The created digital patient can be viewed and analyzed using MatLab software. The overall position of the patient along with patient movements such as adduction, rotation and flexion of the joints can be viewed. CONCLUSIONS The digital patient is a powerful tool that permits the medical doctor to consult the patient even when the patient is not present. Graphical abstract: The Digital Patient shown in the MatLab Viewer. REFERENCES 1. Botezatu M, Hult H, Kassaye TM, Fors U. Virtual patient simulation for learning and assessment: superior results in comparison with regular course exams. Med Teach. 2010;32:845-850. 2. Ross AC, Pua YH, Fortin K, Callan R, Webster KE, Denehy L, Bryant AL. Validity of the Microsoft Kinect for assessment of postural control. Gait and posture. 2012;1:372-377.

  13. A High-Fat/High-Cholesterol Diet Inhibits Growth of Fetal Hippocampal Transplants via Increased Inflammation

    OpenAIRE

    Freeman, L. R.; Small, B. J.; Bickford, P. C.; Umphlet, C.; Granholm, A.-Ch.

    2011-01-01

    A diet containing high levels of saturated fat and cholesterol is detrimental to many aspects of health and is known to lead to obesity, metabolic syndrome, heart disease, diabetes, and cancer. However, the effects of a diet rich in saturated fat and cholesterol on the brain are not currently well understood. In order to determine direct effects of a high saturated fat and cholesterol diet upon fetal hippocampal tissue, we transplanted hippocampal grafts from embryonic day 18 rats to the ante...

  14. Autologous breast reconstruction using the immediately lipofilled extended latissimus dorsi flap.

    Science.gov (United States)

    Johns, N; Fairbairn, N; Trail, M; Ewing, A; Yong, L; Raine, C; Dixon, J M

    2018-02-01

    The latissimus dorsi flap is a popular choice for autologous breast reconstruction. To dramatically improve volume, we report our experience of using the immediately lipofilled extended latissimus dorsi (ELD) flap and show it as a valid option for autologous breast reconstruction. Patients undergoing the procedure between December 2013 and June 2016 were included. Demographic, clinical and operative factors were analysed, together with in-hospital morbidity and duration of postoperative hospital stay. A total of 71 ELD flaps with immediate lipofilling were performed. Forty-five reconstructions were immediate and the remaining 26 delayed. Median (range) volume of autologous fat injected immediately was 171 ml (40-630 ml). Contralateral reductions were performed in 25 patients with the median reduction volume 185 g (89-683 g). Median duration of admission was 6.5 (3-18) days and patients were followed up for 12 months (1-37). Three total flap failures occurred and had to be excised (4%). One haematoma occurred requiring drainage (1%). Signs of infection requiring intravenous antibiotics occurred in five patients (7%). In 5 patients wound dehiscence occurred, and only two of these required resuturing (3%). In total, 7 patients developed a seroma requiring repeated drainage (10%). Three reconstructions experienced mild mastectomy flap necrosis with no needing reoperation (4%). Our experience represents the largest series to date and shows that in carefully selected patients the technique is safe, can avoid the requirement for implants, and has the potential to streamline the reconstructive journey. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Grafts for Ridge Preservation

    Science.gov (United States)

    Jamjoom, Amal; Cohen, Robert E.

    2015-01-01

    Alveolar ridge bone resorption is a biologic phenomenon that occurs following tooth extraction and cannot be prevented. This paper reviews the vertical and horizontal ridge dimensional changes that are associated with tooth extraction. It also provides an overview of the advantages of ridge preservation as well as grafting materials. A Medline search among English language papers was performed in March 2015 using alveolar ridge preservation, ridge augmentation, and various graft types as search terms. Additional papers were considered following the preliminary review of the initial search that were relevant to alveolar ridge preservation. The literature suggests that ridge preservation methods and augmentation techniques are available to minimize and restore available bone. Numerous grafting materials, such as autografts, allografts, xenografts, and alloplasts, currently are used for ridge preservation. Other materials, such as growth factors, also can be used to enhance biologic outcome. PMID:26262646

  16. [Chickenpox, burns and grafts].

