Ilkay Ozdemir

Fat graft applications are one of the most frequently used procedures in reconstructive and aesthetic surgery. Fat graft survival rate is variable and depends on many parameters. Those are the features of recipient area, method of obtaining the fat graft, the procedures applied to the harvest to get pure fat graft and the application techniques. In this study, we aimed to find the optimal revolutions per minute(rpm) and duration to be used in the centrifugation technique, which is one of the most frequently used methods in fat grafting. In our study, we used perilipin protein as a survival marker. Liposuction samples were obtained from 10 Caucasian women individuals; whose age range is between 22 and 29 years without any other reported health problem. Fat grafts from all patients were taken by the same surgical team by the same liposuction procedure. The grafts obtained in our study were divided into 6 different groups, these are A1 group (1 minute–1000 rpm) A2 group (3 minutes–1000 rpm) A3 group (5 minutes–1000 rpm) B1 group (1 minute–3000 rpm) B2 group (3 minutes–3000 rpm) and B3 group (5 minutes–3000 rpm). Perilipin expression measurements were made in the sections taken by immunohistochemistry technique. Three minutes–3000 rpm combination (B2 group) was found to be perilipin stained statistically significantly higher than other combinations. This study seeks to make a notable contribution to the literature by demonstrating the relation between frequently used centrifuge combinations and measuring the expression of perilipin. This protein’s role in adipocyte regulation is becoming increasingly apparent. Level of Evidence III 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.

Background and Objectives: Lymphedema is a progressive, chronic condition. Traumatic damage to the lymphatics, removal of lymph nodes, and/or radiation are the major causes of fibrosis and a subsequent pathological cascade. Macrophages play a crucial role in wound healing, with M1 macrophages known for their pro-inflammatory effects and M2 macrophages recognized for their anti-inflammatory effects, including improved angiogenesis, lymph angiogenesis, and tissue healing. This study aims to assess the use of calcitriol to alter the M2/M1 macrophage balance, reduce tissue fibrosis in a lymphedema model, promote new micro-lymphatic vessel formation, and evaluate the benefits of active vitamin D. Material and Methods: Forty-five rats were randomly divided into three groups: control surgery (group A), surgery with preoperative–postoperative calcitriol (group B), and postoperative calcitriol (group C). One week after the surgical ablation a total dose of 20 Gy radiation therapy was administered to the operated groin region. Micro-computed tomography was used for limb volume calculation, fluorescence lymphatic imaging was used to assess the presence of lymphedema, and histopathological analyses were conducted to evaluate the M1/M2 macrophage ratio, fibrosis accumulation, and lymph angiogenesis. Results: The micro-computed tomography evaluation revealed that 75% of the rats of group A exhibited long-lasting lymphedema. In group B, the initial lymphedema ratio was the lowest, affecting only 25% of the rats. After ligating the main vessels, a linear lymphatic microvascular structure was observed in groups B and C. Group B had a significant increase in M2 macrophages and newly formed lymphatic vessels (p < 0.05). However, group A showed a significant elevation of M1 macrophages and collagen accumulation (p < 0.05) in the surgically treated hind limb. Conclusions: Both histological analyses and clinical results reported a relevant influence of calcitriol administration. Among all groups, the most favorable outcomes were seen in group B (prophylaxis group). Hence, calcitriol administration could play a crucial role in enhancing the migration of M2 macrophages to the damaged tissue. Such migration may contribute to lymphedema resolution either by enhancing the organization of superficial lymphatic vessels or resolving fibrosis, or with a combination of both these mechanisms.

Background Since cartilage, unlike skin, does not contain vessels, it obtains nutrition by diffusion. This reduces graft viability, resulting in problems such as reductions in size, changes in shape, and resorption of the cartilage graft in the late post-graft period. This study aimed to investigate the effects of adipose-derived mesenchymal cells and conditioned medium (CM) on cartilage graft viability.Methods Dissections were performed 4 months after the injection of 0.5 mL of CM or 2×106 mesenchymal stem cells (MSCs) in 0.5 mL after grafting into a control group and two experimental groups (n=21 rabbits in total). Chondrocyte viability and type II collagen expression in the grafted areas were analyzed by hematoxylin-eosin staining and immunohistochemical methods, respectively.Results In the MSC and CM groups, chondrocyte proliferation at the graft tissue incision margin (MSC: P<0.01, CM: P<0.0001), chondrocyte proliferation at the auricular cartilage incision margin (MSC: P<0.05, CM: P<0.0001), integration of the graft with the surrounding cartilage (MSC: P<0.001, CM: P<0.0001) and type II collagen expression levels (MSC: P=0.001, CM: P=0.0002) significantly increased.Conclusions Xenogenic injection of MSCs and CM contributed to new cartilage production without any tumoral effects or immune reactions. In particular, the cell-free nature of CM strengthened its potential for safe use. Since injections of MSC and CM can preserve cartilage graft viability, interest in this technique is expected to increase as long-term results from clinical studies on the subject become available.

Baştuğ AY, et al. J Periodontal Implant Sci. 2021 Dec;52:e2. https://doi.org/10.5051/jpis.2101360068