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The treatment of injuries with loss of skin tissue has improved significantly with the advent of bioengineered tissue. Previous studies showed that the use of dermal substitutes combined with autologous Adipose-derived Stem Cells (ASCs) improve angiogenesis and collagen synthesis; however, epithelialization is an outstanding issue to be resolved. In the present study, we evaluated the epithelial progression and differentiation in an extended period of time. We obtained the adipose tissue derived stem cells (ASCs) from the inguinal fat pad of 4 Sprague Dawley rats. The non-expanded cells were cultivated in a dermal scaffold (Integra®) for 48 hours and marked with a green fluorescent protein (GFP) lentiviral vector. The scaffold plus stem cells and a contralateral cell-free scaffold (control) were implanted in the same rats. After 4 weeks, epithelial surface was assesses by planimetry and histology. The results show that macroscopic wound closure by contraction from the edges has no significant differences (82.63% ± 3.4% vs. 80.66% ± 3.89%, p = 0.08), but the closure by epithelialization was significantly higher in the side with stem cells (93.47% ± 5.98% vs. 79.88% ± 6.28%, p = 0.0028). All samples were positive for staining with anti-cytokeratin antibody 34βE12 and linear epithelial advancement quantified by microscopy was significantly higher in the side with stem cells (6408 ± 275 µm vs. 5375 ± 250 µm, p <0.001). GFP positive cells were identified as part of the regenerated dermis but not the epidermis. In conclusion, the autologous adipose tissue derived stem cells seeded in a Integra® scaffold significantly increase epithelial formation, most likely by an induction mechanism rather than affecting differentiation. [ABSTRACT FROM AUTHOR]

The adipose tissue obtained by liposuction is an abundant source to isolate regenerative cells, the stromal vascular fractions cells (SVF), including adipose mesenchymal stem cells. These cells have became an excellent tool for autologous cell therapy in different clinical applications, and several platforms for adipose tissue processing have been developed for SVF isolation. In this study we describe a new medical device for SVF isolation from human lipoaspirates, using a fast, efficient and user-friendly procedure in the same surgical act in a cost-effective way. Additionally, we present different methods to guarantee the quality, safety and potency of the cell inoculum obtained. [ABSTRACT FROM AUTHOR]

Many reports concerning the success of fat auto-grafts in humans are widely subjective or semi-quantitative in best of cases. Even today, additional studies, clinical or basic, are necessary before the value of this technique can be calculated. With the aim of quantifying the survival of fat auto-grafts on the face, a prospective randomized study was designed, selecting 71 patients suffering facial soft tissue subcutaneous defects fulfilling the inclusion criteria. Two groups were described according to reconstructive and aesthetic surgery. Facial lipostructure technique was used as the standard surgical procedure and a biopsy of the grafted adipose tissue was taken at 14 months follow-up. The stereological method was used to measure the quantitative volumetric parameters of the fat at the injection time and at the biopsy time. By means of simple mathematical equations, the volumetric and numerical take rate could be obtained. Descriptive and quantitative statistical analyses of all data were performed. Fat auto-grafts on the face survive two thirds of the injected volume at 14 months follow-up. The unique confirmation proof of survival of fat auto-grafts is the histological evidence and demonstration of viable adipose tissue in recipient sites and its quantification by a volumetric, accurate and objective valuation method, as it is provided by Stereology. [ABSTRACT FROM AUTHOR]

Fat grafting has become one of the main tools in Plastic Surgery and as it could only be, the breast is the main target organ of our performance. Since we introduced the technique in our private practice in 2009 we have been increasing its use. The top three indications are: breast augmentation, correction of defects and asymmetries and more recently breast augmentation combining both techniques. Breast enhancement with fat is indicated for patients who want to increase the volume without using implants. It must be explained very well to the patient what we can achieve in terms of volume and projection of the breast, along with the potential problems of cysts and microcalcifications in mammograms. Adipose tissue is a great complement to the implants, and we can correct deformities and asymmetries that with implants are much more difficult to solve. Breast augmentation combining both techniques is the final result of the therapeutic evolution as we combine the advantages of both: the firmness and stable volume supported by the implants and the plasticity of the adipose tissue to achieve greater symmetry. [ABSTRACT FROM AUTHOR]

