The reconstruction of large-volume soft tissue defects is a major problem in plastic surgery. Many plastic surgeons have focused on external volume expansion (EVE) because of its capacity to promote regeneration of soft tissues, including breast, subcutaneous fat, and skin. EVE is a minimally invasive and less costly tissue engineering approach that has shown great clinical potential. However, many challenges still need to be addressed before such technology can become a common clinical practice. Basic in vivo and in vitro studies have been performed to determine the possible mechanisms by which EVE promotes tissue regeneration and to design optimized animal models. EVE application was found to facilitate cell proliferation and migration, enhance adipogenesis, improve angiogenesis, and provide available space for soft tissue growth. Understanding the mechanical and chemical signals associated with EVE during tissue regeneration may enable the clinical adaptation of this technology. This article reviews the clinical application of EVE techniques, describes preclinical animal models, and evaluates the possible mechanisms by which EVE induces tissue regeneration.

中文翻译：

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体外扩容术在软组织再生中的应用及作用机制

大体积软组织缺损的重建是整形外科的一大难题。许多整形外科医生将注意力集中在体外体积膨胀 (EVE) 上，因为它能够促进软组织再生，包括乳房、皮下脂肪和皮肤。EVE 是一种微创且成本较低的组织工程方法，已显示出巨大的临床潜力。然而，在这种技术成为常见的临床实践之前，仍有许多挑战需要解决。基本在体内和体外已经进行了研究以确定 EVE 促进组织再生的可能机制并设计优化的动物模型。发现 EVE 应用促进细胞增殖和迁移，增强脂肪生成，改善血管生成，并为软组织生长提供可用空间。了解组织再生过程中与 EVE 相关的机械和化学信号可能使该技术的临床适应成为可能。本文回顾了 EVE 技术的临床应用，描述了临床前动物模型，并评估了 EVE 诱导组织再生的可能机制。