Research

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18 pages, 4903 KiB

Open AccessArticle

Differential Immune Response to Bioprosthetic Heart Valve Tissues in the α1,3Galactosyltransferase-Knockout Mouse Model

by Kelly Casós, Roger Llatjós, Arnau Blasco-Lucas, Sebastián G. Kuguel, Fabrizio Sbraga, Cesare Galli, Vered Padler-Karavani, Thierry Le Tourneau, Marta Vadori, Andrea Perota, Jean-Christian Roussel, Tomaso Bottio, Emanuele Cozzi, Jean-Paul Soulillou, Manuel Galiñanes, Rafael Máñez and Cristina Costa

Bioengineering 2023, 10(7), 833; https://0-doi-org.brum.beds.ac.uk/10.3390/bioengineering10070833 - 13 Jul 2023

Viewed by 1000

Abstract

Structural valve deterioration (SVD) of bioprosthetic heart valves (BHVs) has great clinical and economic consequences. Notably, immunity against BHVs plays a major role in SVD, especially when implanted in young and middle-aged patients. However, the complex pathogenesis of SVD remains to be fully [...] Read more.

Structural valve deterioration (SVD) of bioprosthetic heart valves (BHVs) has great clinical and economic consequences. Notably, immunity against BHVs plays a major role in SVD, especially when implanted in young and middle-aged patients. However, the complex pathogenesis of SVD remains to be fully characterized, and analyses of commercial BHVs in standardized-preclinical settings are needed for further advancement. Here, we studied the immune response to commercial BHV tissue of bovine, porcine, and equine origin after subcutaneous implantation into adult α1,3-galactosyltransferase-knockout (Gal KO) mice. The levels of serum anti-galactose α1,3-galactose (Gal) and -non-Gal IgM and IgG antibodies were determined up to 2 months post-implantation. Based on histological analyses, all BHV tissues studied triggered distinct infiltrating cellular immune responses that related to tissue degeneration. Increased anti-Gal antibody levels were found in serum after ATS 3f and Freedom/Solo implantation but not for Crown or Hancock II grafts. Overall, there were no correlations between cellular-immunity scores and post-implantation antibodies, suggesting these are independent factors differentially affecting the outcome of distinct commercial BHVs. These findings provide further insights into the understanding of SVD immunopathogenesis and highlight the need to evaluate immune responses as a confounding factor. Full article

(This article belongs to the Special Issue Bioengineered Strategies for Surgical Innovation)

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12 pages, 6867 KiB

Open AccessArticle

Long-Term Follow-Up of a Novel Surgical Option Combining Fibula Free Flap and 3D-Bioprinted, Patient-Specific Polycaprolactone (PCL) Implant for Mandible Reconstruction

by Bo-Yeon Hwang, Kwantae Noh and Jung-Woo Lee

Bioengineering 2023, 10(6), 684; https://0-doi-org.brum.beds.ac.uk/10.3390/bioengineering10060684 - 04 Jun 2023

Cited by 1 | Viewed by 1395

Abstract

As the fibula free flap became the gold standard in mandibular reconstruction that required both hard tissue and soft tissue, various methods have been sought to solve the height discrepancy between the mandible and fibula. The purpose of this paper was to propose [...] Read more.

As the fibula free flap became the gold standard in mandibular reconstruction that required both hard tissue and soft tissue, various methods have been sought to solve the height discrepancy between the mandible and fibula. The purpose of this paper was to propose a surgical option that combined the microvascular fibula free flap with a 3D-bioprinted, patient-specific polycaprolactone (PCL) implant as a safe and simple novel method that achieved the best functional and aesthetic results in mandibular reconstruction surgery for young patients with malignant tumors. The patient’s reconstructed mandible maintained volume symmetry without any deformation or complications for over 6 years. Computer-aided design/computer-aided manufacturing (CAD/CAM) and 3D printing technology enabled accurate and safe surgical results. Full article

(This article belongs to the Special Issue Bioengineered Strategies for Surgical Innovation)

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16 pages, 4192 KiB

Open AccessCommunication

Co-Graft of Acellular Dermal Matrix and Split Thickness Skin Graft—A New Reconstructive Surgical Method in the Treatment of Hidradenitis Suppurativa

by Marcin Gierek, Wojciech Łabuś, Anna Słaboń, Karolina Ziółkowska, Gabriela Ochała-Gierek, Diana Kitala, Karol Szyluk and Paweł Niemiec

Bioengineering 2022, 9(8), 389; https://0-doi-org.brum.beds.ac.uk/10.3390/bioengineering9080389 - 14 Aug 2022

Cited by 19 | Viewed by 3874

Abstract

Hidradenitis suppurativa is a chronic disease that significantly reduces patients’ quality of life. Patients are chronically treated with systemic therapies, which are often ineffective. Surgical treatment for severe cases of hidradenitis suppurativa is one option for affected patients. Surgical treatment has its limitations, [...] Read more.

