Al-Himdani Sarah, Jessop Zita M, Al-Sabah Ayesha, Combellack Emman, Ibrahim Amel, Doak Shareen H, Hart Andrew M, Archer Charles W, Thornton Catherine A, Whitaker Iain S
Reconstructive Surgery and Regenerative Medicine Research Group (ReconRegen), Institute of Life Science, Swansea University Medical School, Swansea, UK; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK.
Reconstructive Surgery and Regenerative Medicine Research Group (ReconRegen), Institute of Life Science, Swansea University Medical School , Swansea , UK.
Front Surg. 2017 Feb 23;4:4. doi: 10.3389/fsurg.2017.00004. eCollection 2017.
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.
显微外科、成像技术和移植技术的最新进展使得自体重建方案有了显著改进；然而，供区的发病率依然存在。组织工程解决方案成功转化为临床实践将消除这一问题。整形外科医生在本质上独特地参与到实验室工程组织的研发及其后续应用中。在本文中，我们从整形外科医生的角度对组织工程领域进行了概述。医学研究理事会指出，再生医学和组织工程“有望在21世纪彻底改变患者护理方式”。英国政府将再生医学列为其产业战略中值得大力投资的八大关键技术之一。成功进行生物制造以修复复合缺损的长期目标依赖于细胞生物学家、材料科学家、工程师及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。转化的障碍在基础科学层面根深蒂固，表现为在理想的细胞来源、支架、分子信号、环境及制造策略方面缺乏共识。对组织工程构建体的长期安全性和耐久性也缺乏足够的了解。本综述旨在强调该领域采用个体化方法并不够，研究合作对于整合不同专业领域以加速未来临床转化至关重要。在重建手术中使用组织工程将导致范式转变，但保持现实的期望很重要。人们普遍认为，从基础科学研究开始到临床应用需要20至30年，骨髓移植等当代治疗方法就证明了这一点。尽管组织工程领域已取得巨大进展，但我们强调在看到组织工程解决方案常规应用之前需要克服的障碍。