    Science.gov (United States)

    Rojas Zegers, J; Fidel Avendaño, L

    1979-01-01

    An outbreak of chickenpox that occurred at the Burns Repair Surgery Unit, Department of Children's Surgery, Hospital R. del Río, between June and November, 1975, is reported. 27 cases of burned children were studied, including analysis of correlations of the stages and outcome of the disease (varicela), the trauma (burns) and the graft (repair surgery). As a result, the authors emphasize the following findings: 1. Burns and their repair are not aggravating factors for varicella. In a small number of cases the exanthema looked more confluent in the graft surgical areas and in the first degree burns healing spontaneously. 2. Usually there was an uneventful outcome of graft repair surgery on a varicella patient, either during the incubation period, the acme or the convalescence. 3. The fact that the outmost intensity of secondary viremia of varicella occurs before the onset of exanthemia, that is, during the late incubation period, is confirmed.

  17. Vascular endothelial growth factor 165-transfected adipose-derived mesenchymal stem cells promote vascularization-assisted fat transplantation.

    Science.gov (United States)

    Jun-Jiang, Chen; Huan-Jiu, Xi

    2016-06-01

    To investigate the effect of vascular endothelial growth factor 165 (VEGF165) and adipose-derived mesenchymal stem cells (ASCs) in promoting the survival of fat grafts, and to provide new methods and theoretical evidence for increasing the survival rate of autologous fat particle grafts. The VEGF165 gene was recombined with the target fragment, and the recombinant gene was introduced into adenovirus pAdEasy-1 system; the virus was then packaged and the titer was detected. The control group received the same processing. ASCs were cultured and subcultured, and then identified with immunohistochemistry and adipogenic differentiation assay. The subsequent experiments were performed in three groups: the VEGF165 gene-virus group, blank virus group, and control group. After the viral solution was transfected into the ASCs, the viral transfection efficiency was detected using a tracing factor, EGFP. The expression of VEGF165 mRNA and protein in the transfected cells were determined. The proliferation of ASCs in each group was detected with the MTT assay. (1) Recombinant adenoviral vector was constructed successfully in the two groups and the packaging was identified. The viral titer was 2.0 × 10(8) pfu/ml and 1.9 × 10(8) pfu/ml, which was in line with the requirements of the subsequent transfection experiments. (2) Immunohistochemistry and adipogenic differentiation results showed that the culture of ASCs was successful, and the cultured cells could serve as seed cells in this experiment. (3) The RT-PCR analysis showed that the relative optical density of VEGF165 mRNA expression was 0.76 ± 0.05 in the experimental group, and there were statistically significant differences compared with the values obtained for the other two groups (P < 0.05). (4) The western blot analysis showed that the relative optical density of VEGF165 protein expression in the experimental group was significantly higher than that in the other two groups (P < 0.05). (5) The proliferation of ASCs was

  18. VUV modification promotes endothelial cell proliferation on PTFE vascular grafts

    Science.gov (United States)

    Cezeaux, J. L.; Romoser, C. E.; Benson, R. S.; Buck, C. K.; Sackman, J. E.

    1998-05-01

    Small diameter (⩽6 mm ID ) synthetic vascular grafts, used as lower-limb vessel replacements in patients without suitable autologous saphenous veins, have a failure rate of 53% after 4 yr. Graft failure is due to thrombosis and intimal hyperplasia, an increase in smooth muscle cells in the lumen of the vessel which leads to progressive closing and ultimate occlusion of the vessel. In an effort to increase patency rates of synthetic grafts, investigators have seeded vascular grafts with endothelial cells prior to implantation in an attempt to control both thrombosis and smooth muscle proliferation. This technique has been successful for the development of an endothelial monolayer in animal trials, but has met with limited success in humans. The hydrophobicity, low surface energy, and weak electrical charge of expanded polytetrafluoroethylene (ePTFE) provides conditions which are not optimal for endothelial cell attachment. The purpose of this study is to evaluate the effect of vacuum ultraviolet (VUV) modification of ePTFE on endothelial cell adhesion and proliferation. Pieces of ePTFE graft material were exposed to 10, 20 or 40 W VUV radiation for 10, 20 or 40 min using a UV excimer lamp. Prior to cell adhesion and proliferation experiments, the grafts pieces were autoclaved and cut into pledgets. Half of the pledgets were precoated with fibronectin ( 20 μg/ml). Cell adhesion was measured by seeding 3H-thymidine labeled human umbilical vein endothelial cells (HUVEC) onto the pledgets for 60 min. The pledgets were then washed and the remaining radioactivity assayed using scintillation counting. For the cell proliferation experiments, pledgets were seeded with unlabeled HUVEC which were allowed to adhere to the graft material for 18 h. The cells were then exposed to 3H-thymidine ( 1 μCi/ml) for approximately 48 h and then washed to remove any unincorporated 3H-thymidine. Incorporation of 3H-thymidine was measured using scintillation counting. Four replicate

