Tissue-Engineered Solutions in Plastic and Reconstructive Surgery: Principles and Practice.
Tissue-Engineered Solutions in Plastic and Reconstructive Surgery: Principles and Practice.
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DOI：
10.3389/fsurg.2017.00004
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发表时间：
2017
影响因子：
1.8
通讯作者：
Whitaker IS
中科院分区：
文献类型：
--
作者：
Al-Himdani S;Jessop ZM;Al-Sabah A;Combellack E;Ibrahim A;Doak SH;Hart AM;Archer CW;Thornton CA;Whitaker IS
显微外科、影像学和移植的最新进展使自体重建的选择有了显著的改进;然而，供区的发病率仍然存在。这将通过将组织工程解决方案成功地临床转化为外科实践来消除。整形外科医生处于独特的地位，本质上参与了实验室工程组织的研究和开发及其随后的使用。在这篇文章中，我们提出了一个组织工程领域的概述，与执业整形外科医生铭记。医学研究理事会指出，再生医学和组织工程“有望在21世纪彻底改变病人护理”。英国政府强调再生医学是其产业战略中值得大量投资的八大关键技术之一。成功的生物制造修复复合材料缺陷的长期目标取决于细胞生物学家，材料科学家，工程师和相关医学专业之间的跨学科合作;然而，目前，整个领域缺乏协调。翻译的障碍深深植根于基础科学水平，表现为对理想的细胞来源，支架，分子线索，环境和制造策略缺乏共识。对组织工程结构的长期安全性和耐久性也缺乏足够的了解。本综述旨在强调，个性化的方法，该领域是不够的，研究合作将是必不可少的，汇集不同领域的专业知识，以加快未来的临床翻译。在重建手术中使用组织工程将导致范式转变，但重要的是要保持现实的期望。人们普遍认为，从基础科学研究开始到临床应用需要20-30年的时间，骨髓移植等当代治疗方法证明了这一点。虽然在组织工程领域已经取得了很大的进步，我们强调的障碍，需要克服之前，我们看到组织工程解决方案的常规使用。
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.