Systemic Sclerosis
Conditions
Brief summary
This prospective single-center study evaluates a current care procedure. It includes 14 patients diagnosed with SSc according to the ACR/EULAR criteria or the Leroy & Medsger criteria of the disease. Patients are enrolled if they wish for a therapeutic care of their face, have a Mouth Handicap in Systemic Sclerosis (MHISS) score greater than 20 (scale 0-48), a modified Rodnan skin score upper or equal to 1 on the face (scale 0-3), and a mouth opening less than 55 millimeters. They should not have anticoagulant, anti-platelets aggregation medication or a daily steroid dose upper 20mg per day. Their BMI should exceed 17. Micro fat grafting is a minimally invasive and usual procedure performed under local anesthesia. Fat tissue is harvested (around 50 milliliters) using a 14 gauge or 2 mm diameter cannula from areas around the knees, the abdomen or the hips under a gentle aspiration. Lipoaspirated fat is then filtrated by the PureGraft system that offers a sterile, closed, single-use system, leading to a fast, consistent and controlled preparation. Then, 10 to 25 milliliters of this purified fat product is transferred through a 21 gauge or 0.8 mm diameter cannula in two or four points of the face, with the entry points located around the mouth.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Patients older than 18 or younger than 80 years. * Suffering from systemic scleroderma. * Patient follow-AP-HM. * Score of 20 or greater MHISS. * Score Rodnan level greater than or equal to one face. * Mouth opening (inter-incisor distance) \<5.5 cm * Wishing to receive surgery at the face.
Exclusion criteria
* Less than 18 or greater than 80 age. * Decaying history of abdominal surgery. * Body mass index lower than 18. * Coagulation disorders. * Allergy to Xylocaine. * Greater than 20mg / d steroids. * Severe infection. * Inmates. * Pregnant women. * Adults protected by law (under guardianship and trusteeship). * No affiliation to a social security scheme.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| improvement of the MHISS score | 12 months | The MHISS questionnaire is chosen as it specifically assesses disability involving the mouth and the face in SSc patients. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| evaluate the effect of the procedure on quality of life | 12 months | Health Assessment Questionnaire adapted to scleroderma, SHAQ |
| evaluate the effect of the procedure on face pain | 12 months | face pain scale (VAS 0-100) |
| evaluate the effect of the procedure on skin fibrosis | 12 months | skin fibrosis is measured by Rodnan skin score for the face, mouth opening measure and cutometry) |
| evaluate the effect of the procedure on physical face changes | 12 months | physical face changes is evaluated by standard and 3D photographs. |
Countries
France