Department of Plastic and Cosmetic Surgery, Southern Hospital, Southern Medical University, Guangzhou North Road, 1838 Guangzhou, Guangdong 510515, PR China.
Med Hypotheses. 2012 Aug;79(2):267-70. doi: 10.1016/j.mehy.2012.05.007. Epub 2012 Jun 9.
In plastic and reconstructive surgery, there is a tremendous clinical need for adequate implants are needed to restore soft-tissue defects resulting from tumor resection, traumatic injury, or congenital anomalies. Restoring the aesthetic function of the soft tissue is as important as restoring the natural tissue function. To address aesthetic issues, injection of hyaluronic acid and collagen and use of artificially synthesized biomaterials and autologous fat tissue grafts is extensive in the clinic, still faces limitations. Achieving minimal morbidity while compensating contour irregularities remains a major challenge because the available reconstruction methods and unsatisfactory biomaterials. Adipose tissue engineering holds great promise for reconstruction, but so far, there was no reports of large-volume engineered adipose tissue. Construction of a large volume of vascularized engineered fat tissue may overcome clinical challenges because vascularization is essential for the survival of engineered fat tissue and its integration with the host tissue. An arteriovenous bundle model for soft tissue has been used in prefabricating a large volume fat tissue with axial vascularization in vivo. Therefore, we hypothesized that combining adipose tissue-derived stem cells (ASCs), and prefabricated vascularized collagen scaffolds, with perforated chamber and arteriovenous bundle, could generate a large volume of engineered fat tissue with an axial vascular pedicle in vivo. Like vascularized autologous tissue, the new constructs could be transferred to the defective site by local transference or microsurgical techniques. The novel strategy could provide a large volume of engineered fat tissue suitable for clinical application and new therapeutic strategies for reconstructing defects if the hypothesis proved to be practical.
在整形和重建外科中，临床上需要大量的植入物来修复因肿瘤切除、创伤或先天畸形而导致的软组织缺损。恢复软组织的美学功能与恢复其自然组织功能同样重要。为了解决美学问题，临床上广泛应用透明质酸和胶原蛋白注射以及人工合成生物材料和自体脂肪组织移植，但仍存在局限性。在补偿轮廓不规则的同时实现最小的发病率仍然是一个主要挑战，因为现有的重建方法和生物材料并不令人满意。脂肪组织工程在重建方面具有很大的前景，但到目前为止，还没有关于大容量工程化脂肪组织的报道。构建大容量的血管化工程化脂肪组织可能会克服临床挑战，因为血管化对于工程化脂肪组织的存活及其与宿主组织的整合至关重要。动静脉束模型已用于在体内预制具有轴向血管化的大容量脂肪组织。因此，我们假设将脂肪组织来源的干细胞（ASCs）与预制的带孔腔和动静脉束的血管化胶原支架结合起来，可以在体内生成带有轴向血管蒂的大容量工程化脂肪组织。与血管化的自体组织类似，新构建体可以通过局部转移或显微外科技术转移到缺陷部位。如果假设被证明是可行的，那么这种新策略可以为临床应用提供大量适合的工程化脂肪组织，并为重建缺陷提供新的治疗策略。
