Document Detail


Tissue-engineered breast reconstruction: bridging the gap toward large-volume tissue engineering in humans.
MedLine Citation:
PMID:  22094739     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Use of autologous tissue is ideal in breast reconstruction; however, insufficient donor tissue and surgical and donor-site morbidity all limit its use. Tissue engineering could provide replacement tissue, but only if vascularization of large tissue volumes is achievable. The authors sought to upscale their small-animal adipose tissue-engineering models to produce large volumes of tissue in a large animal (i.e., pig).
METHODS: Bilateral large-volume (78.5 ml) chambers were inserted subcutaneously in the groin enclosing a fat flap (5 ml) based on the superficial circumflex iliac pedicle for 6 (n = 4), 12 (n = 1), and 22 weeks (n = 2). Right chambers included a poly(L-lactide-co-glycolide) sponge. Other pedicle configurations, including a vascular pedicle alone (n = 2) or in combination with muscle (n = 2) or a free fat graft (n = 2), were investigated in preliminary studies. Serial assessment of tissue growth and vascularization by magnetic resonance imaging was undertaken during growth and correlated with quantitative histomorphometry at chamber removal.
RESULTS: All chambers filled with new tissue by 6 weeks, vascularized by the arteriovenous pedicle. In the fat flap chambers, the initial 5 ml of fat expanded to 25.9 ± 2.4, 39.4 ± 3.9, and 56.5 ml (by magnetic resonance imaging) at 6, 12, and 22 weeks, respectively. Adipose tissue volume was maintained up to 22 weeks after chamber removal (n = 2), including one where the specimen was transferred on its pedicle to an adjacent submammary pocket.
CONCLUSION: The first clinically relevant volumes of tissue for in situ and remote breast reconstruction have been formed with implications for scaling of existing tissue-engineering models into human trials.
Authors:
Michael W Findlay; Juergen H Dolderer; Nicholas Trost; Randall O Craft; Yang Cao; Justin Cooper-White; Geoffrey Stevens; Wayne A Morrison
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  128     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-18     Completed Date:  2012-01-03     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1206-15     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adipose Tissue / blood supply*,  pathology,  transplantation*
Animals
Cell Proliferation
Diffusion Chambers, Culture
Endothelium, Vascular / pathology
Magnetic Resonance Imaging
Mammaplasty / methods*
Muscle, Skeletal / blood supply,  pathology,  transplantation*
Neovascularization, Physiologic / physiology*
Polycarboxylate Cement
Prostheses and Implants
Surgical Flaps / blood supply*,  pathology
Swine
Tissue Engineering / methods*
Chemical
Reg. No./Substance:
0/Polycarboxylate Cement; 25766-59-0/polycarbonate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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