Vranckx Jan Jeroen, Hondt Margot Den
Department of Plastic and Reconstructive Surgery, KU Leuven University Hospitals, 49 Herestraat, B-3000 Leuven, Belgium.
Laboratory of Plastic Surgery and Tissue Engineering Research, Department of Plastic and Reconstructive Surgery, KU-Leuven University Hospitals, Leuven, Belgium.
Innov Surg Sci. 2017 Jun 24;2(4):189-202. doi: 10.1515/iss-2017-0011. eCollection 2017 Dec.
Tissue engineering was introduced as an innovative and promising field in the mid-1980s. The capacity of cells to migrate and proliferate in growth-inducing medium induced great expectancies on generating custom-shaped bioconstructs for tissue regeneration. Tissue engineering represents a unique multidisciplinary translational forum where the principles of biomaterial engineering, the molecular biology of cells and genes, and the clinical sciences of reconstruction would interact intensively through the combined efforts of scientists, engineers, and clinicians. The anticipated possibilities of cell engineering, matrix development, and growth factor therapies are extensive and would largely expand our clinical reconstructive armamentarium. Application of proangiogenic proteins may stimulate wound repair, restore avascular wound beds, or reverse hypoxia in flaps. Autologous cells procured from biopsies may generate an 'autologous' dermal and epidermal laminated cover on extensive burn wounds. Three-dimensional printing may generate 'custom-made' preshaped scaffolds - shaped as a nose, an ear, or a mandible - in which these cells can be seeded. The paucity of optimal donor tissues may be solved with off-the-shelf tissues using tissue engineering strategies. However, despite the expectations, the speed of translation of tissue engineering sciences into clinical reality is very slow due to the intrinsic complexity of human tissues. This review focuses on the transition from translational protocols towards current clinical applications of tissue engineering strategies in surgery.
组织工程学作为一个创新且前景广阔的领域于20世纪80年代中期被引入。细胞在生长诱导培养基中迁移和增殖的能力引发了人们对生成用于组织再生的定制形状生物构建体的巨大期望。组织工程学代表了一个独特的多学科转化平台，在这个平台上，生物材料工程原理、细胞与基因分子生物学以及重建临床科学将通过科学家、工程师和临床医生的共同努力而紧密互动。细胞工程、基质开发和生长因子疗法的预期可能性广泛，将极大地扩展我们的临床重建手段。促血管生成蛋白的应用可能刺激伤口修复、恢复无血管伤口床或逆转皮瓣中的缺氧状态。从活检获取的自体细胞可在大面积烧伤伤口上生成“自体”真皮和表皮分层覆盖物。三维打印可生成“定制”的预成型支架——形状如鼻子、耳朵或下颌骨——并可在其中接种这些细胞。使用组织工程策略的现成组织可能解决优质供体组织稀缺的问题。然而，尽管有这些期望，但由于人体组织的内在复杂性，组织工程科学转化为临床实际应用的速度非常缓慢。本综述重点关注从转化方案到组织工程策略在外科手术中当前临床应用的转变。
