May 19, 2012

Message from the President

Dear Fellow ASPS Member,

It is an honor to write an introduction for this second edition of the PSF e-newsletter foundation. The Foundation is continuing on its course of changes that have, and will continue to, greatly enhance both the quality and quantity of clinically relevant research in our specialty. In September's issue, Dr. Neligan spoke to you about the changes that began with the ASPS/PSF governance task force which resulted in a restructuring of the PSF to focus primarily on a research mission.

Now in its third year, this new governance structure has resulted in a large increase in direct research support and a rigorous grant application review process to increase the quality of PSF supported research. An important, deliberate change in philosophy has also occurred. While it is unquestioned that any research that uncovers new knowledge is valuable, it is also true that the members of ASPS/PSF are practicing surgeons who need and want research that will directly allow them to better care for their patients, now. For this reason, the PSF has focused its effort on basic and translational research that has a high potential to impact clinical practice in the short term and on clinical research that has direct impact on patient care now.

The process works like this. The Research Oversight Committee (ROC) is composed of representatives from all the component, subspecialty organizations in plastic surgery including ASAPS, ASRM, and AAHS, to name a few. This group meets each year in conjunction with the ASPS/PSF Winter Board Meeting with the task of establishing the "short list" of research priorities for our specialty in that year. Again, the emphasis is on clinically relevant topics.

Simultaneously, the grant applications received each December are reviewed in a rigorous process modeled directly after the NIH's study section mechanism. Each application is assigned a score based on scientific merit. The Research Coordinating Council (RCC) meets shortly thereafter and considers both the short list of priorities generated by the ROC and the scientific merit scores from the study sections when awarding research funding. This mechanism is designed to direct PSF funded research towards the highest-impact clinical areas and to make that research scientifically superior. This process has worked well to focus the PSF's research effort on the topics most important to us all. 

This year, we will enhance, expand, and refine this mechanism. We need better communication and input from all constituencies of our specialty; we need more scientific reviewers; we need more research applications focused on clinically relevant topics; we need more research trainees; in short, we need more relevant and high-quality research. To make that happen, of course, we need more money. Our challenge will be to convince all of you to help us by supporting this vital work. We promise to work as hard as we can to continue to meet that challenge.

Sincerely,

William M. Kuzon, Jr., MD, PhD
PSF President

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PSF National Endowment Grant Award Winner - Wound healing research aims to eliminate significant health burden

The Researcher: J. Peter Rubin, MD
Title: Associate Professor of Surgery and Co-Director of the Adipose Stem Cell Center - University of Pittsburgh
Project: "Adipose-Derived Stem Cells to Enhance Wound Healing"

What is the intent of your project?

Dr. Rubin: Non-healing wounds are a significant health burden. Our group is investigating strategies to improve wound healing through the use of adipose-derived stem cells (ASCs). We are approaching this question from two directions. First, we are asking: How does the wound environment impact the function of ASCs? We know from previous studies that ASCs can vigorously produce growth factors such as VEGF (vascular endothelial growth factor) and FGF (fibroblast growth factor) with an up-regulation of this function during times of stress. The first aim of the grant involves using wound exudate from human subjects to stimulate human ASCs, and then characterize cell proliferation, differentiation, migration and growth factor secretion. We hope to better understand how ASCs would be signaled to participate in the wound-healing process.

Our second approach is to examine the effect of ASCs on wounds in both small and large animals (rodents and pigs). We will use information gained from our first aim to stimulate the cells prior to applying them to the wound model. We will examine specific wound-healing factors including time to closure, rate of re-epithelialization and granulation tissue formation.

At what stage are you in this project?

Dr. Rubin: We are progressing well with this study, and are performing the validation experiments in an animal model. This funding has provided the opportunity to meticulously refine the in-vitro model, collect reproducible data, and move to an in-vivo model.

