PREFABRICATED ENGINEERED BONE FLAPS - AN EXPERIMENTAL-MODEL OF TISSUERECONSTRUCTION IN PLASTIC-SURGERY

In light of the recently described experimental technique of in vivo b one reconstitution with biotechnologic methods (from bone marrow strom al cells) and the prefabrication flap procedures, the possibility to o btain autologous bone growth in a myocutaneous flap, thus creating a c omposite osteomyocutaneous preformed flap, is postulated. Human bone m arrow stromal cells were delivered into the latissimus dorsi of athymi c mice by a porous hydroxyapatite ceramic model. Eight weeks after the implantation, histologic examination revealed the presence of spongio us bone tissue. A simple myocutaneous flap was thus transformed into a composite osteomyocutaneous flap. This flap is called the biotechnolo gic prefabricated flap, because it was the result of ex vivo expanded osteogenic precursor cells and in vivo bone tissue neoformation. The s hape of the bone flap was exactly the same as the shape of the ceramic model used. A possible clinical application may be the correction of skeletal defects. The advantages of this procedure are simple surgical execution, the possibility of preshaping the graft to the exact chara cteristics of the defect, and the availability of autogenous donor tis sue without donor site morbidity.