Tissue-engineered solutions in plastic and reconstructive surgery: principles and practice

Al-Himdani, S., Jessop, Z. M., Al-Sabah, A., Combellack, E., Ibrahim, A., Doak, S. H., Hart, A. M., Archer, C. W., Thornton, C. A. and Whitaker, I. S. (2017) Tissue-engineered solutions in plastic and reconstructive surgery: principles and practice. Frontiers in Surgery, 4, 4. (doi: 10.3389/fsurg.2017.00004) (PMID:28280722) (PMCID:PMC5322281)

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Abstract

Recent advances in microsurgery, imaging, and transplantation have led to significant refinements in autologous reconstructive options; however, the morbidity of donor sites remains. This would be eliminated by successful clinical translation of tissue-engineered solutions into surgical practice. Plastic surgeons are uniquely placed to be intrinsically involved in the research and development of laboratory engineered tissues and their subsequent use. In this article, we present an overview of the field of tissue engineering, with the practicing plastic surgeon in mind. The Medical Research Council states that regenerative medicine and tissue engineering "holds the promise of revolutionizing patient care in the twenty-first century." The UK government highlighted regenerative medicine as one of the key eight great technologies in their industrial strategy worthy of significant investment. The long-term aim of successful biomanufacture to repair composite defects depends on interdisciplinary collaboration between cell biologists, material scientists, engineers, and associated medical specialties; however currently, there is a current lack of coordination in the field as a whole. Barriers to translation are deep rooted at the basic science level, manifested by a lack of consensus on the ideal cell source, scaffold, molecular cues, and environment and manufacturing strategy. There is also insufficient understanding of the long-term safety and durability of tissue-engineered constructs. This review aims to highlight that individualized approaches to the field are not adequate, and research collaboratives will be essential to bring together differing areas of expertise to expedite future clinical translation. The use of tissue engineering in reconstructive surgery would result in a paradigm shift but it is important to maintain realistic expectations. It is generally accepted that it takes 20-30 years from the start of basic science research to clinical utility, demonstrated by contemporary treatments such as bone marrow transplantation. Although great advances have been made in the tissue engineering field, we highlight the barriers that need to be overcome before we see the routine use of tissue-engineered solutions.

Item Type:Articles
Keywords:Barriers to translation, bioengineering, plastic and reconstructive surgery, regenerative medicine, stem cells, tissue engineering, translation, translational research.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Hart, Professor Andrew
Authors: Al-Himdani, S., Jessop, Z. M., Al-Sabah, A., Combellack, E., Ibrahim, A., Doak, S. H., Hart, A. M., Archer, C. W., Thornton, C. A., and Whitaker, I. S.
College/School:College of Medical Veterinary and Life Sciences > School of Molecular Biosciences
College of Medical Veterinary and Life Sciences > School of Life Sciences
Journal Name:Frontiers in Surgery
Publisher:Frontiers Media
ISSN:2296-875X
ISSN (Online):2296-875X
Published Online:23 February 2017
Copyright Holders:Copyright © 2017 Al-Himdani, Jessop, Al-Sabah, Combellack, Ibrahim, Doak, Hart, Archer, Thornton and Whitaker
First Published:First published in Frontiers in Surgery 4:4
Publisher Policy:Reproduced under a Creative Commons License

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