Custom Designed Pre-Fabricated Bone Flaps for Mandibular Reconstruction

用于下颌重建的定制设计预制骨瓣

• 批准号: 8228437
• 负责人: Sean Peter Edwards
• 金额: $ 24.9万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8228437
• 关键词: Address; Adoption; Anastomosis - action; Anatomy; Angiography; Animal Model; Animals; Aspirate substance; Atherosclerosis; BMP2 gene; Beds; Biocompatible Materials; Biological Factors; Blood Vessels; Bone Development; Bone Growth; Bone Marrow; Bone Tissue; Bone Transplantation; Caliber; Cicatrix; Clinical; Complex; Custom; Defect; Deformity; Development; Engineering; Excision; Face; Family suidae; Goals; Harvest; Head and neck structure; Histology; Implant; Investigation; Jaw; Mandible; Morbidity - disease rate; Muscle; Neck; Operative Surgical Procedures; Osteogenesis; Outcome; Outcome Measure; Performance; Peripheral arterial disease; Pre-Clinical Model; Reconstructive Surgical Procedures; Relative (related person); Science; Site; Source; Staging; Surgeon; Surgical Flaps; Techniques; Technology; Testing; Time; Tissue Engineering; Tissue Grafts; Tissues; Translations; Transplantation; Trauma; Vascularization; Wound Healing; X-Ray Computed Tomography; bone; bone imaging; design; falls; fibula; mandible/maxilla; meetings; mineralization; polycaprolactone; pre-clinical; prevent; recombinant human bone morphogenetic protein-2; reconstruction; repaired; scaffold; scapula; soft tissue; tumor

DESCRIPTION (provided by applicant): Microsurgical techniques have been a major advancement in head and neck reconstructive surgery, allowing surgeons to transfer a variety of tissues, termed flaps, to repair congenital, acquired, traumatic and oncologic defects and deformities. However, despite these advances, there are still significant limitations to current vascularized fibula, scapula and iliac crest grafts, most prevalently the inability to match defect geometry and the harvest morbidity. We propose to develop pre-fabricated flaps by implanting custom designed 3D scaffolds with integrated biologics (concentrated bone marrow aspirate or rhBMP2) into the lastissimus dorsi muscle in Yorkshire pigs. Outcome measures of vascularity and bone growth will be determined up to 4 weeks to assess flap development. The flap with associated vascular pedicle will then be transplanted to reconstruct a mandibular angle defect in a realistic pre-clinical model, the Yorkshire pig. Viability and long term outcome of the flap transfer will be determined using CT angiography, micro-CT scanning and histology. Successful completion of this project will accomplish three specific goals: 1) a pre-clinical animal model to study and refine pre- fabricated flaps, 2) a better understanding of flap maturation in a muscle site, and 3) a customizable platform technology (computational flap planning, scaffold fabrication and functionalization) for generating pre-fabricated flaps for further investigation and subsequent translation to address clinical head and neck reconstruction problems. PUBLIC HEALTH RELEVANCE: Microsurgical techniques have been a major advancement in head and neck reconstructive surgery allowing surgeons to transfer a variety of tissues, termed flaps, to repair congenital, acquired, traumatic and oncologic defects and deformities. However, despite these advances, there are still significant limitations to current flaps. We propose to develop pre-fabricated flaps by implanting custom designed 3D scaffolds with integrated biologics (concentrated bone marrow aspirate or rhBMP2) into the lastissimus dorsi muscle in Yorkshire pigs. We will then transfer the flaps to reconstruct large defects in the mandible (jaw).

描述(申请人提供)：显微外科技术是头颈部重建外科的一项重大进步，允许外科医生转移各种组织，称为皮瓣，以修复先天性、获得性、创伤性和肿瘤性缺陷和畸形。然而，尽管有这些进展，目前带血管的腓骨、肩胛骨和髂骨移植仍然存在显著的局限性，最常见的是不能匹配缺陷几何形状和收获发病率。我们建议在约克郡猪的背阔肌中植入定制设计的3D支架和整合的生物制剂(浓缩骨髓抽吸物或重组人骨形态发生蛋白2)，以开发预制的皮瓣。血管和骨生长的结果指标将在4周内确定，以评估皮瓣的发育情况。然后移植带有相关血管蒂的皮瓣，以重建现实的临床前模型约克郡猪的下颌角缺损。将通过CT血管成像、显微CT扫描和组织学来确定瓣转移的存活率和长期结果。该项目的成功完成将实现三个具体目标：1)研究和完善预制皮瓣的临床前动物模型；2)更好地了解肌肉部位的皮瓣成熟过程；3)可定制的平台技术(计算皮片规划、支架制作和功能化)，用于生成预制皮瓣，以供进一步研究和后续翻译，以解决临床头颈部重建问题。 公共卫生相关性：显微外科技术是头颈部重建外科的一项重大进步，允许外科医生转移各种组织，称为皮瓣，以修复先天性、获得性、创伤性和肿瘤性缺陷和畸形。然而，尽管有这些进步，目前的皮瓣仍有很大的局限性。我们建议在约克郡猪的背阔肌中植入定制设计的3D支架和整合的生物制剂(浓缩骨髓抽吸物或重组人骨形态发生蛋白2)，以开发预制的皮瓣。然后，我们将转移这些皮瓣来重建下颌骨(颌骨)的大缺陷。