Adult stem cells-based therapy represents the most innovative treatment to regenerate the pathologic tissues (absent or lacking), to "replace like with like" as an aesthetic filler for a variety of cosmetic and reconstructive indications, and is one of the trending translational research lines all over the world; avoiding the host immune response and implant rejection problems of the human allotransplants, the inherent complications due to the implantation of alloplastic materials, the functional and aesthetic secuelae of donor sites in high morbidity autotrasplants, and the bioethical problems with the use of embrionary stem cells. Plastic surgeon has a relevant role such in the extraction of the cellular graft from the abdomen by means of a tumescent manual liposuction, as in the quick clinical application to different defects, deformities and losses of substance. The protocol of extraction and processing of adipose derived stem cells (ADSC) approved by the Clinical Researching Ethical Committee is presented as a feasible, safe and reproducible guide for the design of new controlled clinical studies about the efficacy of the stem cell autotrasplants for the treatment of many pathologies inside the universe of plastic surgery in which scarring process is compromised. [ABSTRACT FROM AUTHOR]

Though adipose tissue grafts have been used for decades in last century, the technique has been considered as slightly usefull provided that the graft was tending to reabsorption. It was Coleman who introduced a system of atraumatic harvesting-processing-infiltration that increased the percentage of survival of the graft obtaining positive similar results in its application all over the world. Nonetheless, publication of unlike results in the literature regarding survival of the graft with different percentages of reabsorption and the discovery of stem cells in the adipose tissue, have led to the accomplishment of numerous research works directed to understanding the biology of the fat graft, the role of the stem cells in this process and the influence that the different steps for transplantation have on the cellular viability. We present a review of the scientific literature about the theme to bring together the available information about these controversies. [ABSTRACT FROM AUTHOR]

Over the past decade, cell therapy has emerged as a new approach to reverse several diseases as myocardial ischemia and fistula in Crohn disease; but lately new efforts are centered in breast reconstruction. Several types of adult stem cell have been studied in both preclinical and clinical condition for this purpose: bone marrow cells, circulating cells, and myoblasts. Recently the existence of a population of stem cells located in the adipose tissue has been observed. These cells are able to differentiate into multiple cell lineage including adipocytes and endothelial cells. In this review we discuss the basic principle of adipose-derived stem cell (types, characteristic, harvesting and expansion), the initial experimental studies and the currently ongoing clinical trials. [ABSTRACT FROM AUTHOR]

The harvest of adipose tissue will be a promising labor marketing for plastic surgeons, since tissue banks will certainly choose fat as the easiest way to obtain a high-yield source of stem cells, as this type of tissue can produce al least five times more colony-forming units (CFUs) than bone marrow extracts. The aim of this study is to show what can be expected from fat tissues as an origin of adult stromal vascular fraction (SVF) cells, and to evaluate the best areas to be elected as donor sites within the human body, all obtained by liposuction. The routine to obtain SVF cells by collagenase digestion of human adipose tissue samples was described. At the time of harvest, these cells displayed a viability of 92+/- 1% based on Trypan Blue exclusion, SVF cells were counted after 48 hours culture in Dulbecco's modified Eagle medium (DMEM) in a Neubauer counting chamber. The average yield of SVF cells was 7,2 +/- 1,3 x 10³ cells per milliliter of liposuctioned tissue. As a conclusion, best strategies to obtain SVF cells are an important challenge nowadays. This study, although preliminary, showed that SVF may be easily obtained From liposuction. Comparison among different donor sites showed a 22% higher yield of SVF cells when fat tissue had been obtained from the trunk regions, when confronted with limbs. [ABSTRACT FROM AUTHOR]