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: 8436179
• 负责人: Sean Peter Edwards
• 金额: $ 18.84万
• 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/8436179
• 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.

描述（由申请人提供）：显微外科技术是头颈部重建手术的主要进步，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，尽管取得了这些进展，目前的血管化腓骨、肩胛骨和髂嵴移植物仍存在明显的局限性，最常见的是无法匹配缺损几何形状和收获发病率。我们建议通过将定制设计的3D支架与集成生物制剂（浓缩骨髓穿刺液或rhBMP 2）植入约克郡猪的背阔肌中来开发预制皮瓣。将在4周内确定血管分布和骨生长的结果指标，以评估皮瓣发育。然后将带有相关血管蒂的皮瓣移植到一个逼真的临床前模型（约克郡猪）中，以重建下颌角缺损。将使用CT血管造影、显微CT扫描和组织学来确定皮瓣转移的活力和长期结果。成功完成本项目将实现三个具体目标：1）临床前动物模型，用于研究和改进预制皮瓣，2）更好地了解肌肉部位的皮瓣成熟，以及3）可定制的平台技术（计算襟翼规划，支架制造和功能化）用于产生预-制造皮瓣，用于进一步研究和随后的平移，以解决临床头颈部重建问题。