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Facial InjuriesBTIPlusUpNCT01822301

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

A study testing Repeat Fat grafting in people with Facial Injuries and Adipose Tissue, run by University of Pittsburgh at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial 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. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Facial Injuries, Adipose Tissue
What is being tested?
Repeat Fat grafting
Could I receive a placebo?
No, everyone receives an active treatment
How many people
5 participants
Where
1 siteUnited States
Study dates
Apr 2013to May 2015
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Aged 18 years or older and able to provide informed consent
  • Have suffered injury resulting in craniofacial volume defects which could be treated with a graft volume of between 5 and 150 cc of lipoaspirate
  • Be at least 3 months post-injury or post-surgery (from trauma procedures) so that acute edema is resolved
  • Volume defects are covered by intact skin and do not communicate with oral cavity or sinuses
  • The three dimensional geometry of the volume defects would allow for treatment with lipoaspirate injection that in a manner that at least two distinct treated areas could be discerned on gross examination and radiographically (e.g. treated regions are on opposite sides of the face, on lower face versus upper face, or separated by a bony landmark such as zygoma. This would include the ability to treat an uninjured contralateral region with lipaspirate in order to obtain symmetry.
  • Willing and able to comply with follow up examinations, including radiographic studies
  • Have completed participation in IRB# PRO09060101.

Who cannot join

  • Age less than 18 years
  • Inability to provide informed consent
  • Craniofacial defects intended for treatment have open wounds or communicate with oral cavity or sinus (note: presence of such a defect in the setting of another defect(s) that meets treatment criteria will not exclude the patient from participating).
  • Active infection anywhere in the body
  • Diagnosed with cancer within the last 12 months and /or presently receiving chemotherapy or radiation treatment
  • Known coagulopathy
Show all 9Show fewer
  • Systemic disease that would render the fat harvest and injection procedure, along with associated anesthesia, unsafe to the patient.
  • Pregnancy
  • Subjects with Schizophrenia, Bipolar Disorder. (Subjects who are found to be stable on medication and receive psychiatric clearance could be eligible for study participation per the Physician's discretion.)

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Unversity of Pittsburgh

    Pittsburgh, Pennsylvania, 15213

Other trials in United States

About this study

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.

Read the detailed description

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

Being tested
Repeat Fat grafting
Keywords
Craniomaxillofacial (CMF) Battle-injured (BI), Facial Trauma, Fat Grafts, Autogenous Fat Transfers (AFT), Wounded warriors
Medical subject headings
Facial Injuries

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Repeat Fat graftingProcedure or surgery

    Fat grafting is a minimally invasive clinical procedure that has been widely used by plastic surgeons within reconstructive surgery for many years. Fat grafting is considered a standard of care procedure in plastic surgery. In brief, fat tissue to be used for grafting is harvested (usually from abdomen or thighs) with a small liposuction cannula in the operating room. The fat tissue is then sterilely centrifuged and allowed to decant before separating the fluid and oil layers from the fat tissue fraction. The aspirated fat is then loaded into 1cc syringes and injected into the facial deformity using specialized injection cannulas. In this study, we will treat 5 subjects from protocol (IRB # PRO09060101) with an additional fat graft treatment to assess whether this will increase fat graft retention over time. Additionally, data from our current study assessing volume retention after fat grafting for facial deformities (IRB # PRO09060101) with be used for comparison.

Study groups in NCT01822301
Study groupRoleWhat they receive
Repeat Facial fat graftingExperimentalNot described
Receives: Procedure: Repeat Fat grafting

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Facial Volume Score

    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.

    Measured: assessed at baseline (pre-op), days 7-21 post-op, 3 months post-op, and 9 months post-op

Secondary outcomes (1)
  1. Serial Computed Tomography Imaging

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

    Measured: assessed at 7-21 days, 3 months and 9 months post op.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Apr 2013 (estimated)
  2. Study startApr 2013
  3. Primary completionMay 2015
  4. Study completionMay 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
5 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01822301
Sponsor's protocol ID
PRO12100585
Acronym
BTIPlusUp
Status last verified
Jun 2017
First submitted
19 Mar 2013
Last updated
11 Jul 2017
Data monitoring committee
Yes
Individual data sharing
Yes: It is the Principal Investigator's intention to make stored samples and subject de-identified information available to secondary investigators after all research study testing has been completed. These stored samples and associated subject information will not include subject identifiers.

Publications

  • Moseley TA, Zhu M, Hedrick MH. Adipose-derived stem and progenitor cells as fillers in plastic and reconstructive surgery. Plast Reconstr Surg. 2006 Sep;118(3 Suppl):121S-128S. doi: 10.1097/01.prs.0000234609.74811.2e.

    PubMed 16936551
  • Cardenas JC, Carvajal J. Refinement of rhinoplasty with lipoinjection. Aesthetic Plast Surg. 2007 Sep-Oct;31(5):501-5. doi: 10.1007/s00266-006-0136-2. Epub 2007 Jul 25.

