Premium
Microvascular Angiogenesis and Apoptosis in the Survival of Free Fat Grafts
Author(s) -
Nishimura Toshiro,
Hashimoto Harumi,
Nakanishi Isao,
Furukawa Mitsuru
Publication year - 2000
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200008000-00021
Subject(s) - tunel assay , terminal deoxynucleotidyl transferase , angiogenesis , vascular endothelial growth factor , immunohistochemistry , medicine , connective tissue , apoptosis , adipose tissue , revascularization , necrosis , pathology , biology , vegf receptors , myocardial infarction , biochemistry
Objectives/Hypothesis Autologous fat is an ideal material for augmentation in plastic surgery because of its minimal tissue reaction and easy availability, but its long‐term graft survival is somewhat unpredictable. This study was conducted to determine how fat grafts get their vascular supply from the recipient bed and why they keep reducing in volume and weight. Study Design Experimental study using animal models. Methods The expression of vascular endothelial growth factor (VEGF) in grafted fat tissue was examined by using immunohistochemical staining, and apoptotic cell death in the grafted fat was studied by using terminal deoxynucleotidyl transferase (TdT)–mediated deoxy‐uridine triphosphate (dUTP)‐biotin nick end‐labeling method. Twenty‐five Wistar rats were used as models of free fat grafts. Fat tissue taken from inguinal fat pads was grafted to the back skin with an 18‐gauge needle injection. Results The weight of the injected fat was significantly reduced on the 180th day compared with the original weight (32% ± 10%). VEGF+ cells were observed in fibrous connective tissue of the grafts on days 7 and 30 but not after day 90. Apoptotic cells were also observed on days 7 and 30. Conclusions Angiogenic factors including VEGF started to revascularize the graft around day 7, and the extent of the vasculature was not reduced after the revascularization. In addition to necrosis in the graft's early stages, apoptosis induced by many factors in the graft's environment is also, at least in part, a cause of long‐term volume reduction of the fat graft. Thus clinical application of angiogenic factors such as VEGF to fat grafts and control of apoptosis may contribute to improvements in fat‐grafting techniques.