Clinical Trial: Structural Fat Grafting for Craniofacial Trauma: Repeat Fat Grafting Injection-5 Subject Cohort

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Structural Fat Grafting for Craniofacial Trauma: Repeat Fat Grafting Injection-5 Subject Cohort

Brief Summary:

Fat grafting represents a technique with great potential to improve outcomes in minimally invasive facial reconstruction. Fat grafting has already been demonstrated as a safe and minimally invasive technique over decades of widespread practice in plastic surgery. In our current study of fat grafting for facial deformities (IRB# PRO09060101), we have treated 9 subjects without adverse event and all have had a significant improvement. Since all methods of treatment and evaluation are the same in this study, we will be able to use the data in our prior study as additional control data.

We hypothesize that repeating the fat grafting in subjects with previous facial fat grafts will enable successful restoration of tissue volume and craniofacial form. Additionally, we hypothesize that the results will be durable and subject quality of life improved.

Five (5) subjects (who were previously enrolled into IRB# PRO09060101) will be enrolled to this single center University of Pittsburgh site research study.


Detailed Summary:

Facial trauma injuries, especially those sustained in military combat and severe automobile crashes, are characterized by destruction of bone and soft tissue anatomy. While the bony skeleton can often be reconstructed, the overlying soft tissue is difficult to restore.

Importantly, it is the structure of the soft tissue that imparts the normal human form, and adequate reconstruction of soft tissue defects allows trauma victims to reintegrate into society. Accepted procedures for soft tissue reconstruction of the face involve tissue flap reconstruction procedures and autologous fat grafting. Tissue flap operations are extensive, often including microvascular surgery, and do not precisely correct the deformities. Fat grafting is a less invasive technique that allows for more precise shaping of the reconstructed tissues. However, autologous fat grafts may undergo resorption that can affect the appearance of the reconstruction over time. The degree of change in appearance after fat grafting has not been well studied for facial trauma patients.

We hypothesize that subjects who have successfully completed participation in the study (PRO09060101) and experienced graft resorbtion will have improved outcomes with an additional fat graft treatment. We anticipate that additional fat graft treatment will fully restore the facial features and overcome fat loss from the initial fat graft treatment. Additionally, we hypothesize that the cellular properties of the fat precursor cells (preadipocytes) may correlate with fat graft retention


Sponsor: University of Pittsburgh

Current Primary Outcome: Facial Volume Score [ Time Frame: assessed at baseline (pre-op), days 7-21 post-op, 3 months post-op, and 9 months post-op ]

the facial volume and appearance grading scale evaluates each aesthetic region in the face based on both physical examination and 3D photography by the clinician. scale ranges from 1-3 where a score of 1 indicates an obvious contour defect; 2 shows a noticeable improvement in contour but not sufficient to impart a normal appearance; 3 represents a normal appearance and/or close approximation with a normal uninjured contralateral structure.


Original Primary Outcome: The Change over time in the volume and contour of the fat graft site. [ Time Frame: Change over time as assessed at baseline; 7-21 days, 3 months and 9 months post op ]

The investigators anticipate that additional fat graft treatment will fully restore the facial features and overcome fat loss from the initial fat graft treatment as assessed by CT scans and assessing appearance with 2D and 3D photography


Current Secondary Outcome: Serial Computed Tomography Imaging [ Time Frame: assessed at 7-21 days, 3 months and 9 months post op. ]

serial computed tomography images were collected to evaluate the volume of the defect


Original Secondary Outcome:

  • Examination of the cellular properties of the grafted material in each subject for future correlation with clinical outcomes [ Time Frame: 20 years ]
    A secondary objective is to examine the cellular properties of the grafted material in each subject for future correlation with clinical outcomes
  • Change in time of Quality of life measures [ Time Frame: as assessed at baseline then 7-21 days, 3 months and 9 months post op. ]


Information By: University of Pittsburgh

Dates:
Date Received: March 19, 2013
Date Started: April 2013
Date Completion:
Last Updated: May 10, 2017
Last Verified: May 2017