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Dr. Joel Aronowitz — Clinical Safety of Adipose Stem Cell Separation at the Point of Care

Dr. Joel A. Aronowitz , Cloe S. Hakakian BS, Ryan A. Lockhart BS Cedars-Sinai Medical Center, University Stem Cell Center, Los Angeles CA Abstract Background: Pluripotential cells concentrated in perivascular areas of adipose tissue are pivotal in long term volume retention and regenerative effects of fat grafting. Unfortunately adipose stem cells are significantly depleted by all lipoaspiration techniques used to harvest fat graft [1] . Autogenous stem cells can be replenished to the fat graft in a strategy termed Cell Assisted Lipotransfer (CAL) by Yoshimura. Mounting preclinical and clinical evidence supports the rationale of CAL but routine clinical adoption of CAL in fat grafting requires a safe and predictable method of isolating adipose stem cells during the procedure in the operating room, that is, at the point of care (POC). Mechanical, non enzymatic methods can concentrate free stem cells [2] in the stromal vascular fraction of lipoaspirate with yields in the range of a

Dr. Joel Aronowitz — Mechanical versus enzymatic isolation of stromal vascular fraction cells from adipose tissue

Dr. Joel Aronowitz Joel A. Aronowitz , Ryan A. Lockhart and Cloe S. Hakakian Abstract Clinical use of adipose-derived stem cells (ASCs) for a variety of indications is rapidly expanding in medicine. Most commonly, ASCs are isolated at the point of care from lipoaspirate tissue as the stromal vascular fraction (SVF). The cells are immediately administered to the patient as an injection or used to enrich fat grafts. Isolation of ASCs from adipose tissue is a relatively simple process performed routinely in cell biology laboratories, but isolation at the point of care for immediate clinical administration requires special methodology to prevent contamination, ensure integrity of clinical research and comply with regulatory requirements. A lack of practical laboratory experience, regulatory uncertainty and a relative paucity of objective published data can make selection of the optimum separation method for specific indications a difficult task for the clinician and can discourage clini

PLASTIC SURGERY…for Neurosurgeons

Dr. Joel Aronowitz CSMC Div. Plastic Surgery Sutures are as old as creation “And they knew they were naked and SEWED fig leaves to cover themselves” Genesis A Brief Suture History 30,000 BC Neolithic eyed needles 3,500 BC Edwin Smith Papyrus 210 AD Galen sewed gladiators w/gut 1887 sterile sutures introduced 1920 Merson invents the Swage Classification of Sutures Absorbable vs. Permanent Natural vs. Synthetic Tensile strength loss over time Braided vs. Monofilament BRAIDED VS MONOFILAMENT SUTURE BRAIDED Handling better Knots more secure Softer No snitching, Clinching Infection risk hi, 10,000X less bact innoculum Freq spitting MONOFILAMENT Lower infection risk Snitches easily Stiffer Less spitting ABSORBABLE VS NON-ABSORBABLE ABSORBABLE No retained foreign body No late suture reaction Risk of premature tensile strength failure Elicits cellular response, ie wbc NON-ABSORBABLE Permanent strength Useful anatomic marker Min inflamm response, monofil., relatively inert Long term FB effects

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