بررسي و مقايسه‌‌ي ماندگاري در انتقال سريالي پيوند (گرافت) چربي اتولوگ ذخيره شده در دماي فريز و چربي تازه در جوان‌سازي صورت: يك مطالعه‌ي كارآزمايي باليني

Comparison of Survival in Serial Autologous Fat Transfer between Frozen and Fresh Fat in Face Rejuvenation: A Clinical Trial Study

ﻣﻘﺪﻣﻪ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﻣﻘﺎﯾﺴﻪ ي ﻣﺎﻧﺪﮔﺎري در اﻧﺘﻘﺎل ﺳﺮﯾﺎﻟﯽ ﭘﯿﻮﻧﺪ )ﮔﺮاﻓﺖ( ﭼﺮﺑﯽ اﺗﻮﻟﻮگ ذﺧﯿﺮه ﺷﺪه در دﻣﺎي ﻓﺮﯾﺰ و ﭼﺮﺑﯽ ﺗﺎزه در ﺟﻮان ﺳﺎزي ﺻﻮرت اﻧﺠﺎم ﮔﺮﻓﺖ.وش ﻫﺎ: در ﯾﮏ ﻣﻄﺎﻟﻌﻪ ي ﮐﺎرآزﻣﺎﯾﯽ ﺑﺎﻟﯿﻨﯽ، 60 ﺑﯿﻤﺎر داوﻃﻠﺐ ﺗﺰرﯾﻖ ﭼﺮﺑﯽ در ﻧﺎﺣﯿﻪ ي ﻧﺎزوﻟﯿﺒﯿﺎل در دو ﮔﺮوه 30 ﻧﻔﺮه ﺗﻮزﯾﻊ ﺷﺪﻧﺪ. در ﮔﺮوه اول، ﭼﺮﺑﯽ ﺗﺎزه از ﻧﺎﺣﯿﻪ ي داﺧﻠﯽ ران ﺑﺮداﺷﺘﻪ ﺷﺪ و ﺑﻪ ﻣﻘﺪار 3 ﺳﯽ ﺳﯽ در دو ﻃﺮف ﻣﺤﻞ ﻧﺎزوﻟﯿﺒﯿﺎل ﺗﺰرﯾﻖ ﺷﺪ. در 3-4 ﺟﻠﺴﻪ ي ﭘﯽ ﮔﯿﺮي ﺑﺎ ﻓﻮاﺻﻞ 3-4 ﻫﻔﺘﻪ، ﺗﺰرﯾﻘﺎت ﺑﻌﺪي ﺑﻪ ﻫﻤﯿﻦ ﺗﺮﺗﯿﺐ ﺻﻮرت ﮔﺮﻓﺖ. در ﮔﺮوه دوم، ﻣﻘﺪار ﭼﺮﺑﯽ ﻣﻮرد ﻧﯿﺎز ﺑﺮاي 4 ﺟﻠﺴﻪ ﺗﺰرﯾﻖ از ﻗﺴﻤﺖ داﺧﻠﯽ ران ﺑﺮداﺷﺘﻪ ﺷﺪ و 3 ﺳﯽ ﺳﯽ در اوﻟﯿﻦ ﻧﻮﺑﺖ ﺗﺰرﯾﻖ ﺷﺪ و ﻣﺎﺑﻘﯽ ﭼﺮﺑﯽ در دﻣﺎي 20- درﺟﻪ ي ﺳﺎﻧﺘﯽ ﮔﺮاد ﻓﺮﯾﺰ ﺷﺪ و در ﻃﯽ ﻧﻮﺑﺖ ﻫﺎي ﺑﻌﺪي، ﭘﺲ از ﯾﺦ زداﯾﯽ در ﻣﺤﻞ ﻧﺎزوﻟﯿﺒﯿﺎل ﺗﺰرﯾﻖ ﺷﺪ. ﻣﯿﺰان ﻣﺎﻧﺪﮔﺎري ﺑﺎﻓﺖ ﭼﺮﺑﯽ در 12 ،9 ،6 ،3 و 15 ﻣﺎه ﺑﻌﺪ از ﺗﺰرﯾﻖ در دو ﮔﺮوه ﺗﻌﯿﯿﻦ و ﻣﻘﺎﯾﺴﻪ ﮔﺮدﯾﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﻣﻘﺎﯾﺴﻪ ي ﺗﻐﯿﯿﺮات ﻧﻤﺮه ي ارزﯾﺎﺑﯽ ﭼﺮوك ﻫﺎي ﺻﻮرت )Modified Fitzpatrick wrinkle scale ﯾﺎ MFWS( در ﻗﺒﻞ از ﻋﻤﻞ و ﻣﺎه ﻫﺎي 12 ،9 ،6 ،3 و 15 ﺑﻌﺪ از ﻋﻤﻞ، ﺗﻔﺎوت ﻣﻌﻨﯽ داري را ﺑﯿﻦ دو ﮔﺮوه ﻧﺸﺎن ﻧﺪاد )0/37 = P(. درﺻﺪ ﮐﻠﯽ ﮐﺎﻫﺶ ﺑﺎﻓﺖ ﭼﺮﺑﯽ در ﻃﯽ 15 ﻣﺎه ﺑﻌﺪ از ﺗﺰرﯾﻖ در ﮔﺮوه ﺗﺤﺖ ﺗﺰرﯾﻖ ﭼﺮﺑﯽ ﺗﺎزه 0/13 ± 0/59 و در ﮔﺮوه ﺗﺤﺖ ﺗﺰرﯾﻖ ﭼﺮﺑﯽ ﻓﺮﯾﺰ ﺷﺪه 0/11 ± 0/61 درﺻﺪ ﺑﻮد و ﺗﻔﺎوت ﻣﻌﻨﯽ دار ﺑﯿﻦ دو ﮔﺮوه دﯾﺪه ﻧﺸﺪ )0/73 = P(. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ اﯾﻦ ﮐﻪ ﻣﺎﻧﺪﮔﺎري ﺑﺎﻓﺖ ﭼﺮﺑﯽ در دو روش ﺗﺰرﯾﻖ ﭼﺮﺑﯽ ﺗﺎزه و ﻓﺮﯾﺰ ﺗﻔﺎوت ﻧﺪارد، ﺑﻪ ﻧﻈﺮ ﻣﯽ رﺳﺪ اﺳﺘﻔﺎده از ﭼﺮﺑﯽ ﻓﺮﯾﺰ ﺷﺪه ﺑﻪ ﻋﻠﺖ ﯾﮏ ﺑﺎر ﺑﺮداﺷﺖ ﭼﺮﺑﯽ و ﻫﺰﯾﻨﻪ ﻫﺎي ﭘﺎﯾﯿﻦ ﺗﺮ ﻋﻤﻞ، ﺑﺮاي ﺟﻮان ﺳﺎزي ﭘﻮﺳﺖ ارﺟﺢ ﺑﺎﺷﺪ