In practical terms, what do you hope will come of this research

Dr. Rubin: We hope to show that ASCs may have a practical role in helping to heal difficult wounds. ASCs are easy to harvest and extract from liposuctioned fat, and they can be used from the same patient. This autologous use improves safety in a cell-based therapy compared with allogeneic therapies. Mesenchymal stem cells have tremendous potential to promote wound healing, given their ability to differentiate into multiple cell types and to express various growth and angiogenic factors.

Who are you working with on this project?

Dr. Rubin: I am fortunate to have very talented people working with me on this study. Joseph Michaels, MD, the co-principal investigator, is a body-contouring fellow and surgery instructor at the University of Pittsburgh; as a graduate of the plastic surgery residency program and a surgical basic science fellow at New York University, he brings to the project a strong background in wound-healing research and a focused clinical perspective. Kacey Marra, PhD, is the University of Pittsburgh's Plastic Surgery Research Laboratory director and Adipose Stem Cell Center co-director. She has extensive experience with experiments designed to elucidate the biology of mesenchymal stem cells. Dr. Marra and I founded the Adipose Stem Cell Center to serve as a center of expertise and resources for the Pittsburgh research community.

Once you've met these current grant goals, what is the next step for your overall research model?

Dr. Rubin: If our results are favorable, our next step will be to pursue additional experiments that would be necessary for a clinical trial. That would include refining the cell isolation and delivery methods to conform with FDA guidelines. These additional steps build upon the studies designed to prove that the therapy has promise to improve wound healing.

How has the PSF grant affected your ability to obtain funding from other sources?

Dr. Rubin: The PSF funding mechanism is very important to our work - it allows us to generate data that can support applications for major federal grants. There are very few sources of seed money that allow researchers to perform the initial experiments to test scientific concepts specific to plastic surgery.

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PSF Grants and Giving

PSF focuses on investigator-initiated research and international scholars

Your contributions are helping the PSF stimulate and support new innovation and research ideas and foster academic career development through research project grants, research training grants and our new career development grants.
In our mission to support research and international education activities of plastic surgeons, we are devoted to supporting the development of the field by funding clinically relevant scientific research in plastic surgery and international scholarship.

The International Scholar Program enables plastic surgeons from abroad to come to the United States for three to six months to study at host plastic surgery institutions. Since 1990, the International Scholar Program has funded 72 scholars from 35 countries. These funds are awarded to plastic surgeons who have completed their plastic surgery training and are in the developmental stage of their studies.

2009 PSF International Scholars:

  • Dr. Surinder Singh Makkar of India
  • Dr. Aik-Ming Leow of Malaysia
  • Dr. Bahir Sabah Allawi of Iraq
  • Dr. Peter Babatunde Olaitan of Nigeria
  • Dr. Raj Kumar Mishra of India

Through our three main research funding programs, the PSF is currently funding projects to provide the answers to clinically relevant questions that will have a tangible impact on your practice. We are working to develop a vibrant, specialty-wide research program, and your contributions are helping us move forward with this goal! 

Last year, the Plastic Surgery Foundation (PSF) awarded funding to 32 investigator-initiated research projects and allocated nearly $800,000 to support investigators in their pursuit of the most cutting-edge, clinically relevant research in plastic surgery. Supporting investigator-initiated research is of utmost importance to the PSF. The Foundation provides research opportunities for investigators from their residencies on up to well established plastic surgeons.

Since 1988 your support has enabled PSF to:

  • Fund 764 grants
  • Award nearly $8 million to directly support plastic surgery research (one-half of that in the last 8 years)
  • Fund 514 distinct investigators (82 institutions)
  • 15% of past Research Fellowship recipients have received subsequent NIH funding

A sample of our most recent clinically relevant research projects are highlighted below:

Project: Post-bariatric Outcomes Subject Tracking (POST) Study

  • Investigator: J. Peter Rubin, MD
  • Institution: University of Pittsburgh
  • Aim: To organize leaders in the field of post-bariatric reconstruction into a consortium designed to track surgical outcomes while providing a flexible framework for collaboration between multiple sites that can be extended to other topics of research.

