Abstract
Objectives:
To create surgeon awareness that some liposuction instruments should not be used for harvest and reinjection during autologous fat grafting (AFG), to outline which instruments need special cleaning techniques, and to increase awareness of available customized devices that will eliminate the accumulation of debris in defect areas.
Methods:
The author examined 13 common liposuction handles and 22 liposuction cannulas noting their construction and ease of cleaning by brush and pressured water. Internal examination of the handles was done by cutting them in half longitudinally observing the pathway of the fat during harvest. The cannulas were examined by probing the tips of the cannulas to determine if blind pockets were present.
Results:
A few of the instruments had an acceptable continuous pathway and no problem cleaning areas. However, 10 of the 13 liposuction handles had severe drop-offs and cracks that would be very difficult to clean, and 18 out of the 22 cannulas contained a blind pocket in their distal tip. The most common structural problem for the handles was the severe drop-off but the most serious problem for the handles was the crack. The most common and serious problem for the cannulas was the tip blind pocket. These areas would require special cleaning efforts to qualify for use during AFG/T.
Discussion:
When AFG became a more popular procedure, surgeons adapted by using liposuction instruments for harvest and reinjection. However, because fat transfer involves reinjecting fat back into the body, the instruments must be easy to clean. Most liposuction instruments are built to transport liposuction waste fat only; thus, they have a crude interior design with drop-offs and pockets that make them difficult to clean. Some of these devices can harbor pockets of old tissue. In general, if the pathway is continuous and is not interrupted by drop-offs or blind pockets, the instrument can be used for both liposuction and AFG. If, however, there are drop-offs and/or blind pockets, the surgeon should make certain the unit is dismantled and every area cleaned manually between procedures or should turn to the many customized instruments for AFG.
Conclusions:
The decision to purchase and use liposuction instruments for AFG should be made only after the surgeon has examined the product and is confident that the pathway has no drop-offs and/or blind pockets that make it difficult to clean. Custom AFG instruments are available that are constructed in a manner that negates the need for special cleaning procedures.
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