Zusammenfassung
Introduction. In reconstructive surgery the integration of tissue-engineered cartilage in a prefabricated free flap may make it possible to generate flaps combining a variety of tissue components to meet the special requirements of a particular defect. The aim of the present-study was to establish the technique of prefabricating, a microvascular free flap by,implanting a vessel loop under a skin ...
Zusammenfassung
Introduction. In reconstructive surgery the integration of tissue-engineered cartilage in a prefabricated free flap may make it possible to generate flaps combining a variety of tissue components to meet the special requirements of a particular defect. The aim of the present-study was to establish the technique of prefabricating, a microvascular free flap by,implanting a vessel loop under a skin flap in a rabbit model. The second aim was to gather experience with p. relaminating the flap with autologous tissue-engineered cartilage in terms of matrix development, inflammatory reaction and host-issue interaction. Methods. The microvascular flap was created by implanting a vessel loop under a random pattern abdominal skin flap. The tissue-engineered cartilage constructs were made by isolating chondrocytes from auricular biopsies. Following a period of amplification,the cells were seeded onto a nonwoven scaffold made of a hyaluronic acid derivative and cultivated for 2-3 weeks.One cell-,biomaterial construct was placed beneath the prefabricated flap, and the others were placed subcutaneously under the abdominal skin and intermuscularly at the lower extremity. In addition,a biomaterial sample without cells was placed subcutaneously as a control. All implanted specimens were left in position for 6 or 12 week. After explantation,the specimens were examined by histological and immunohistological methods. The prefabricated flap was analyzed by angiography. Results. The prefabricated flaps showed a well-developed network of blood vessels formed by neovascularization between the implanted vessel loop and the original random-pattern blood supply. The tissue-engineered constructs remained stable in size and showed signs of tissue similar to hyaline cartilage, as evidenced by the expression of cartilage-specific collagen type 11 and proteoglycans. No hints of inflammatory reactions were observed. Conclusion. These results show the potential of prefabricated flaps as custom-made flaps for reconstructive surgery in difficult circumstances, more or less independent of anatomical prerequisites. Cartilage tissue engineering provides a 3-dimensional structure with minimal donor-site morbidity.
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