Project: Venous Thromboembolism Prevention (VTEP) Study

  • Investigator: Edwin Wilkins, MD
  • Institution: University of Michigan
  • Aim: To evaluate the effectiveness of a perioperative clinical protocol in preventing postoperative venous thromboembolism (VTE) in plastic surgery patients considered to be at moderate to high risk.

Research is the engine that drives our future and the PSF exists to invest in the advancement of plastic surgeons, our specialty and quality patient care. Your contributions help us to be the leader in fostering innovation in plastic surgery research and deliver on our promise to pursue the most cutting-edge clinically relevant research in the field.

For more information on how you may impact plastic surgery research or if you would like to make a contribution, please visit our Foundation page.

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PSF Clinical Trials Network in Action

The PSF, in its ongoing efforts to advance the practice of plastic surgery, is continuing to strengthen the Clinical Trials Network. The Network is designed to be a leading facilitator of evidence-based medicine and plastic surgery health services research with a focus on improving quality of care and patient safety. Its charge is to build multicenter networks of leading clinicians to identify and research clinical priority areas in plastic surgery.

The Network is currently conducting a study focused on examining DVT/PE prevention strategies -- the VTEP Study. Additionally, the Network is supporting and facilitating the development of two other multi-center projects, the FACE-Q and POST study. The aim of the FACE-Q project is to develop a validated measurement tool to evaluate procedural outcomes, patient satisfaction and quality of life following facial procedures. The POST study is a registry for the purpose of evaluating outcomes following post-bariatric body contouring surgery. By supporting these studies and others like them, the PSF is ensuring that important clinical information is available to help advance plastic surgery practice.

The Clinical Trials Network Committee, which is responsible for identifying important clinical research issues in aesthetic and reconstructive plastic surgery, met during Plastic Surgery 2009 to discuss opportunities for future multicenter clinical trials. The committee is charged with forming and managing multicenter research networks of leading academic and private practice centers. They discussed a number of opportunities including partnering with private practice on aesthetic research studies and how to best leverage the Committee's support for investigator sites in multicenter clinical trials, to name a few.

The 2010 PSF Clinical Trials Network Committee:

  • Edwin Wilkins, MD, Chair
  • Andrea Pusic, MD, Co-Chair
  • Amy Alderman, MD
  • Kaveh Alizadeh, MD
  • Ronald Hoxworth, MD
  • Susan Kaweski, MD
  • Loree Kalliainen, MD
  • Clara Lee, MD
  • Terence Myckatyn, MD
  • Foad Nahai, MD
  • J. Peter Rubin, MD
  • Marissa Tenenbaum, MD
  • V. Leroy Young, MD

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PSF has Great Presence at PS2009

Plastic Surgery 2009 offered many opportunities to explore research and innovation in plastic surgery through a variety of PSEF panels and programs that spanned the entire week long event. From exploring innovation in plastic surgery research to physician relationships with industry, PSF has a lot to offer!

2009 PSF Research Awards

PSF honored two individuals at PS2009 for their outstanding achievement in clinical and basic & translational research. These awards recognize investigators whose novel and significant work has had or may have a far-reaching impact on the treatment of surgical disorders and the practice of plastic surgery.

The 2009 PSF Award for Outstanding Achievement in Clinical Research was awarded to:

  • Joseph G. McCarthy, MD
    Institute of Reconstructive Plastic Surgery, NYU Medical Center

The 2009 PSF Award for Outstanding Achievement in Basic & Translational Research was awarded to:

  • Cho Y. Pang, PhD
    Hospital for Sick Children Research Institute, Toronto, Canada

Innovation panel

During this interactive panel, the current research environment and the PSF's role and focus in growing the research and innovation engine were explored. Leadership demonstrated how clinically relevant and translational projects will benefit the practice of plastic surgery and patient outcomes through highlighting PSF-supported research and showcasing the potential that these projects have to change clinical practice.

