Microsurgical techniques have been a major advancement in head and neck reconstructive surgery, allowing surgeons to transfer a variety of tissues, termed flaps, to repair congenital, acquired, traumatic and oncologic defects and deformities. However, despite these advances, there are still significant limitations to current vascularized fibula, scapula and iliac crest grafts, most prevalently the inability to match defect geometry and the harvest morbidity. We propose to develop pre-fabricated flaps by implanting custom designed 3D scaffolds with integrated biologics (concentrated bone marrow aspirate or rhBMP2) into the lastissimus dorsi muscle in Yorkshire pigs. Outcome measures of vascularity and bone growth will be determined up to 4 weeks to assess flap development. The flap with associated vascular pedicle will then be transplanted to reconstruct a mandibular angle defect in a realistic pre-clinical model, the Yorkshire pig. Viability and long term outcome of the flap transfer will be determined using CT angiography, micro-CT scanning and histology. Successful completion of this project will accomplish three specific goals: 1) a pre-clinical animal model to study and refine pre- fabricated flaps, 2) a better understanding of flap maturation in a muscle site, and 3) a customizable platform technology (computational flap planning, scaffold fabrication and functionalization) for generating pre-fabricated flaps for further investigation and subsequent translation to address clinical head and neck reconstruction problems.
Microsurgical techniques have been a major advancement in head and neck reconstructive surgery allowing surgeons to transfer a variety of tissues, termed flaps, to repair congenital, acquired, traumatic and oncologic defects and deformities. However, despite these advances, there are still significant limitations to current flaps. We propose to develop pre-fabricated flaps by implanting custom designed 3D scaffolds with integrated biologics (concentrated bone marrow aspirate or rhBMP2) into the lastissimus dorsi muscle in Yorkshire pigs. We will then transfer the flaps to reconstruct large defects in the mandible (jaw).
