Garza RM, Paik KJ, Chung MT, Duscher D, Gurtner GC, Longaker MT, Wan DC, et al.
Plastic and reconstructive surgery. Date of publication 2014 Aug 1;volume 134(2):249-57.
1. Plast Reconstr Surg. 2014 Aug;134(2):249-57. doi: 10.1097/PRS.0000000000000326.
Studies in fat grafting: Part III. Fat grafting irradiated tissue--improved skin
quality and decreased fat graft retention.
Garza RM(1), Paik KJ, Chung MT, Duscher D, Gurtner GC, Longaker MT, Wan DC.
Author information:
(1)Stanford, Calif. From the Hagey Laboratory for Pediatric Regenerative
Medicine, Plastic and Reconstructive Surgery Division, Department of Surgery,
Stanford University School of Medicine; and the Institute for Stem Cell Biology
and Regenerative Medicine, Stanford University.
BACKGROUND: Following radiation therapy, skin becomes fibrotic and can present a
difficult problem for reconstructive surgeons. There is an increasing belief that
fat grafting under irradiated skin can reverse the damage caused by radiation.
The present study evaluated the effect of fat grafting on irradiated skin, along
with fat graft quality and retention rates in irradiated tissue.
METHODS: Nine adult Crl:NU-Foxn1 CD-1 mice underwent 30-Gy external beam
irradiation of the scalp. Four weeks after irradiation, scalp skin from
irradiated and nonirradiated mice was harvested and compared histologically for
dermal thickness, collagen content, and vascular density. Human fat grafts were
then injected in the subcutaneous plane of the scalp. Skin assessment was
performed in the irradiated group at 2 and 8 weeks after grafting, and fat graft
retention was measured at baseline and every 2 weeks up to 8 weeks after grafting
using micro-computed tomography. Finally, fat graft samples were explanted at 8
weeks, and quality scoring was performed.
RESULTS: Fat grafting resulted in decreased dermal thickness, decreased collagen
content, and increased vascular density in irradiated skin. Computed tomographic
analysis revealed significantly decreased fat graft survival in the irradiated
group compared with the nonirradiated group. Histologic scoring of explanted fat
grafts demonstrated no difference in quality between the irradiated and
nonirradiated groups.
CONCLUSIONS: Fat grafting attenuates dermal collagen deposition and vessel
depletion characteristic of radiation fibrosis. Although fat graft retention
rates are significantly lower in irradiated than in nonirradiated tissue, the
quality of retained fat between the groups is similar.
DOI: 10.1097/PRS.0000000000000326
PMCID: PMC4116637
PMID: 25068325 [Indexed for MEDLINE]
