Advances and challenges in decellularized adipose tissue based composite hydrogels for adipose tissue regeneration: a review over the last fifteen years

Adipose tissue regeneration has emerged as a transformative strategy for addressing soft-tissue defects resulting from trauma, oncologic resection, and burn injuries, leveraging adipose tissue's dual role as a dynamic endocrine organ that regulates systemic metabolism. Decellularized adipose tissue (DAT) scaffolds hold significant promise in adipose tissue regeneration due to their unique preservation of pro-adipogenic and structurally preserved extracellular matrix (ECM) components. However, their clinical translation faces bottlenecks, including inadequate compressive modulus, unpredictable biodegradation kinetics and limited neovascularization capacity. This review critically synthesizes methodological advancements in DAT processing, systematically evaluating protocol efficacy in DAT preservation versus immunogenic residue elimination while assessing their translational potential as implant materials. Building upon methodological innovations in DAT composite hydrogel engineering since 2013, this overview concurrently elucidates mechanobiological regulation paradigms governing hydrogel functionality and evaluates crosslinking strategies that optimize structural fidelity. Critical challenges and emerging frontiers are also discussed. The current comparative assessment of material performance metrics may offer new insights for further investigation and translational optimization in DAT based composite hydrogels for repair of soft tissue defects.