Kiseleva Viktoriia, Bagdasarian Aida, Vishnyakova Polina, Elchaninov Andrey, Karyagina Victoria, Rodionov Valeriy, Fatkhudinov Timur, Sukhikh Gennady
National Medical Research Center for Obstetrics, Gynecology and Perinatology Named after Academician V.I. Kulakov of Ministry of Healthcare of Russian Federation, Moscow 117997, Russia.
Research Institute of Molecular and Cellular Medicine, Peoples' Friendship University of Russia (RUDN University), Moscow 117198, Russia.
Polymers (Basel). 2025 Jul 25;17(15):2036. doi: 10.3390/polym17152036.
In recent years, significant progress has been made in breast reconstructive surgery, particularly with the use of three-dimensional (3D) disassemblable scaffolds. Reconstructive plastic surgery aimed at restoring the shape and size of the mammary gland offers medical, psychological, and social benefits. Using autologous tissues allows surgeons to recreate the appearance of the mammary gland and achieve tactile sensations similar to those of a healthy organ while minimizing the risks associated with implants; 3D disassemblable scaffolds are a promising solution that overcomes the limitations of traditional methods. These constructs offer the potential for patient-specific anatomical adaptation and can provide both temporary and long-term structural support for regenerating tissues. One of the most promising approaches in post-mastectomy breast reconstruction involves the use of autologous cellular and tissue components integrated into either synthetic scaffolds-such as polylactic acid (PLA), polyglycolic acid (PGA), poly(lactic-co-glycolic acid) (PLGA), and polycaprolactone (PCL)-or naturally derived biopolymer-based matrices, including alginate, chitosan, hyaluronic acid derivatives, collagen, fibrin, gelatin, and silk fibroin. In this context, two complementary research directions are gaining increasing significance: (1) the development of novel hybrid biomaterials that combine the favorable characteristics of both synthetic and natural polymers while maintaining biocompatibility and biodegradability; and (2) the advancement of three-dimensional bioprinting technologies for the fabrication of patient-specific scaffolds capable of incorporating cellular therapies. Such therapies typically involve mesenchymal stromal cells (MSCs) and bioactive signaling molecules, such as growth factors, aimed at promoting angiogenesis, cellular proliferation, and lineage-specific differentiation. In our review, we analyze existing developments in this area and discuss the advantages and disadvantages of 3D disassemblable scaffolds for mammary gland reconstruction, as well as prospects for their further research and clinical use.
近年来，乳房重建手术取得了重大进展，特别是在使用三维（3D）可拆解支架方面。旨在恢复乳腺形状和大小的整形重建手术具有医学、心理和社会效益。使用自体组织可使外科医生重塑乳腺外观，并获得与健康器官相似的触感，同时将与植入物相关的风险降至最低；3D可拆解支架是一种很有前景的解决方案，克服了传统方法的局限性。这些构建体具有根据患者特定解剖结构进行适配的潜力，可为再生组织提供临时和长期的结构支撑。乳房切除术后乳房重建中最有前景的方法之一是使用整合到合成支架（如聚乳酸（PLA）、聚乙醇酸（PGA）、聚乳酸-乙醇酸共聚物（PLGA）和聚己内酯（PCL））或天然衍生的基于生物聚合物的基质（包括藻酸盐、壳聚糖、透明质酸衍生物、胶原蛋白、纤维蛋白、明胶和丝素蛋白）中的自体细胞和组织成分。在此背景下，两个互补的研究方向正变得越来越重要：（1）开发新型混合生物材料，将合成聚合物和天然聚合物的有利特性结合起来，同时保持生物相容性和生物降解性；（2）推进三维生物打印技术，以制造能够纳入细胞疗法的患者特异性支架。此类疗法通常涉及间充质基质细胞（MSC）和生物活性信号分子，如生长因子，旨在促进血管生成、细胞增殖和谱系特异性分化。在我们的综述中，我们分析了该领域的现有进展，并讨论了用于乳腺重建的3D可拆解支架的优缺点，以及它们进一步研究和临床应用的前景。
