Autologous fat grafting auxiliary methods in craniofacial deformities: A systematic review and network meta-analysis

IF 2 3区医学 Q2 SURGERY Journal of Plastic Reconstructive and Aesthetic Surgery Pub Date : 2024-09-19 DOI:10.1016/j.bjps.2024.09.060

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Abstract

Background

To increase autologous fat grafting (AFG) volume retention, current advancements focus on adding an auxiliary method to the process. This review aimed to address which auxiliary methods prove to be the best in terms of volume retention outcome.

Methods

A comprehensive literature search was performed in five medical databases, including PubMed, Proquest, Scopus, CENTRAL, and ScienceDirect, until March 2024, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines.

Results

Twenty-six studies were included in this review, and seven studies were included in the network meta-analysis. Reported auxiliary methods include stromal vascular fractions (SVFs) [12.20, 95% confidence intervals (CI) 0.04 to 24.35], adipose tissue-derived stem cells (ADSCs) (24.20, 95% CI 4.14 to 44.26), and platelet-rich plasma (PRP) [24.10, 95% CI −2.68 to 50.88]. When compared with the standard AFG approach, SVFs (p = 0.049) and ADSCs (p = 0.018) were more successful in retaining volume. However, PRP (p = 0.077) was not as effective. The comparison between auxiliary approaches, ADSCs vs PRP (p = 0.994), ADSCs vs SVFs (p = 0.271), and PRP vs SVF (p = 0.383), did not show any significant differences. Subgroup analysis revealed that the use of volumetric measuring methods has a substantial impact on the reported volume retention (p < 0.0001).

Conclusion

Enhanced volume retention can be attained with the utilization of SVF and ADSCs auxiliary methods in comparison to AFG, with or without PRP. Given the insignificant differences between SVF and ADSC, along with the greater complexity of the ADSC process, we recommend for the preferable use of SVF.

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颅面畸形的自体脂肪移植辅助方法：系统综述和网络荟萃分析。

背景：为了提高自体脂肪移植（AFG）的容积保持率，目前的进展主要集中在为这一过程添加辅助方法。本综述旨在探讨哪种辅助方法在容积保持效果方面被证明是最好的：根据系统综述和元分析首选报告项目（PRISMA）指南，在五大医学数据库（包括 PubMed、Proquest、Scopus、CENTRAL 和 ScienceDirect）中进行了全面的文献检索，检索期至 2024 年 3 月：本综述纳入了 26 项研究，网络荟萃分析纳入了 7 项研究。报告的辅助方法包括基质血管碎片（SVFs）[12.20，95%置信区间（CI）0.04至24.35]、脂肪组织衍生干细胞（ADSCs）（24.20，95% CI 4.14至44.26）和富血小板血浆（PRP）[24.10，95% CI -2.68至50.88]。与标准 AFG 方法相比，SVFs（p = 0.049）和 ADSCs（p = 0.018）在保留容积方面更为成功。然而，PRP（p = 0.077）的效果不佳。ADSCs vs PRP (p = 0.994)、ADSCs vs SVFs (p = 0.271)和 PRP vs SVF (p = 0.383)等辅助方法之间的比较没有显示出任何显著差异。分组分析表明，使用容积测量方法对报告的容积保持率有很大影响（p < 0.0001）：结论：使用 SVF 和 ADSCs 辅助方法与使用或不使用 PRP 的 AFG 相比，可以提高容积保持率。鉴于 SVF 和 ADSC 之间的差异并不明显，而且 ADSC 过程更为复杂，我们建议优先使用 SVF。

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来源期刊

Journal of Plastic Reconstructive and Aesthetic Surgery 医学-外科

CiteScore

3.10

自引率

11.10%

发文量

578

审稿时长

3.5 months

期刊介绍： JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.