Background: This study aimed to compare the survival in serial autologous fat transfer between frozen and fresh fat among patients referred for face rejuvenation. Methods: In a clinical trial study, 60 volunteer patients for fat injection in the nasolabial region were divided into two groups of 30. In the first group, fresh fat was removed from the inner thigh, and 3 cc was injected on both sides of the nasolabial fold. 3 to 4 weeks later, subsequent injections were performed in the same way. In the second group, the amount of fat required for 4 sessions of injection was removed from the inner thigh, and 3 cc was injected in the first time; the rest of the fat was frozen at -20° C and during the next times, after defrosting in place, was injected in nasolabial region. The shelf life of adipose tissue was determined and compared between the two groups 3, 6, 9, 12, and 15 months after injection. Findings: Comparison of changes in facial wrinkle assessment score (MFWS) before and 3, 6, 9, 12, and 15 months after surgery did not show any significant difference between the two groups (P = 0.37). The overall percentage of adipose tissue reduction during 15 months after injection was 0.59 ± 0.13 percent in the fresh fat injection group and 0.61 ± 0.11 percent in the frozen fat injection group with no significant difference between the two groups (P = 0.73). Conclusion: Due to the fact that survival injected fat is not differ between the two methods of injecting fresh and frozen fat, the use of frozen fat seems to be preferable for rejuvenation of the skin due to one-time fat removal and lower operating costs.