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An engineered muscle flap for reconstruction of large soft tissue defects
- Shandalov, Yulia, Egozi, Dana, Koffler, Jacob, Dado-Rosenfeld, Dekel, Ben-Shimol, David, Freiman, Alina, Shor, Erez, Kabala, Aviva, Levenberg, Shulamit
- Proceedings of the National Academy of Sciences of the United States of America 2014 v.111 no.16 pp. 6010-6015
- animal organs, biodegradability, endothelial cells, fibroblasts, mice, morbidity, muscles, myoblasts, polymers, strength (mechanics), surgery, tissue engineering
- Large soft tissue defects involve significant tissue loss, requiring surgical reconstruction. Autologous flaps are occasionally scant, demand prolonged transfer surgery, and induce donor site morbidity. The present work set out to fabricate an engineered muscle flap bearing its own functional vascular pedicle for repair of a large soft tissue defect in mice. Full-thickness abdominal wall defect was reconstructed using this engineered vascular muscle flap. A 3D engineered tissue constructed of a porous, biodegradable polymer scaffold embedded with endothelial cells, fibroblasts, and/or myoblasts was cultured in vitro and then implanted around the femoral artery and veins before being transferred, as an axial flap, with its vascular pedicle to reconstruct a full-thickness abdominal wall defect in the same mouse. Within 1 wk of implantation, scaffolds showed extensive functional vascular density and perfusion and anastomosis with host vessels. At 1 wk posttransfer, the engineered muscle flaps were highly vascularized, were well-integrated within the surrounding tissue, and featured sufficient mechanical strength to support the abdominal viscera. Thus, the described engineered muscle flap, equipped with an autologous vascular pedicle, constitutes an effective tool for reconstruction of large defects, thereby circumventing the need for both harvesting autologous flaps and postoperative scarification.