Autologous platelet-rich plasma as an adipocyte in vivo delivery system

Background: The authors hypothesized that autologous platelet- rich plasma (APRP) could be used as an in vivo adipocyte delivery system to favor cell survival and to stimulate early recruitment of microcapillaries to the site of implantation. The objective for this case report was to describe a completely autologous novel technique for in vivo adipose tissue engineering in which autologous fat is included in APRP and injected as a gel into a subcutaneous pocket to treat problematic scar. Materials and methods: Autologous fat was included in APRP and injected as a gel into a subcutaneous pocket created to correct a painful, adherent, and unpleasant scars in 10 patients. The surgical outcome was evaluated by histologic and immunohistochemical analysis as well as by ecography before and after surgery ad different time points (6 and 12 months after surgery). Results: The results were satisfactory, showing fat survival 1 year after surgery. As a three-dimensional gel that can be mixed easily with cellular components, APRP provides an autologous environment rich in growth factors secreted by platelets. Conclusions: This preliminary observation established that APRP can support an adipose tissue graft, preserving its volume for 1 year. The characteristics of this new material should stimulate research into future clinical applications for such cell constructs in plastic and reconstructive surgery. The proposed approach satisfies many safety considerations: cells (adipocytes) are completely autologous and immediately employed without any type of in vitro preconditioning; biomaterials are obtained from an autologous peripheral blood sample processed without any media components; finally, the surgeon mixes adipocytes with the APRP gel in the operating room using dedicated and sterile instruments.