title: Tissue augmentation with fibrin sealant and cultured fibroblasts: a preliminary study.
abstract: BACKGROUND
  Nonoperative subdermal tissue augmentation is one of the most frequently performed procedures in plastic surgery and dermatological practice. Many products, from biological to synthetic filler substances, are currently available. However, none has achieved ideal clinical efficacy, especially regarding volume maintenance and longevity. We examined the use of fibrin sealant as a biological and fully degradable matrix for dermal augmentation in combination with precultured human fibroblasts and hyaluronic acid gel (HYAFF).
  
  
  METHODS
  Four implant preparations were studied: fibrin glue only (F); 1% HYAFF mixed in fibrin glue (FH); 1.8 × 10(6) cells/ml of fibrin glue (FC); and 1% HYAFF and 1.8 × 10(6) cells/ml of fibrin glue (FHC). Each mouse was given two separate subcutaneous injections of implant material. At 1, 3, and 6 weeks two mice from each group were sacrificed, such that there was an n = 4 for each implant group at each time point. The mice were grossly examined for implant retention and the implants were evaluated by means of immunohistochemistry for fibrosis, integration into surrounding tissue, presence of elastin, and blood vessel infiltration.
  
  
  RESULTS
  Only the implants in the cell-containing groups, FC and FHC, remained after 6 weeks. Moreover, with the exception of a mild inflammatory response, no adverse affects of the cell-seeded implants were noted.
  
  
  CONCLUSIONS
  Presence of fibroblasts increases implant durability. Further studies should evaluate the ideal hyaluronic acid and fibroblast concentration for long-term longevity.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA. gmbhoben@gmail.com
authors.forename: Gwendolyn
authors.initials: G
authors.lastname: Hoben
authors.forename: Volker J
authors.initials: VJ
authors.lastname: Schmidt
authors.forename: Holger
authors.initials: H
authors.lastname: Bannasch
authors.forename: Raymund E
authors.initials: RE
authors.lastname: Horch
mesh_terms: D000818:Animals; D002478:Cells, Cultured; D003357:Cosmetic Techniques; D015718:Fibrin Tissue Adhesive; D005347:Fibroblasts; D006801:Humans; D051379:Mice; D008819:Mice, Nude; D014014:Tissue Adhesives
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives