- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03880188
Long Term Status of Free Dermal Fat Autografts for Complex Craniofacial Wounds (FTFDT2)
June 14, 2022 updated by: Dufresne, Craig, MD, PC
Fat to the Future, Dermal Time 2: Long Term Clinical and Histological Status of Free Dermal Fat Autograft Recipient Sites: Cross-Sectional Assessment in a Retrospective Cohort Treated for Complex Craniofacial Wounds
This study will evaluate the use of free autologous dermal fat grafting (also called free dermal fat autografting) to treat complex craniofacial wounds that have failed standard treatment and to understand how well these grafts work to repair wounds long term.
Patients who have undergone free autologous dermal fat grafting to treat complex craniofacial wounds 2-30 years ago will have photographs and small biopsies taken of the area that was grafted.
Study Overview
Status
Enrolling by invitation
Conditions
- Wounds and Injuries
- Soft Tissue Injuries
- Surgical Wound
- Surgical Wound Infection
- Wound Infection
- Wounds, Nonpenetrating
- Skull Fractures
- Wound Healing
- Wounds
- Wounds, Penetrating
- Wound Complication
- Wound of Skin
- Wound Open
- Wound Dehiscence
- Facial Bones Fracture
- Disturbance of Wound Healing
- Wound; Head, Multiple
- Wound; Head, Scalp
- Wound; Head
Detailed Description
Complex craniofacial wounds (CCW) are those considered to be refractory to initial reconstructive and antibiotic treatment and may involve chronic infection, exposed hardware, irradiated local tissue, and soft tissue volume loss.
They are a functional, aesthetic, quality-of-life, and economic burden and have many aetiologies and impact patients of all ages from diverse socio-economic and geographical backgrounds.
The present study will evaluate if free dermal fat autografts (DFA) can serve as a less involved, more dynamic approach than the standard of microvascular flaps to facilitate healing and reconstruction for CCW.
A previous 33-year retrospective study of free DFA for CCW indicated recipient graft sites healed and remained volume-stable in most patients.
To evaluate the long-term viability of this modality, clinical and histological assessments of free DFA recipient and undisturbed tissue at donor sites will be carried out in patients from the original cohort.
In the present study, it will be first determined if free DFA continues to provide stable long-term outcomes for prevention of infection and hardware exposure and stable volume and contour results.
Then, it will be determined if free DFA recipient sites retain normal, expected histology and immune cells (dermal lymphocytes, macrophages, and mast cells).
Finally, it will be evaluated if the long-term free DFA recipient site tissues are significantly different from undisturbed tissue at donor sites with respect to the presence of adipose tissue and populations of immune cells.
The present study will be the first to (1) evaluate the long-term fate of free DFA recipient sites in this complex craniofacial wounds, (2) determine the presence of immune cells within free DFA recipient sites, and (3) compare the long-term differences of free DFA recipient and undisturbed tissue at donor sites.
Outcomes from this project will serve as the basis of understanding of free DFA survival and function in treating CCW and provide an investigative framework for more rigorous follow-up studies to define indications and refine techniques for free DFA use in this context and more generally.
Study Type
Observational
Enrollment (Anticipated)
20
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Virginia
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Fairfax, Virginia, United States, 22031
- Office of Craig R Dufresne, MD, PC
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Sampling Method
Non-Probability Sample
Study Population
Potential patients are drawn from a retrospective cohort of consecutive patients who underwent free autologous dermal fat grafting for one or more complex craniofacial wounds between 1985 and 2018, carried out by a single sub-speciality trained plastic surgeon (Study Principal Investigator).
Description
Inclusion Criteria:
- Underwent free autologous dermal fat grafting carried out by the Study Principal Investigator for one or more complex craniofacial wounds
- Speaks, reads, and understands English
- Willing to freely give consent
- Is able or has a legal representative to give consent
Exclusion Criteria:
- Did not have free autologous dermal fat grafting
- Did not undergo free autologous dermal fat grafting carried out by the Study Principal Investigator
- Underwent free autologous dermal fat grafting carried out by the Study Principal Investigator for an indication other than for one or more complex craniofacial wounds
- Lacks sufficient chart data for study requirements
- Patients for whom it cannot be determined when they underwent free vs injected autologous dermal fat grafting
- Does not speak, read, or understand English
- Unwilling to freely give consent
- Is unable or does not have a legal representative to give consent
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Wound healing and defect amelioration.
Time Frame: Outcomes are evaluated at one clinical encounter, lasting approximately 1 hour.
|
Wound healing and defect amelioration will be clinically evaluated.
Evaluation will be based on the absence of drainage, erythema, and oedema; reduction of pain; the presence of intact tissues and stable volume and contour in the area where the graft was placed.
|
Outcomes are evaluated at one clinical encounter, lasting approximately 1 hour.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Histology and the presence of stem and immune cells in the free autologous dermal fat graft recipient site.
Time Frame: Outcomes are evaluated at one clinical encounter, lasting approximately 1 hour.
|
Histology and the presence of stem and immune cells in the free autologous dermal fat graft recipient site will be qualitatively and quantitatively evaluated, according to standard laboratory procedures of the receiving institution, using the biopsies taken during the consultation and minor procedure visit.
|
Outcomes are evaluated at one clinical encounter, lasting approximately 1 hour.
|
Histology and the presence of stem and immune cells in the native local tissue.
Time Frame: Outcomes are evaluated at one clinical encounter, lasting approximately 1 hour.
|
Histology and the presence of stem and immune cells in the native local tissue will be qualitatively and quantitatively evaluated, according to standard laboratory procedures of the receiving institution, using the biopsies taken during the consultation and minor procedure visit.
|
Outcomes are evaluated at one clinical encounter, lasting approximately 1 hour.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Craig R Dufresne, MD, Dr Craig R Dufresne, MD, PC
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Dufresne CR, Poling MI. Free Dermal Fat Autografting for Complex Craniofacial Wounds. J Craniofac Surg. 2020 Sep;31(6):1563-1567. doi: 10.1097/SCS.0000000000006398.
- Dufresne CR, Poling MI. Free Dermal Fat Autografts for Complex Craniofacial Wounds: A 3-decade, Retrospective Cohort Study. PRS Global Open. 2019 August; 7(8S-1):101. doi: 10.1097/01.GOX.0000584800.01063.18.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Anticipated)
September 10, 2022
Primary Completion (Anticipated)
June 30, 2024
Study Completion (Anticipated)
June 30, 2024
Study Registration Dates
First Submitted
March 15, 2019
First Submitted That Met QC Criteria
March 15, 2019
First Posted (Actual)
March 19, 2019
Study Record Updates
Last Update Posted (Actual)
June 16, 2022
Last Update Submitted That Met QC Criteria
June 14, 2022
Last Verified
June 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pathologic Processes
- Nervous System Diseases
- Postoperative Complications
- Disease Attributes
- Craniocerebral Trauma
- Trauma, Nervous System
- Infections
- Communicable Diseases
- Wounds and Injuries
- Soft Tissue Injuries
- Fractures, Bone
- Surgical Wound
- Surgical Wound Infection
- Wound Infection
- Wounds, Penetrating
- Wounds, Nonpenetrating
- Skull Fractures
Other Study ID Numbers
- U1111-1219-3733
- 000083 (Other Identifier: FSRG #1 IRB)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
IPD Plan Description
No individual participant data (IPD) or biospecimens will be shared.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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