The Plastic Surgery Foundation
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Grants We Funded

Grant applicants for the 2022 cycle requested a total of over $2.9 million dollars. The PSF Study Section subcommittees of Basic & Translational Research and Clinical Research evaluated 115 grant applications on the following topics:

The PSF awarded research grants totaling almost $550,000 to support 19 plastic surgery research proposals.

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.

Improved Diagnostic Accuracy of Periprosthetic Breast Infection: Alpha-Defensin 1

Principal Investigator
Marten Basta MD

Year
2019

Institution
Rhode Island Hospital

Funding Mechanism
AAPS/PSF Research Grant

Focus Area
Breast (Cosmetic / Reconstructive), General Reconstructive

Abstract
Breast implant-related infection is among the most feared complications after breast reconstruction. Patients often require multiple reoperations, possible implant loss, and associated diminished quality of life. The ability to promptly recognize and accurately diagnose breast periprosthetic infection is critical to reducing the risk of implant loss and possibly avoiding operative intervention. However, the standard for diagnosis, bacterial culture, may be falsely negative in as high as 25-30% of patients with clinical evidence of implant infection. Also, cultures take several days prior to being finalized, and delay in treatment or unnecessary antibiotic administration to patients with negative cultures are potentially avoidable with rapid diagnosis. Alpha defensin 1 (AD-1), an antimicrobial peptide released from neutrophils in response to local pathogen invasion, is an indicator of periprosthetic infections. Cheap and available within 24 hours of sampling, it has outperformed bacterial culture for periprosthetic joint infection, leading to a paradigm shift in the work up of orthopedic joint infections. We are investigating AD-1 in diagnosis of breast periprosthetic infection which has yet to be evaluated. We partnered with Synavosure and CD diagnostics, who provided AD-1 analysis, in a pilot study to determine if AD-1 is appropriate for study in this setting. With 10 subjects included, our results demonstrated higher sensitivity with AD-1 (100%) vs. culture (86%), although a larger sample size is needed for adequate evaluation. We propose a prospective cohort study including patients with breast implant-based reconstruction who demonstrate clinical evidence of periprosthetic infection refractory to conservative management and require operative intervention. Intraoperative or office-based (AlloX2 expander) samples of pocket fluid will be analyzed for culture and AD-1 assay and results compared. A control cohort includes patients undergoing routine exchange of expanders or implant revision surgery without clinical evidence of infection. Our aim is to compare diagnostic performance of AD-1 versus culture by analyzing sensitivity and specificity. We anticipate AD-1 will have significantly higher sensitivity than culture and comparable specificity. This would be the first investigation of AD-1 activity in breast periprosthetic infections and may offer an opportunity to improve outcomes in a cost-effective manner after implant-based reconstruction.

Biography
I am in residency training for plastic and reconstructive surgery at Brown University and Rhode Island Hospital. I have had wide exposure to a spectrum of clinical research throughout my education and training which provides me a unique advantage in conducting the proposed prospective cohort study investigating the diagnostic utility of AD-1 for periprosthetic breast infections. I have designed and executed many studies that effectively answer my research questions and provide ample evidence of my commitment based upon the quality and quantity of my peer-reviewed publications and presentations I have given before both national and international audiences. Furthermore, I have developed and honed a broad set of analytic techniques across multiple areas of clinical research, including observational and outcomes research, risk modeling and predictive risk stratification, cost-efficacy analyses, and meta-analyses. Regarding executing a study such as the one proposed, I have managed a multicenter prospective observational registry of cleft palate perioperative outcomes currently defining the benchmarks and perioperative guidelines making palatoplasty safer. I have maintained a number of IRB protocols and am highly familiar with the logistics of being a research coordinator. As such, I feel qualified for this study and the PSF grant proposed here and am truly passionate about finding ways to improve upon current practices to optimize our patient outcomes.