  19. Arteriovenous shunt graft ulceration with sinus and graft epithelialization

    Directory of Open Access Journals (Sweden)

    Pooja Singhal

    2015-03-01

    Full Text Available Arteriovenous fistula and grafts are used as access sites for patients with chronic kidney disease and are prone for complications. Stent grafts are used to treat access site complications. We report a rare and unusual finding of epithelialization of the sinus tract and the lumen of a polytetrafluoroethylene graft, following ulceration of the overlying skin.

  20. Full-thickness skin graft vs. synthetic mesh in the repair of giant incisional hernia: a randomized controlled multicenter study.

    Science.gov (United States)

    Clay, L; Stark, B; Gunnarsson, U; Strigård, K

    2018-04-01

    Repair of large incisional hernias includes the implantation of a synthetic mesh, but this may lead to pain, stiffness, infection and enterocutaneous fistulae. Autologous full-thickness skin graft as on-lay reinforcement has been tested in eight high-risk patients in a proof-of-concept study, with satisfactory results. In this multicenter randomized study, the use of skin graft was compared to synthetic mesh in giant ventral hernia repair. Non-smoking patients with a ventral hernia > 10 cm wide were randomized to repair using an on-lay autologous full-thickness skin graft or a synthetic mesh. The primary endpoint was surgical site complications during the first 3 months. A secondary endpoint was patient comfort. Fifty-three patients were included. Clinical evaluation was performed at a 3-month follow-up appointment. There were fewer patients in the skin graft group reporting discomfort: 3 (13%) vs. 12 (43%) (p = 0.016). Skin graft patients had less pain and a better general improvement. No difference was seen regarding seroma; 13 (54%) vs. 13 (46%), or subcutaneous wound infection; 5 (20%) vs. 7 (25%). One recurrence appeared in each group. Three patients in the skin graft group and two in the synthetic mesh group were admitted to the intensive care unit. No difference was seen for the primary endpoint short-term surgical complication. Full-thickness skin graft appears to be a reliable material for ventral hernia repair producing no more complications than when using synthetic mesh. Patients repaired with a skin graft have less subjective abdominal wall symptoms.

  1. Predeposit autologous blood transfusion: Do we require to promote it?

    Directory of Open Access Journals (Sweden)

    Gurjit Singh

    2015-01-01

    Full Text Available Introduction: Safest blood a patient can receive is his own. Quest for safe blood transfusion has remained of prime concern. To meet this aspiration, various forms of autologous blood transfusions can be practiced. It is especially suitable for patients with rare blood groups and religious sects such as Jehovah′s witness autologous transfusion is extremely safe. Cross matching is not required; iso-immunization to a foreign body is excluded. Fear of transfusion transmissible disease can be ignored. Therefore, autologous blood transfusion is required to be revisited. Materials and Methods: This is a prospective study carried out at Padmashree Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune between July 2010 and May 2012. Study comprised of 100 patients divided into two groups, autologous and homologous. Benefits of autologous transfusion were studied. Results: There was no significant change in hematocrit and blood parameters after blood donation. That is mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration (P < 0.001 after blood donation. Only one complication of vasovagal syncope was observed at the time of blood donation. Conclusion: Autologous blood transfusion is safe. Easy alternative to be practiced in elective surgeries, especially in patients with rare blood group or believers of Jehovah′s witness faith. It helps to reduce the shortfall in national blood inventory. Autologous blood donation should be practiced whenever possible.

