Authors: Rubin J. Peter, Gurtner Geoffrey C., Liu Wei, March Keith L., Seppänen-Kaijansinkko Riitta, Yaszemski Michael J., and Yoo James J
Summary:
Innovations in tissue engineering and regenerative medicine are often realized in the operating room as surgeons restore form and function using biomaterials and grafted tissues. Examples seen every day in operating rooms around the world include the use of decellularized dermal matrix allograft or xenograft for reconstructing the abdominal wall, chest wall, or the pelvic floor. In breast reconstruction, acellular dermal matrix is commonly used along with silicone implants to provide a supportive structure to the surrounding tissues. The practice of autologous fat grafting is utilized to reconstruct tissues throughout the body using minimally invasive harvest techniques, and additives such as platelet-rich plasma have been employed. In cases of nasal reconstruction, cartilage grafts are taken from the ear and combined with a tissue flap to provide shape. For ear reconstruction, rib cartilage is harvested and carved to match the shape of the normal ear before implanting. The ready availability of biomaterials and tissue transfer techniques enable new reconstructive solutions facilitated by the creativity of the surgeons applying them. This is well evidenced by the development of techniques for “prefabricated” flaps, in which tissue grafts from other parts of the body are assembled in a heterotopic location within the boundaries of a tissue flap that will be harvested and transferred at a later date. A specific example is building structures of a nose on the forearm and allowing the tissues to heal over supportive stents before transferring the flap. In similarly advanced clinical scenarios, surgeons have used mesh trays to fashion morselized bone chips in the shape of craniofacial bones, and even employed calcium-based scaffolds along with adipose stem cells and growth factors to generate vascularized bone segments for clinical reconstruction. In essence, surgeons are applying tissue engineering concepts in real time in the operating room.
Source:
Tissue Engineering, Part A; March 2016, 22(5-6): 397-400