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Pedal Fat Grafting: Correlating Adipose Tissue Characteristics to Volume Retention
DiBernardo G, Wang S, James IB, Minteer D, Dreifuss SE, Grybowski D, Zhang W, Gusenoff BR, Marra K, Gusenoff JA
University of Pittsburgh
2018-02-15
Presenter: Gabriella A DiBernardo
Affidavit:
This material has not been proposed or presented at any major meeting or published and is original work.
Director Name: Kacey Marra
Author Category: Medical Student
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Pedal fat pad atrophy alters foot pressure distribution, causes extreme pain and affects quality of life. Autologous fat grafting is a popular and safe treatment for various soft tissue defects, although unpredictable volume retention remains a limitation. Previous animal studies in our laboratory demonstrated correlations between CD34+ adipose stem cells (ASCs) and increased adipose tissue retention. Our goal was to assess the molecular characteristics of ASCs and correlate volume retention and fibrous tissue formation in patients undergoing pedal fat grafting over the metatarsal heads.
Fat was harvested from the abdomen, flank, or thighs of 24 patients enrolled in a randomized cross over study using manual liposuction and processed with the standard Coleman technique. Stromal vascular fraction (SVF) was isolated from processed lipoaspirate. SVF was characterized using flow cytometry for CD3, CD31, CD34, CD45, CD90 and CD146. Western blot and histological staining were performed for collagen assessment. Soft tissue and dermal thickness was evaluated at baseline through 2-years using ultrasound.
The amount of CD34+ ASCs and SVF viability were correlated with increased tissue thickness through 6 months. Increased dermal thickness was observed through 2-years. Lipoaspirate with lower collagen1 concentration was found to have higher CD34+ ASCs and greater SVF viability. Overall pain score decreased through 2-years post-op. Average age was 63.6±6.7. Average BMI was 26.1±4.6.
Volume retention after fat grafting procedures remains a challenge. The correlation between SVF viability and CD34+ ASCs with decreased fibrous tissue formation and increased volume retention at 6 months is an interesting avenue for further study.
