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nastyleg
12-19-2009, 09:19 AM
Study aims to help reconstruct injured faces
University of Pittsburgh doctors hope old techniques can be adapted to battle injuries
By Dan Blottenberger, Stars and Stripes
Mideast edition, Saturday, December 19, 2009

BAMBERG, Germany — The University of Pittsburgh School of Medicine is looking for 20 troops with severe facial injuries to take part in a research program that might return their lives to some sort of normalcy.

The Defense Department has awarded a $1.6 million grant to the university to test advanced surgical tools that would help surgeons repair troops’ damaged faces to look like they did before they were injured.

Military medical officials estimate that 26 percent of wounded servicemembers in Iraq and Afghanistan have suffered some kind of facial injury.

Surgeons can rebuild the facial bone structure, but there is still an unmet need in the precise restoration of facial features, according to Dr. J. Peter Rubin, associate professor of plastic surgery at the University of Pittsburgh School of Medicine, who is leading the research team. The goal of the study, known as the Biomedical Translational Initiative, is to craft the facial tissue back to normal, Rubin said.

The plan is to take fat tissue from another part of the body and use it to restore the wounded facial features. Fat grafting, as it is known, has been used as a cosmetic procedure for decades. But this would be the first time doctors use the technology for reconstructive surgery to accurately restore facial form after battlefield injuries.

“While we can reconstruct bony structures very well, it is the surrounding soft tissues that give people a recognizable face. This project will investigate how soft tissue grafting can more precisely restore facial form and improve the lives of our wounded soldiers,” Rubin, a faculty member of the McGowan Institute of Regenerative Medicine at the university, said in a news release.

Full facial reconstruction is an unattainable goal, Rubin said, but “what we are trying to do is make a meaningful improvement in the lives of soldiers above and beyond what might be possible with other treatments.”

There are certain risks involved in the procedure, including bleeding and infection, Rubin said. And the risk that some patients’ expectations may not be met.

“The benefit of this surgery is worth the risk,” said Rubin, citing the experience level in the faculty involved in the study.

Faculty include Kacey Marra, director of the university’s plastic surgery laboratory; Gretchen Haas, an associate professor of psychiatry; and radiologist Barton Branstetter. In addition, Col. Robert Hale, a dentist from the U.S. Army Institute of Surgical Research, and Sydney Coleman, a New York plastic surgeon and inventor of fat grafting technology, are involved with the project.

For the study, special surgical instruments were developed to deliver grafted fat tissue into injured and scarred tissue beds. Additionally, the equipment will separate unneeded fluid from the fat before it is delivered to the injured tissues.

“One of the problems that we know can happen when moving fat from one part of the body to another,” Rubin said, “is that it can be absorbed by the body and the volume can decrease” in the grafted area.

Now all the study needs is 20 willing servicemembers to be part of the study.

“At this point, we would take all comers,” he said. “We would be happy to hear from anyone who has a disfiguring facial injury and we can make a more careful determination if they would be a good candidate for this study.”

The Defense Department is funding all of the treatment and travel expenses related to the treatment.

http://www.stripes.com/article.asp?section=104&article=66766