    PubMed 17653684
  • Hu S, Zhang H, Feng Y, Yang Y, Han X, Han X, Zhong Y, Shi J. Introduction of an easy technique for purification and injection of autogenous free fat parcels in correcting of facial contour deformities. Ann Plast Surg. 2007 Jun;58(6):602-7. doi: 10.1097/01.sap.0000248110.59452.49.

    PubMed 17522480
  • Kaufman MR, Bradley JP, Dickinson B, Heller JB, Wasson K, O'Hara C, Huang C, Gabbay J, Ghadjar K, Miller TA. Autologous fat transfer national consensus survey: trends in techniques for harvest, preparation, and application, and perception of short- and long-term results. Plast Reconstr Surg. 2007 Jan;119(1):323-331. doi: 10.1097/01.prs.0000244903.51440.8c.

    PubMed 17255689
  • Sardesai MG, Moore CC. Quantitative and qualitative dermal change with microfat grafting of facial scars. Otolaryngol Head Neck Surg. 2007 Dec;137(6):868-72. doi: 10.1016/j.otohns.2007.08.008.

    PubMed 18036412
  • Coleman SR. Structural fat grafting: more than a permanent filler. Plast Reconstr Surg. 2006 Sep;118(3 Suppl):108S-120S. doi: 10.1097/01.prs.0000234610.81672.e7.

    PubMed 16936550
  • Domergue S, Psomas C, Yachouh J, Lesnik A, Reynes J, Goudot P, Jammet P. Fat microinfiltration autografting for facial restructuring in HIV patients. J Craniomaxillofac Surg. 2006 Dec;34(8):484-8. doi: 10.1016/j.jcms.2006.07.857. Epub 2006 Dec 8.

    PubMed 17157518
  • Narins RS, Tope WD, Pope K, Ross EV. Overtreatment effects associated with a radiofrequency tissue-tightening device: rare, preventable, and correctable with subcision and autologous fat transfer. Dermatol Surg. 2006 Jan;32(1):115-24. doi: 10.1111/1524-4725.2006.32019. No abstract available.

    PubMed 16393612
  • Pontius AT, Williams EF 3rd. The evolution of midface rejuvenation: combining the midface-lift and fat transfer. Arch Facial Plast Surg. 2006 Sep-Oct;8(5):300-5. doi: 10.1001/archfaci.8.5.300.

    PubMed 16982984
  • Burnouf M, Buffet M, Schwarzinger M, Roman P, Bui P, Prevot M, Deleuze J, Morini JP, Franck N, Gorin I, Dupin N. Evaluation of Coleman lipostructure for treatment of facial lipoatrophy in patients with human immunodeficiency virus and parameters associated with the efficiency of this technique. Arch Dermatol. 2005 Oct;141(10):1220-4. doi: 10.1001/archderm.141.10.1220.

    PubMed 16230558
  • Ellenbogen R, Motykie G, Youn A, Svehlak S, Yamini D. Facial reshaping using less invasive methods. Aesthet Surg J. 2005 Mar-Apr;25(2):144-52. doi: 10.1016/j.asj.2005.02.001.

    PubMed 19338805
  • Guaraldi G, Orlando G, De Fazio D, De Lorenzi I, Rottino A, De Santis G, Pedone A, Spaggiari A, Baccarani A, Borghi V, Esposito R. Comparison of three different interventions for the correction of HIV-associated facial lipoatrophy: a prospective study. Antivir Ther. 2005;10(6):753-9.

    PubMed 16218175
  • Kanchwala SK, Holloway L, Bucky LP. Reliable soft tissue augmentation: a clinical comparison of injectable soft-tissue fillers for facial-volume augmentation. Ann Plast Surg. 2005 Jul;55(1):30-5; discussion 35. doi: 10.1097/01.sap.0000168292.69753.73.

    PubMed 15985788
  • Kuran I, Tumerdem B. A new simple method used to prepare fat for injection. Aesthetic Plast Surg. 2005 Jan-Feb;29(1):18-22; discussion 23. doi: 10.1007/s00266-004-0059-8. Epub 2005 Mar 10.

    PubMed 15759091
  • Ellenbogen R, Youn A, Yamini D, Svehlak S. The volumetric face lift. Aesthet Surg J. 2004 Nov-Dec;24(6):514-22. doi: 10.1016/j.asj.2004.08.006.

    PubMed 19336203

Questions about this trial

What is this clinical trial studying?

A study testing Repeat Fat grafting in people with Facial Injuries and Adipose Tissue, run by University of Pittsburgh at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Jul 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 12 May 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Facial Volume Score (time frame: assessed at baseline (pre-op), days 7-21 post-op, 3 months post-op, and 9 months post-op). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01822301, which also lists 48 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Jul 2017.

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