  2. Sclerocorneal graft and sequential removal of melted cornea after severe corneal burn with perforation.

    Science.gov (United States)

    Viestenz, Anja; Seitz, Berthold; Struck, Hans-Gert; Viestenz, Arne

    2018-01-01

    Corneal burn grade IV usually leads to blindness. Several different surgical techniques remain challenging owing to the extensive tissue damage. Here, we introduce a novel technique with a 15 mm corneoscleral and limbal homologous graft combined with sequential autologous corneal removal ab interno, with a vitrectomy probe to save the anterior chamber angle. In vivo anatomy with optical coherence tomography is the surgical key. A large 15 mm sclerocorneal graft is sutured on top of the remainder of the destroyed cornea and sclera after removal of the epithelium and conjunctiva, with anterior synechiolysis if necessary, peripheral iridectomy and conjunctivoplasty. The recipient central corneal stroma is not removed, primarily to protect the anterior chamber angle. After three weeks, the collagenolytic central recipient corneal stroma can be removed with a small 23 g vitrectomy probe, respecting the lens and scleral spur. The corneoscleral graft remains clear under systemic and local immunosuppression. Intraocular pressure is well controlled because the anterior chamber angle is respected. Recurrent corneal erosions need close follow-up. Therapeutic soft contact lenses can support topical therapy. In cases of sclercorneal graft decompensation or rejection after 3-5 years, a new sclerocorneal graft (with limbal donation) seems to be superior to perforating keratoplasty without limbal stem cell transplantation. Repeated sclerocorneal grafts after severe corneal burn with limbal transplantation and maintenance of the complete anterior angle structure are a successful option for preventing blindness and achieving good visual acuity. Clin. Anat. 31:39-42, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  3. Submillimeter Diameter Poly(Vinyl Alcohol) Vascular Graft Patency in Rabbit Model

    Science.gov (United States)

    Cutiongco, Marie F. A.; Kukumberg, Marek; Peneyra, Jonnathan L.; Yeo, Matthew S.; Yao, Jia Y.; Rufaihah, Abdul Jalil; Le Visage, Catherine; Ho, Jackie Pei; Yim, Evelyn K. F.

    2016-01-01

    Microvascular surgery is becoming a prevalent surgical practice. Replantation, hand reconstruction, orthopedic, and free tissue transfer procedures all rely on microvascular surgery for the repair of venous and arterial defects at the millimeter and submillimeter levels. Often, a vascular graft is required for the procedure as a means to bridge the gap between native arteries. While autologous vessels are desired for their bioactivity and non-thrombogenicity, the tedious harvest process, lack of availability, and caliber or mechanical mismatch contribute to graft failure. Thus, there is a need for an off-the-shelf artificial vascular graft that has low thrombogenic properties and mechanical properties matching those of submillimeter vessels. Poly(vinyl alcohol) hydrogel (PVA) has excellent prospects as a vascular graft due to its bioinertness, low thrombogenicity, high water content, and tunable mechanical properties. Here, we fabricated PVA grafts with submillimeter diameter and mechanical properties that closely approximated those of the rabbit femoral artery. In vitro platelet adhesion and microparticle release assay verified the low thrombogenicity of PVA. A stringent proof-of-concept in vivo test was performed by implanting PVA grafts in rabbit femoral artery with multilevel arterial occlusion. Laser Doppler measurements indicated the improved perfusion of the distal limb after implantation with PVA grafts. Moreover, ultrasound Doppler and angiography verified that the submillimeter diameter PVA vascular grafts remained patent for 2 weeks without the aid of anticoagulant or antithrombotics. Endothelial cells were observed in the luminal surface of one patent PVA graft. The advantageous non-thrombogenic and tunable mechanical properties of PVA that are retained even in the submillimeter diameter dimensions support the application of this biomaterial for vascular replacement in microvascular surgery. PMID:27376059

  4. Knee Osteochondral Autologous Transplantation: Long-term MR findings and clinical correlations

    Energy Technology Data Exchange (ETDEWEB)

    Tetta, Cecilia, E-mail: cecilia.tetta@ior.i [Radiology, Rizzoli Orthopedic Institute, Bologna (Italy); Busacca, Maurizio; Moio, Antonio; Rinaldi, Raffaella [Radiology, Rizzoli Orthopedic Institute, Bologna (Italy); Delcogliano, Marco; Kon, Elizaveta; Filardo, Giuseppe; Marcacci, Maurilio [Biomechanics Laboratory, Rizzoli Orthopedic Institute, Bologna (Italy); Albisinni, Ugo [Radiology, Rizzoli Orthopedic Institute, Bologna (Italy)

