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Investigation of an Implantable Dexamethasone Drug Delivery System comprised of a Silk Cather and Osmotic Pump for Fat Graft Volume Retention
B Schilling1, BS; A Kelmendi-Doko1, MD, PhD; JJ Yoo2, PhD; SJ Lee2, PhD; L Tozzi2, PhD; D Kaplan2, PhD; KG Marra1, PhD; JP Rubin1, MD
University of Pittsburgh
2017-02-13
Presenter: Benjamin Schilling
Affidavit:
The work as submitted has not been published as presented.
Director Name: B. Schilling, for J. Peter Rubin
Author Category: Other Specialty Resident
Presentation Category: Basic Science Research
Abstract Category: Craniomaxillofacial
After traumatic soft tissue injury, fat grafting can be implemented as a powerful technique for accurate aesthetic restorations. These restoration techniques often use autologous fat grafting, which is clinically favorable due to ease of access, and that autografting does not risk rejection or foreign body response. Despite its successes, fat grafting has been shown to be notoriously variable in terms of volume retention based not only on practitioner, but on technique as well. Tangentially, considerable promising work in elution-based technologies for drug delivery have been published. Some of the most clinically promising of these technologies, like eluting microspheres, however, remain challenging with respect to predictable fabrication, uniform degradation kinetics, and are of questionable regulatory status due to their relative permanence once implanted. Therefore, local, controllable, and explantable drug delivery technologies remain elusive, particularly if interested in coupling with fat grafting.
Dexamethasone is a soluble, potently adipogenic steroid with a high level of FDA recognition. It has previously been shown that elution of dexamethasone into grafted fat pads increase their volumetric longevity. In an effort to marry technologies, a system capable of controlled osmotic elution of aqueous dexamethasone was developed, where grafted fat was supplemented with dexamethasone via a biodegradable silk catheter. Using this system, it has been shown that the osmotic drug delivery system is capable of promoting approximately 20% more retained volume than fat grafting alone in the athymic mouse model. Importantly, the retention promoted from the dexamethasone-eluted condition resulted in an end-volume closest to the baseline injection.
