The use of autologous free fat tissue in prevention of calvarial bone regeneration: an experimental study

Abstract

European "~1 ,,~0x °a'o' i _lflStlC bu¢ ery Abstract. Autologous free fat grafts have been successfully used to limit ingrowth of postlaminectomy fibrous tissue and to prevent reossification after bone resection in long bones. This study was designed to test the effect of placing autologous adipose tissue in standardized craniotomy defects and also to determine the effect of the presence of periosteum and dura in the area of the fat augmented defects. In 18 immature rabbits, aged 18-21 days, two identical full-thickness defects were made bilaterally in the parietal bone. An autologous free fat graft was placed in one of the defects, the second being an internal control. The study groups were as follows: Group I: dura and periosteum left intact; Group II; periosteum removed; dura left intact; Group III; periosteum and dura removed. The animals were sacrificed after ten weeks.Histological examination of all groups demonstrated prevention of bone regeneration at the margins of the defect with some variations. In the first and second groups, new bone formation appeared over the dura, creating an incomplete plate of bone. On the periosteal side of the graft, a smaller amount of bone formation appeared close to the osteotomy line. The third group demonstrated a total prevention of bone regeneration. The use of free fat tissue graft can prevent calvarial bone regeneration and may be a useful adjunct for the treatment of craniosynostosis. Measures should be taken regarding the new bone formation over the dura, since this may cause reoccurrence of craniosynostosis.

Use of muscle graft versus fascia flap as interpositional material in prevention of reossification in a rat model of skull bone defect

“…Past experimental studies have revealed successful outcomes with the use of several interpositional materials in terms of prevention of early re-ossification of skull bone defects. Use of an autologous free fat graft is reportedly associated with total prevention of calvarial bone regeneration after 10 weeks after the formation of parietal bone defects (15), or 8 months after the formation of temporal bone defects in rabbits (13). Authors have noted that the use of free fat tissue transplant can be a useful alternative, serving as a biological interposition material in the surgical treatment of craniosynostosis (13,15).…”

“…Therefore, certain surgical techniques, such as covering of the craniectomy margins with a plastic film (8), and dural split (17), have been described in the initial studies to prevent early re-ossification at the suturectomy site after craniosynostosis surgery. Thereafter, the placement of various types of absorbable and non-absorbable materials between the bone edges as interpositional materials has been investigated in terms of their potential role in preventing early re-ossification as a useful adjunct for the treatment of craniosynostosis (1,2,4,6,13,15). These materials include polyethylene films, pericranial grafts, interpositioned biodegradable polyglycolic acid (PGA) membrane, interposed silicon membrane or expanded polytet-█ INTRODUCTION A chievement of re-ossification is the main goal of treatment in most clinical conditions with bone defects, especially in bone surgery.…”

“…Suboptimal treatment of craniosynostosis increases the risk of aesthetic deformities in later life, while re-operation after primary craniosynostosis surgery may also be required in cases of recurrence of craniofacial deformity with secondary coronal synostoses or craniocerebral disproportion (3,7,9,18,19). rafluoroethylene (ePTFE) membrane as a barrier to calvarial reclosure, as well as dura and muscle graft (MG), and free fat tissue transplants (1,2,4,6,13,15). Polyethylene films are non-biological materials, and pericranial grafts have potential osteogenic capacity.…”

“…Polyethylene films are non-biological materials, and pericranial grafts have potential osteogenic capacity. The use of free fat tissue transplants has been considered useful not only for correcting premature epiphyseal fusion of long bones by preventing re-ossification after bone bridge resection, but also for preventing osseous reunion of the calvarial bone defects (6,13,15). However, early re-ossification at the suturectomy site after craniosynostosis surgery remains challenging given the lack of convincing scientific evidence obtained for any material (1,2,4).…”