Effects of the Acellular Dermal Matrix and Fat Graft on Radiation-Induced Fibrosis in a Prosthesis-Implanted Rat Model

Eun Hye Kang, Sang Woo Han, Won Jai Lee, Sug Won Kim and Chae-Eun Yang

Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Republic of Korea Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine, Republic of Korea

^*Correspondance to: Chae-Eun Yang 

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Abstract:

Introduction: Capsular contracture is a multifactorial process involving inflammation and fibrosis. Although Acellular Dermal Matrix (ADM) is widely used to prevent the formation of capsular contracture, it has drawbacks such as seroma formation, infection, and high costs. Clinical studies have reported that fat grafting performed prior to implantation after irradiation improves fibrosis. However, none has compared ADM and fat grafting because of difficulty in setting the control group. Objective: This study aimed to provide an objective basis for the clinical use of ADM and fat graft by comparing the changes in soft tissue after irradiation in a prosthesis-implanted rat model with those of a control group. Methods: Thirty adult female Wistar rats were implanted and irradiated. For the ADM group, silicone implant was wrapped before implantation. For the fat graft group, autologous fat was grafted around the implant after irradiation. Capsular thickness and expression of fibrosis-related proteins, including α-smooth muscle actin, collagen 1, and transforming growth factor β1, were evaluated. Results: Capsules were thinner at week 12 than at week 4, and they were thickest in the control group and thinnest in the fat graft group. Fibrosis-related protein expression was lowest in the fat graft group and highest in the control group. Conclusion: Both ADM and fat graft had positive effects on fibrotic change after irradiation on the silicone-implanted area in a rat model. Further study is needed to compare with simultaneous use of ADM and fat graft over a longer period in order to obtain more reliable results that are clinically applicable.

Keywords:

Radiation fibrosis, Acellular dermal matrix; Fat graft

Cite the Article:

Kang EH, Han SW, Lee WJ, Kim SW, Yang C-E. Effects of the Acellular Dermal Matrix and Fat Graft on Radiation-Induced Fibrosis in a Prosthesis-Implanted Rat Model. World J Surg Surgical Res. 2022;5:1387..