title: External Volume Expansion Modulates Vascular Growth and Functional Maturation in a Swine Model.
abstract: Despite increasing application of the pre-grafting expansion during autologous fat transplantation in breast reconstruction, little is known about its mechanism of action. To address that, ventral skins of miniature pigs were treated over a 10-day or 21-day period, with continuous suction at -50 mm Hg via a 7-cm diameter rubber-lined suction-cup device. Soft tissue thickness increased immediately after this external volume expansion (EVE) treatment, such increase completely disappeared by the next day. In the dermis and subcutaneous fat, the EVE treated groups showed significant increases in blood vessel density evident by CD31 staining as well as in vascular networks layered with smooth muscle cells when compared with the control group. This finding was corroborated by the increased percentage of endothelial cells present in the treatment groups. There was no significant difference in the percentages of proliferating basal keratinocytes or adipocytes, nor in epidermal thickness. Moreover, the EVE had no effect on proliferation or differentiation potential of adipose stem cells. Taken together, the major effects of EVE appeared to be vascular remodeling and maturation of functional blood vessels. This understanding may help clinicians optimize the vascularity of the recipient bed to further improve fat graft survival.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital &Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Huang-Kai
authors.initials: HK
authors.lastname: Kao
authors.affiliation: Kidney Research Center, Department of Nephrology, Division of Critical Care Nephrology, Chang Gung Memorial Hospital &Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Hsiang-Hao
authors.initials: HH
authors.lastname: Hsu
authors.affiliation: Department of Pathology, Chang Gung Memorial Hospital &Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Chuang
authors.affiliation: Department of Animal Science, National Taiwan University, Taipei, Taiwan.
authors.forename: Sheng-Chih
authors.initials: SC
authors.lastname: Chen
authors.affiliation: Department of Plastic Surgery, Lahey Hospital &Medical Center, Burlington, MA, USA.
authors.forename: Bin
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Animal Science, National Taiwan University, Taipei, Taiwan.
authors.forename: Shinn-Chih
authors.initials: SC
authors.lastname: Wu
authors.affiliation: Department of Plastic Surgery, Lahey Hospital &Medical Center, Burlington, MA, USA.
authors.forename: Lifei
authors.initials: L
authors.lastname: Guo
mesh_terms: D017667:Adipocytes / Q000166:cytology* / Q000378:metabolism; D000273:Adipose Tissue / Q000098:blood supply* / Q000378:metabolism; D000818:Animals; D002454:Cell Differentiation; D049109:Cell Proliferation; D020405:Dermis / Q000098:blood supply / Q000378:metabolism; D023421:Models, Animal; D032389:Myocytes, Smooth Muscle / Q000378:metabolism; D018919:Neovascularization, Physiologic; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D012867:Skin / Q000098:blood supply* / Q000166:cytology / Q000378:metabolism; D013396:Suction; D013552:Swine; D013556:Swine, Miniature; D015626:Tissue Expansion / Q000295:instrumentation* / Q000379:methods
chemical_list: D019408:Platelet Endothelial Cell Adhesion Molecule-1