Transfer of infection via fat grafting: culprit bacteria and responses of lipoaspirate to infection and antibiotic treatment

This is an opportunity for an exciting interdisciplinary project with potentially important clinical outcomes. The student recruited to this project will be carry out work in both the School of Clinical Dentistry and the Department of Materials Science and Engineering at the University of Sheffield.

Fat grafting is widely used in plastic surgery for reconstructive, regenerative and cosmetic surgery and the number of procedures performed annually is increasing. Current guidelines recommend antibiotic prophylaxis for any fat grafting procedure. These guidelines are based on studies from general reconstructive surgery and do not take into account the unique, lipid rich adipose environment. There is a lack of data regarding the microbiological susceptibility of lipoaspirate to different bacterial species, which makes the effective prevention and treatment of infections following fat grafting difficult. Around 1% of fat grafting procedures result in infection and when infection does occur, it often requires a combination of surgical debridement and anti-microbial therapy. Scientific evidence of the interactions between bacteria and lipoaspirate is urgently needed to inform antimicrobial guidelines; thereby improving patient care and reducing morbidity from these devastating infections. This study will investigate the ability of different bacterial species to survive and grow in lipoaspirate and the intracellular survival will be investigated to understand the potential of adipose tissue to act as a reservoir for micro-organisms. The behaviour of lipoaspirate exposed to bacteria and antibiotics will be investigated to understand the effect on fat graft survival and outcomes. Finally, antibiotic efficacy in infected lipoaspirate will be measured to determine which antibiotics will be the most effective in the case of fat graft infections.

In summary, this project aims to determine (i) which microbial species survive in lipoaspirate and whether they survive intracellularly, (ii) the effect of bacterial infection on adipose tissue health and fat graft survival and (iii) the effectiveness of antibiotics for the treatment of adipose infections.

Results from this study will provide the evidence needed to enable informed antibiotic regimes to be given prior to fat grafting and will allow targeted microbial detection and treatment in cases where infections occur.