The PSF Research Coordinating Council selected five projects for presentation during the Innovation Panel for their application to the specialty's clinical immediacy. Presented during the PSF Innovation Panel, the projects and their principal investigators were:

  • Amy Alderman, MD, "Breast Reconstruction Decision-Making & Outcomes in Latinas & African-Americans"
  • Rica Tanaka, MD, "Adoptive Endothelial Progenitor Cell Therapy to Restore Vasculogenic Potential in Diabetes"
  • Geoffrey Gurtner, MD, "Composite Tissue Engineering and Organ Regeneration Using Explanted Microvascular Beds (EMBs)"
  • Oren Tepper, MD, "3D Imaging for Planning and Analysis in Aesthetic Breast Surgery"
  • Stefan Schneeberger, MD, presented by Co-Author W.P. Andrew Lee, MD, "Migratory Inhibitors for Local Immunosuppression in CTA"

PSF Research Breakfast

This has been a tremendous year for the PSF. The PSF Research Breakfast was held to celebrate the achievements and shared commitment to fostering research in plastic surgery and to recognize the 2009 PSF research grant recipients and generous supporters of plastic surgery research. More than 100 people attended this event to honor the 2009 grant recipients.

PSF Industry Panel: Professionalism and Ethics in Working with Industry

Physician collaboration with industry helps facilitate new technology development and techniques that often result in improvements to patient care. The plastic surgeon/industry relationship is important to ensure that medical advancement continues.

This timely and important panel, moderated by Kevin Chung, MD, included panelists from various industry partners as well as AdvaMed, who came together to discuss the role that professionalism and ethics play in the physician/industry relationship.

Panelists for this program were:

  • Susan Clarke, Director, Healthcare Compliance, Mentor Corporation
  • Kien Nguyen, PhD, VP, Global Research and Ideation, KCI
  • Mitchell Wortzman, PhD, Executive Vice President, Chief Scientific Officer, Medicis
  • Bhushan Hardas, MD, MBA, Vice President of US Research & Development, Merz
  • Christopher K. White, Esq., Executive Vice President, General Counsel, Secretary, Advanced Medical Technology Association (AdvaMed)

The panel focused on answering the questions that are on many of our minds such as:

  • What are the most important principles for developing a professional and ethical physician/industry relationship?
  • In the current environment, how will the amount of industry funding for research be affected?
  • How has your company's approach to funding physician research changed, based on the emergence of the new AdvaMed Codes and government regulations?
  • How should or can industry support the education and research missions of the PSF?

Hot Topics in Plastic Surgery

Always a meeting favorite, Hot Topics in Plastic Surgery focused on delivering emerging clinical and technical trends in plastic surgery to what is always a sold out crowd. With standing room only, PS2009 moderators drilled down on presentations on topics including:

  • Truth or Consequences of Fillers
  • Breast Implants
  • Fat Addition and Subtraction
  • Plastic Surgery Enhancements

ASPS/PSF, in collaboration with the Aesthetic Surgery Education and Research Foundation, offers this program on emerging clinical and technical trends in plastic surgery as they relate to practice and to the medical and public communities.

The objective of the Hot Topics symposia is to help attendees:

  • Assess the role of new and innovative technology and techniques in plastic surgery
  • Develop responses to public and media inquiries to new and innovative clinical trends and technology
  • Separate hype from reality in new technology

PSF International Reception

Hosted by PSF Immediate Past President and local host Peter Neligan, MD, this annual event was rich in international participation. This year's East Meets West theme brought together plastic surgeons from all over the world to connect.
Guests from 36 countries were able to network with international colleagues and peers from around the world.

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Did you enjoy this issue of foundation? We would like to hear about it! Please direct your comments and inquiries to us at research@plasticsurgery.org. 

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