| Autogenous fat pearl grafting offers a solution to several difficult problems in the reconstruction for soft-tissue and contour defects. The grafting technique is easily learned and patient satisfaction is high. However, the limitations of fat transplantation are well known, because of the high percentage and variable amount of fat resorption reduce the clinical efficacy of this procedure, particularly the long-term unpredictability of volume maintenance and often result in the need for further grafting. Many experts have done a lot of research works to improve the survival rate. The survival of fat grafts depends on many factors, the majors are early revascularization and the differentiation of the adipocytes. Early and adequate revascularization may be important for both the supply of nutrients and vasoactive interactions between vascular endothelial cells and adipocytes in graft. Early studies showed that adipose tissue has a low tolerance to ischemia. Some methods have been described to increase the tolerance of adipose tissue to ischemia. Just like insulin-like growth factor-1; basic-fibroblast growth factor, angiopoietin-1 and leptin can promote transplanted fat survival respectively, but all have localization of clinic application.Tetramethylpyrazine (TMP) is one of major efficient components from Chinese traditional medicine herb Ligusticum Chuanxiong Hort, Which is currently widely used in China for the treatment of coronary atherosclerotic cardiovascular disease and ischemi cerebrocardiac vascular disease. As reported, TMP can inhibit the platelet aggregation, inhibit vasoconstriction in isolated vascular strips and antithrombosis, but until now, there is no report about relationship between Chinese medicine and fat survival.Objective:Through establishing a rat fat-transplantation model, to detect the reaction of the total and the local of fat particle auto- transplantation and to evaluate the effect of the treatment of TMP in promoting survival of fat particle auto- transplantation.Method:Eighty-four SD rats were randomly assigned into four groups and treated as follows: Autogenous fat grafts were excised from abdominal cavity of every rat. Grafts of 1st group were discarded as control group, Grafts of 2nd group were only transplanted, Grafts of 3rd and 4th group were transplanted with which administered TMP in the abdominal cavity at 50mg/kg.d and 100mg/kg.d for 2 weeks after the transplantation.Fat graft harvested from the left abdominal cavity of every rat. The fat grafts of 1st group were discard. For other groups, minimal skin incision and undermining were performed in lateral dorsum of recipient rat, 1.5 ml purified autogenous fat pearl grafts were transplanted in the rats' dorsum. Four groups were taken samples 4,7,14,28,42,70 days after operation as follows: 1) The harvested blood of the right groin artery of SD rats was processed the measure of Annexin V in order to detect the apoptosis of the cell; and also was to determine the concentration of VEGF in blood serum.2 ) The transplanted fat tissues were extirpated. Skin incision was performed in square to surround on the transplanted region. The half samples of three transplanted groups were taken out only integrality without envelope, and their volumes were measured with their survival rate being calculated.3 ) The samples were stained with HE and VIII factor immunohistochemistry method. Gross and microscopic examinations of autogenous fat grafts were performed. The microvessel density was measured.Results:The VEGF concentration of the blood serum and the apoptosis of the cell were changed in 2nd, 3rd and 4th groups. The values of microvessel density in TMP groups were higher as compared with simplicity graft group in the same observing periods especially in 4,14,42 days. But there was no significant difference between the two TMP groups. Histopathologic evaluation showed degeneration of some adipocytes and inflammatory changes on day 4-14, increased vascularity and fibrosis on day 7-28, as well as fibrosis, microcysties, and the differentiation of the adipocyte on day 42 and later in simplicity graft group. And the two TMP groups had survived better. It was observed that adipose tissue survived in more than 50% of the graft volume in two TMP groups and 41.3% in simplicity graft group. The survival rate of TMP groups were higher than simplicity graft group. There was no significant difference between two TMP groups.Conclusion:A certain dosage Tetramethylpyrazine may be a candidate drug in promoting survival of fat particle auto- transplantation. |
