Protocol for a Systematic Review of Outcome Measurement Tools for Autologous fat Grafting of the Facial Region

BackgroundAutologous fat grafting has become an established therapeutic entity in several regions of the body. Especially in the facial region, AFG has been widely applied in the field of plastic and reconstructive surgery. Indications include reconstructive purposes such as primary genetic disorders in maxillofacial development, or secondary asymmetries following primary reconstructive surgery. In addition, AFG has found several applications in the field of aesthetic surgery, such as skin rejuvenation. In addition to conventional AFG, recently several alternative strategies of grafting have been developed. Examples for these are transplantation of a graft including adipose derived stem cells (ADSC’s), cell-assisted lipofilling (CAL), and grafting with stromal vascular fraction (SVF). Until today, there is no common consensus on how to measure a successful outcome of autologous graft transplantation in the facial region. This systematic review aims to critically evaluate the current available outcome measurement methods, and compare them with regards to accuracy, cost-effectiveness, safety and validation in the clinical setting. The quality of evidence of included publications will be assessed using the GRADE strategy.MethodsA comprehensive, structured literature search of published articles will be conducted. This is designed by authors and performed in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA-P). The literature search will be performed using the electronic databases MEDLINE (PubMed), EMBASE and Cochrane Library, including publications from inception to May 2020. Two independent authors will conduct the search, screen the articles, and complete data collection. The main outcome will be which methods are currently used to determine a successful fat grafting procedure in the face. We propose to review the current methods used to establish their overall performance in several domains. In addition, patients measured via the 3D volumetric photography method will be further analysed with regards to accuracy of the camera and retention of fat per method and ml injected.Discussion Autologous fat grafting in the facial region has gained significant attention in the field of plastic and reconstructive surgery in the past decades. In light of the growing public interest in this topic, a systematic review of the outcome measurement tools is of essence. We will critically evaluate all approaches currently in practice and give a recommendation regarding several aspects of use. A common approach to measurement and reporting of results fosters an environment of high-standard healthcare delivery and promotes future research and informed clinical practice. In addition, we will further analyse the outcomes of different grafting methods using 3D volumetric photography as measurement tool. PROSPERO registration number: CRD42020213407