Grants Funded
ASPS/PSF leadership is committed to continuing to provide high levels of investigator-initiated research support to ensure that plastic surgeons have the needed research resources to be pioneers and innovators in advancing the practice of medicine.
Research Abstracts
Search The PSF database to have easy access to full-text grant abstracts from past PSF-funded research projects 2003 to present. All abstracts are the work of the Principal Investigators and were retrieved from their PSF grant applications. Several different filters may be applied to locate abstracts specific to a particular focus area or PSF funding mechanism.
Assessment of Topical Minoxidil on Skin Flap Viability in Breast Reconstruction
Principal Investigator
Brett Phillips MD, MBA
Brett Phillips MD, MBA
Year
2025
2025
Institution
Duke University School of Medicine
Duke University School of Medicine
Funding Mechanism
PSF Pilot Research Grant
PSF Pilot Research Grant
Focus Area
Tissue Engineering, General Reconstructive
Tissue Engineering, General Reconstructive
Abstract
Project Summary
This pilot study aims to evaluate the feasibility of topical minoxidil as a pharmacologic delay agent in enhancing flap perfusion and viability in breast reconstruction. Mastectomy skin flap necrosis is a surgical complication affecting up to 40% of breast
reconstruction surgeries and occurs when there is insufficient blood perfusion to the mastectomy skin flap. This complication can lead to tissue necrosis, wound dehiscence, infection, reconstructive failure, requiring additional surgeries and prolonged recovery. We seek to enhance flap perfusion by utilizing a topical pharmacologic agent to replicate the "delay phenomenon" observed in existing invasive methods, such as surgical or vascular delay techniques, to re-rout blood flow and dilate choke vessels. Our study involves applying 5% minoxidil to the breast as a "pharmacologic delay" for two weeks preoperatively, leveraging its properties as a
vasodilator that stimulates angiogenesis.
This pilot study, designed as a triple blinded Randomized controlled trial, will involve 25 patients undergoing bilateral risk-reducing mastectomy with immediate tissue expander-based reconstruction. Participants will serve as their own internal control and will undergo randomization to determine which breast will receive the experimental intervention (minoxidil) and the internal control (placebo). Using clinical assessment and the SPY-QP fluorescence assessment technology, flap perfusion will be qualitatively and quantitatively analyzed during surgery. The primary objective is to assess the feasibility of topical minoxidil as a pharmacologic delay agent based on participant recruitment, retention, adherence, acceptability, and effective outcome measurements.
If successful, this cutting-edge research could lay the groundwork for future investigations into a cost-effective and non-invasive method of improving tissue flap viability with potential applications across various reconstructive procedures.
Impact Statement
This research has the potential to significantly improve breast reconstruction outcomes by reducing the incidence of mastectomy skin flap necrosis. Previous studies indicate that minoxidil promotes angiogenesis, offering a promising method to improve flap perfusion without additional patient risk and cost burden. Demonstrating the feasibility of topical minoxidil as a pharmacologic delay technique is crucial prior to assessing its efficacy in a larger trial. This could revolutionize plastic surgery flap-based reconstruction care and improve overall patient outcomes.
Project Summary
This pilot study aims to evaluate the feasibility of topical minoxidil as a pharmacologic delay agent in enhancing flap perfusion and viability in breast reconstruction. Mastectomy skin flap necrosis is a surgical complication affecting up to 40% of breast
reconstruction surgeries and occurs when there is insufficient blood perfusion to the mastectomy skin flap. This complication can lead to tissue necrosis, wound dehiscence, infection, reconstructive failure, requiring additional surgeries and prolonged recovery. We seek to enhance flap perfusion by utilizing a topical pharmacologic agent to replicate the "delay phenomenon" observed in existing invasive methods, such as surgical or vascular delay techniques, to re-rout blood flow and dilate choke vessels. Our study involves applying 5% minoxidil to the breast as a "pharmacologic delay" for two weeks preoperatively, leveraging its properties as a
vasodilator that stimulates angiogenesis.
This pilot study, designed as a triple blinded Randomized controlled trial, will involve 25 patients undergoing bilateral risk-reducing mastectomy with immediate tissue expander-based reconstruction. Participants will serve as their own internal control and will undergo randomization to determine which breast will receive the experimental intervention (minoxidil) and the internal control (placebo). Using clinical assessment and the SPY-QP fluorescence assessment technology, flap perfusion will be qualitatively and quantitatively analyzed during surgery. The primary objective is to assess the feasibility of topical minoxidil as a pharmacologic delay agent based on participant recruitment, retention, adherence, acceptability, and effective outcome measurements.
If successful, this cutting-edge research could lay the groundwork for future investigations into a cost-effective and non-invasive method of improving tissue flap viability with potential applications across various reconstructive procedures.
Impact Statement
This research has the potential to significantly improve breast reconstruction outcomes by reducing the incidence of mastectomy skin flap necrosis. Previous studies indicate that minoxidil promotes angiogenesis, offering a promising method to improve flap perfusion without additional patient risk and cost burden. Demonstrating the feasibility of topical minoxidil as a pharmacologic delay technique is crucial prior to assessing its efficacy in a larger trial. This could revolutionize plastic surgery flap-based reconstruction care and improve overall patient outcomes.
Biography
Dr. Brett T. Phillips is a double board-certified plastic surgeon at Duke University Hospital who specializes in breast reconstruction with clinical interests in complex head to toe oncologic microsurgical reconstruction. He currently serves as Assistant Professor in the Department of Surgery and Program Director for Duke's Integrated Plastic and Reconstructive Surgery Residency. He completed his plastic surgery training at Duke University followed by a fellowship in microvascular reconstructive surgery at University of Texas MD Anderson Cancer Center. His commitment to improving current plastic surgery practices is evident in his active involvement in clinical outcomes and educational research. His expertise in breast reconstruction and clinical trials make him uniquely qualified to lead this project.
Dr. Brett T. Phillips is a double board-certified plastic surgeon at Duke University Hospital who specializes in breast reconstruction with clinical interests in complex head to toe oncologic microsurgical reconstruction. He currently serves as Assistant Professor in the Department of Surgery and Program Director for Duke's Integrated Plastic and Reconstructive Surgery Residency. He completed his plastic surgery training at Duke University followed by a fellowship in microvascular reconstructive surgery at University of Texas MD Anderson Cancer Center. His commitment to improving current plastic surgery practices is evident in his active involvement in clinical outcomes and educational research. His expertise in breast reconstruction and clinical trials make him uniquely qualified to lead this project.