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The clinical trial is testing the use of a novel method to grow new tissue within the breast injecting fat tissue harvested from patient's own fat deposits. A scaffold implant acts as a absorbable frame to support this growth of cells. The scaffold will be absorbed within at least 3 years. The main assumption of this clinical trial is that the method used is safe and effective for treatment of women requiring a silicone implant and /or correction of breast defect and/or deformity. The other assumption is that this method is applicable to a wider range of tissue defects, such as breast reconstruction after breast tissue removal. The new method is called '3D printed scaffold-based soft tissue regeneration', and uses a combination of own fat cells (called adipocytes) with a 3D printed scaffold to support soft tissue regeneration using the natural healing processes in their body. This substance is absorbable and is similar to the substance used for sutures and stitches that are dissolvable or absorbable in the body. The substance used for the scaffold is already Therapeutic Goods Administration (TGA) approved for bone reconstruction of the skull. The implanted scaffold degrades over time, leaving the their own tissue in its place. The combination of scaffold implantation and their own fat cells is the novel method in this trial. Conventional liposuction techniques are used from another site on the patients body to harvest their fat cells.
A 3D printed scaffold made of medical grade polycaprolactone is planned to be implanted for breast revision an/or congenital defect correction. First the patient will be thoroughly evaluated with history taking and examination to determine whether they are suitable for implantation. If deemed suitable for the trial, the surgeon together with the patient will choose the right scaffold size and fix a date for the surgery. All scaffolds are sterilized and transported in sealed packaging.
The implantation surgery will be done at a tertiary teaching hospital by an experienced breast surgeon and plastic and reconstructive surgeon. During the implantation procedure, the patient's own fat cells are harvested through simple liposuction techniques usually harvesting from the abdomen and thighs depending on availability of tissue. The fat cells that are harvested are then injected into the implanted scaffold at the time of initial implantation. The total length of procedure is estimated to take 2 hours.
Recovery from the operation can take up to one week. From that, the effectiveness, complications and side-effects will be monitored for up to two years. The patient progress will be evaluated daily after the procedure while they are in hospital with clinical assessment of the wounds and overall status. On discharge a number of surveys will be performed to document the progress at regular intervals, as well as MRI studies. The duration of follow up for the study is 2 years after implantation.
All appointments and clinical assessments will be documented in the electronic patient medical record as well as electronic Case Report Form (QH-REDCap database).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Implantation of PCL Breast scaffold | Experimental | Insertion of a 3D printed medical-grade polycaprolactone-PCL Breast scaffold with autologous fat graft for unilateral or bilateral breast implant revision and congenital defect correction surgery. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Surgical implantation of the PCL Breast scaffold with autologous fat grafting | Device | Single shot of prophylactic perioperative antibiotics is given to the patient. A suitable incision is made to provide access followed by mobilisation of the breast gland.If present, the silicone implant is removed and capsulectomy performed. The implant pocket shall be rinsed with saline or antiseptic and a surgical drain shall be placed in the pocket at the discretion of the PI. The PCL Breast scaffold shall be inserted into the pocket and fixed using 2 to 4 sutures. The incision is closed. Liposuction is performed from another area of the body and lipofilling is performed within the breast scaffold. Sterile bandaging is applied and a daily wound revision is performed whilst an inpatient. A prophylactic antibiotic shall be administered to the patient.The patients shall be hospitalized overnight for clinical observation. |
| Measure | Description | Time Frame |
|---|---|---|
| Post-operative device safety | Feasibility assessed through post-operative device safety measured through the adverse device effect rate (ADE rate). Adverse events are defined as per EN ISO 14155:2020. This will be regularly monitored during impatient and outpatient follow up. | Assessed at 12- and 24-months post-surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse Event rate and severity | Adverse events and severity are defined as per EN ISO 14155:2020. Regularly monitored during inpatient and outpatient follow up. | Assessed daily during inpatient stay at 1-week, 2-,6-,12- and 24-months post-surgery. |
| Frequency of complication |
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Inclusion Criteria:
Exclusion Criteria:
Females
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| Name | Affiliation | Role |
|---|---|---|
| Owen Ung | Comprehensive Breast Cancer Institute (CBCI), Royal Brisbane and Women's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Royal Brisbane and Women's Hospital (RBWH) | Brisbane | Queensland | QLD 4029 | Australia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40306907 | Derived | Cheng M, Chapman G, Wagels M, Ung O. Protocol for single-arm clinical trial evaluating medical grade polycaprolactone breast scaffold implantation with autologous fat grafting for breast implant revision and congenital defect correction surgery. BMJ Open. 2025 Apr 29;15(4):e088151. doi: 10.1136/bmjopen-2024-088151. |
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Composite outcome of short term and long term complications. This will be regularly monitored during inpatient and outpatient follow up. |
| Short term complications will be assessed at 1-week and 2-months follow-up visits.Long term complications will be assessed at 6-months, 12-months and 24-months follow-up visits. |
| Number of revision surgeries due to Adverse Device Effects | Adverse events are defined as per EN ISO 14155:2020. This will be regularly monitored during inpatient and outpatient follow up. | Assessed daily during inpatient stay, at 1-week, 2-,6-,12- and 24-months post-surgery. |
| Frequency of successful breast surgeries | This will be assessed as a composite outcome of:
| The frequency of successful breast surgeries will be assessed at the 24-month visit. The outcome of the surgeries will be assessed at enrolment and at 1-week, 2-, 6-, 12- and 24-month post-surgery. |
| QoL score obtained from BREAST-Q | It will be measured using the BREAST-Q questionnaire. Scales: Quality of Life:
Satisfaction:
| Assessed at enrolment and at 2-,6-,12- and 24-months post-surgery. |
| Volume replacement | This will be assessed as a composite outcome of:
| Assessed at enrolment and at 2-, 6-, 12- and 24-month post-surgery. |