Tissue engineering in plastic reconstructive surgery

Tissue engineering (TE) is a new interdisciplinary field of applied researc h combining engineering and biosciences together with clinical application, mainly in surgical specialities, to develop living substitutes for tissues and organs. Tissue engineering approaches can be categorized into substitu tive approaches, where the aim is the ex vivo construction of a living tiss ue or organ similar to a transplant, vs. histioconductive or histioinductiv e concepts in vivo. The main successful approaches in developing tissue sub stitutes to date have been progresses in the understanding of cell-cell int eractions, the selection of appropriate matrices (cell-matrix interaction) and chemical signalling (cytokines, growth factors) for stimulation of cell proliferation and migration within a tissue-engineered construct. So far v irtually all mammalian cells can be cultured under specific culture conditi ons and in tissue specific matrices. Future progress in cell biology may pe rmit the use of pluripotent stem cells for TE. The blueprint for tissue dif ferentiation is the genome: for this it is reasonable to combine tissue eng ineering with gene therapy. The key to the progress of tissue engineering i s an understanding between basic scientists, biochemical engineers, clinici ans, and industry. Anat Rec 263:372-378, 2001. (C) 2001 Wiley-Liss, Inc.