    2010-10-15

    We evaluated long-term magnetic resonance imaging (MRI) features of Knee Osteochondral Autologous Transplantation (OAT)-Mosaicplasty and correlated MRI findings and clinical outcome. Twenty-four patients (mean age 29.9 {+-} 8.7, 70.8% male) undergoing arthroscopic OAT between 1997 and 2000 were prospectively enrolled. The International Cartilage Repair Society (ICRS)/International Knee Documentation Committee (IKDC) scores and Tegner scores were employed for clinical evaluation. The magnetic resonance observation of cartilage repair tissue (MOCART) was utilized for description and assessment of the repair tissue. Median follow up was 113 months (interquartile range [IQR] 106-122). MRI showed good survival of grafted cartilage in 62.5% of patients. The integration of the graft was complete in 75% of cases, while the repaired tissue was intact in 62.5% and had an homogeneous structure in 70.8%. The MOCART score significantly correlated with objective and subjective scores (p = 0.003 and p = 0.002). Contrastingly, overall MOCART showed no correlation with the Tegner score. MRI revealed to be a powerful tool for non-invasive long-term assessment of OAT.

  5. Knee Osteochondral Autologous Transplantation: Long-term MR findings and clinical correlations

    International Nuclear Information System (INIS)

    Tetta, Cecilia; Busacca, Maurizio; Moio, Antonio; Rinaldi, Raffaella; Delcogliano, Marco; Kon, Elizaveta; Filardo, Giuseppe; Marcacci, Maurilio; Albisinni, Ugo

    2010-01-01

    We evaluated long-term magnetic resonance imaging (MRI) features of Knee Osteochondral Autologous Transplantation (OAT)-Mosaicplasty and correlated MRI findings and clinical outcome. Twenty-four patients (mean age 29.9 ± 8.7, 70.8% male) undergoing arthroscopic OAT between 1997 and 2000 were prospectively enrolled. The International Cartilage Repair Society (ICRS)/International Knee Documentation Committee (IKDC) scores and Tegner scores were employed for clinical evaluation. The magnetic resonance observation of cartilage repair tissue (MOCART) was utilized for description and assessment of the repair tissue. Median follow up was 113 months (interquartile range [IQR] 106-122). MRI showed good survival of grafted cartilage in 62.5% of patients. The integration of the graft was complete in 75% of cases, while the repaired tissue was intact in 62.5% and had an homogeneous structure in 70.8%. The MOCART score significantly correlated with objective and subjective scores (p = 0.003 and p = 0.002). Contrastingly, overall MOCART showed no correlation with the Tegner score. MRI revealed to be a powerful tool for non-invasive long-term assessment of OAT.

  6. Additive Manufacturing of Vascular Grafts and Vascularized Tissue Constructs.

    Science.gov (United States)

    Elomaa, Laura; Yang, Yunzhi Peter

    2017-10-01

    There is a great need for engineered vascular grafts among patients with cardiovascular diseases who are in need of bypass therapy and lack autologous healthy blood vessels. In addition, because of the severe worldwide shortage of organ donors, there is an increasing need for engineered vascularized tissue constructs as an alternative to organ transplants. Additive manufacturing (AM) offers great advantages and flexibility of fabrication of cell-laden, multimaterial, and anatomically shaped vascular grafts and vascularized tissue constructs. Various inkjet-, extrusion-, and photocrosslinking-based AM techniques have been applied to the fabrication of both self-standing vascular grafts and porous, vascularized tissue constructs. This review discusses the state-of-the-art research on the use of AM for vascular applications and the key criteria for biomaterials in the AM of both acellular and cellular constructs. We envision that new smart printing materials that can adapt to their environment and encourage rapid endothelialization and remodeling will be the key factor in the future for the successful AM of personalized and dynamic vascular tissue applications.

  7. Graft nephrectomy: The SGPGI experience

    OpenAIRE

    Nand Kishore Arvind; Aneesh Srivastava; Anant Kumar; Subodh K Das

    2002-01-01

    Background: Graft nephrectomy is often considered a hazardous procedure with high morbidity and occasional mortality, and this may pose a technical challenge. The aim of this study was to evaluate the indications, etiology and complications following graft nephrectomy. Materials and Methods: From 1988 to 2001, among total of 1,019 live related renal transplants carried at our center, 46 underwent graft nephrectomy. Patients were divided into 2 groups depending on timing of graft re-mova...

  8. Autologous Bone Marrow Mononuc