Ciptomurti J. Lupitasari
Resident of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Agus Santoso Budi
Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
Magda Rosalina Hutagalung
Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
ABSTRACT
Fat is often used in soft tissue reconstruction procedures that require adding volume and contour to the defect. According to the International Society of Aesthetic Plastic Surgery, more than 1,000,000 procedures were performed in 2016. However, data shows that the fat graft survival rate is 20% – 90% depending on the method of taking the donor, the process, transplantation, and the condition of the recipient. Insulin has been shown to stimulate adipocyte cell proliferation, differentiation and trophic activity in vitro. This study aims to prove morphologically the effect of insulin administration on increasing fat weight and volume on the success of a significant fat graft survival rate. This research used an experimental method using a randomised post test-only control group design. The experimental animals in this study are male New Zealand rabbits (Oryctolagus cuniculus). Separation is carried out after fat grafting process at the end each 2nd, 4th and 8th week from the animal population. The final weight and volume were measured for macroscopic evaluation, and each sample was observed microscopically pre- and post-treatment using a Nikon Eclipse Ci-E microscope with a digital camera DS Fi2 300 megapixel. A comparison of the means for each group was tested using the analysis of the Mainn Whitney, Wilcoxon, and sample T-test. Comparison of fat volumes in the control and treatment groups, at the 2nd week, 4th week and 8th week, a comparison test was carried out using the Paired T-test with p <0.05(0.014). Fat grafting volume in the control group 8 weeks, there was a significant difference between the weight of the pre-fat graft group compared to the post-fat graft control group with a p-value of p<0.05 (0.043). A comparison test using the Wilcoxon test in the pre-fat graft control group compared to the post-fat graft control group at 4 weeks showed a significant difference with a p-value of p<0.05 (0.043). Insulin administration has been observed to impact the macroscopic alterations in the morphology of fat grafts, depending on whether weight or volume is maintained. These alterations contribute to the overall survival rate of the grafts. Additionally, insulin administration has been found to induce microscopic changes in the morphology of fat grafts, specifically in the form of fat cell hypertrophy. This further enhances the survival rate of the grafts.
Keywords: Fat Graft, Insulin, Survival Rate, Volume Maintenance, Weight Maintenance.
