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Facial Cartilaginous Reconstruction—A Historical Perspective, State-of-the-Art, and Future Directions
,
Adam Hague,
Thomas Dobbs,
Kenneth J. Stewart,
Iain Whitaker
Frontiers in Surgery, Volume: 8
Swansea University Authors:
Zita Jessop , Thomas Dobbs, Iain Whitaker
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DOI (Published version): 10.3389/fsurg.2021.680186
Abstract
Importance: Reconstruction of facial deformity poses a significant surgical challenge due to the psychological, functional, and aesthetic importance of this anatomical area. There is a need to provide not only an excellent colour and contour match for skin defects, but also a durable cartilaginous s...
| Published in: | Frontiers in Surgery |
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| ISSN: | 2296-875X |
| Published: |
Frontiers Media SA
2021
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa60386 |
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| Abstract: |
Importance: Reconstruction of facial deformity poses a significant surgical challenge due to the psychological, functional, and aesthetic importance of this anatomical area. There is a need to provide not only an excellent colour and contour match for skin defects, but also a durable cartilaginous structural replacement for nasal or auricular defects. The purpose of this review is to describe the history of, and state-of-the-art techniques within, facial cartilaginous surgery, whilst highlighting recent advances and future directions for this continually advancing specialty.Observations: Limitations of synthetic implants for nasal and auricular reconstruction, such as silicone and porous polyethylene, have meant that autologous cartilage tissue for such cases remains the current gold standard. Similarly, tissue engineering approaches using unrelated cells and synthetic scaffolds have shown limited in vivo success. There is increasing recognition that both the intrinsic and extrinsic microenvironment are important for tissue engineering and synthetic scaffolds fail to provide the necessary cues for cartilage matrix secretion.Conclusions and Relevance: We discuss the first-in-man studies in the context of biomimetic and developmental approaches to engineering durable cartilage for clinical translation. Implementation of engineered autologous tissue into clinical practise could eliminate donor site morbidity and represent the next phase of the facial reconstruction evolution. |
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| Item Description: |
MINI REVIEW article. |
| Keywords: |
facial reconstruction, cartilage, tissue engineering, regenerative medicine, plastic and reconstructivesurgery |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
Research reported in this study was supported by the Medical Research Council (MR/N002431/1), The Royal College of Surgeons of England, The British Association of Plastic, Reconstructive, and Aesthetic Surgeons (BAPRAS), The Scar Free Foundation and the Fulbright Commission. ZJ and TD were funded by the Welsh Clinical Academic Training (WCAT) Fellowship. |