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Cryopreserved Adipose for Hypodermal Augmentation after Full-Thickness Burns
Shawn Loder, MD; Phoebe Lee, BS; Patricia Leftwich; MS; Wayne Nerone, BA; Jeffrey Gusenoff, MD; Kacey Marra, PhD; Lauren Kokai, PhD, and J. Peter Rubin, MD
University of Pittsburgh
2021-02-01
Presenter: Shawn Loder
Affidavit:
Certified
Director Name: Vu T. Nguyen, MD
Author Category: Resident Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Introduction:
Burn and blast injuries to the face are highly morbid affecting quality of life and psychosocial well-being. Without exception, extensive facial burns require debridement with reconstruction involving skin grafts to restore cutaneous integrity. Hypodermal restoration via autologous fat helps restore native features and enhance contour. This technique is limited by graft retention and often requires multiple rounds of grafting to achieve adequate results. Here we demonstrate the therapeutic validity and efficacy of cryopreserved adipose to restore hypodermal integrity without serial liposuction.
Methods:
Adipose from Yorkshire swine was cryopreserved for three-months prior to initiation of experiments. Next, female swine received 16 4x4 cm full-thickness burns. After 48-hours eschar was removed to fascia and wounds were treated as follows: A) Untreated; B) Fat Grafting; C: Skin Grafting; D) Skin and Fat Grafting. Pigs were maintained for 8 for interval serum, photography, ultrasound, and biopsies. At 8-weeks animals were sacrificed and wounds collected for histology.
Results:
All wounds with skin graft demonstrated significant reduction in contracture (p<0.05) at 8-weeks; skin with cryopreserved fat improved dermal-hypodermal thickness vs. skin only controls (p<0.05). Cryopreserved adipose remains viable throughout the duration of the experiment.
Conclusion:
Hypodermal augmentation with lipografting as part of a strategy of autologous skin grafting addresses contour deficits and skin quality, however is limited by the need for multiple liposuction and grafting requiring multiple trips to the operating room with increased surgical and anesthetic risk and high economic burden. Here we demonstrate cryopreservation of adipose as an avenue to