Hidradenitis suppurativa is a chronic disease that significantly reduces patients’ quality of life. Patients are chronically treated with systemic therapies, which are often ineffective. Surgical treatment for severe cases of hidradenitis suppurativa is one option for affected patients. Surgical treatment has its limitations, and wound closure may be particularly problematic. This requires the use of reconstructive techniques. The methods of choice for wound closure are split-thickness skin grafts or local flaps reconstructions. However, each method has its limitations. This is a presentation of a new reconstructive surgical method in hidradenitis suppurativa surgery: the use of a co-graft of Acellular dermal matrix and split thickness skin graft as a novel method in wound closure after wide excisions, based on two cases. The results of this method are very promising: we achieved very fast wound closure with good aesthetic results regarding scar formation. In this paper, we used several examinations: laser speckle analysis, cutometer tests, and health-related quality of life (QoL) questionnaire to check the clinical impact of this method. Our initial results are very encouraging. ADM with STSG as a co-graft could be widely used in reconstructive surgery. This is a preliminary study, which should be continued in further, extended research. Full article

(This article belongs to the Special Issue Bioengineered Strategies for Surgical Innovation)

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6 pages, 1270 KiB

Open AccessArticle

Telehealth and Burn Care: From Faxes to Augmented Reality

by Caroline Park, Youngwoo Cho, Jalen Harvey, Brett Arnoldo and Benjamin Levi

Bioengineering 2022, 9(5), 211; https://0-doi-org.brum.beds.ac.uk/10.3390/bioengineering9050211 - 13 May 2022

Cited by 1 | Viewed by 2059

Abstract

Despite advances in telemedicine, practices remain diverse, ranging from telephonic to still images and video-based conferencing. We review the various modes of telemedicine in burn care and summarize relevant studies, including their contributions and limitations. We also review the role of a more [...] Read more.

Despite advances in telemedicine, practices remain diverse, ranging from telephonic to still images and video-based conferencing. We review the various modes of telemedicine in burn care and summarize relevant studies, including their contributions and limitations. We also review the role of a more recent technology, augmented reality, and its role in the triage and management of burn patients. Telemedicine in burn care remains diverse, with varied outcomes in accuracy and efficiency. Newer technologies such as augmented reality have not been extensively studied or implemented but show promise in immersive, real-time triage. Full article

(This article belongs to the Special Issue Bioengineered Strategies for Surgical Innovation)

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Review

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13 pages, 616 KiB

Open AccessReview

Deconstructing Fat to Reverse Radiation Induced Soft Tissue Fibrosis

by Hannes Prescher, Jill R. Froimson and Summer E. Hanson

Bioengineering 2023, 10(6), 742; https://0-doi-org.brum.beds.ac.uk/10.3390/bioengineering10060742 - 20 Jun 2023

Cited by 2 | Viewed by 1469

Abstract

Adipose tissue is composed of a collection of cells with valuable structural and regenerative function. Taken as an autologous graft, these cells can be used to address soft tissue defects and irregularities, while also providing a reparative effect on the surrounding tissues. Adipose-derived [...] Read more.

Adipose tissue is composed of a collection of cells with valuable structural and regenerative function. Taken as an autologous graft, these cells can be used to address soft tissue defects and irregularities, while also providing a reparative effect on the surrounding tissues. Adipose-derived stem or stromal cells are primarily responsible for this regenerative effect through direct differentiation into native cells and via secretion of numerous growth factors and cytokines that stimulate angiogenesis and disrupt pro-inflammatory pathways. Separating adipose tissue into its component parts, i.e., cells, scaffolds and proteins, has provided new regenerative therapies for skin and soft tissue pathology, including that resulting from radiation. Recent studies in both animal models and clinical trials have demonstrated the ability of autologous fat grafting to reverse radiation induced skin fibrosis. An improved understanding of the complex pathologic mechanism of RIF has allowed researchers to harness the specific function of the ASCs to engineer enriched fat graft constructs to improve the therapeutic effect of AFG. Full article

(This article belongs to the Special Issue Bioengineered Strategies for Surgical Innovation)

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24 pages, 1103 KiB

Open AccessReview

Lymphatic Tissue Bioengineering for the Treatment of Postsurgical Lymphedema

by Cynthia J. Sung, Kshitij Gupta, Jin Wang and Alex K. Wong

Bioengineering 2022, 9(4), 162; https://0-doi-org.brum.beds.ac.uk/10.3390/bioengineering9040162 - 06 Apr 2022

Cited by 6 | Viewed by 3955

Abstract

Lymphedema is characterized by progressive and chronic tissue swelling and inflammation from local accumulation of interstitial fluid due to lymphatic injury or dysfunction. It is a debilitating condition that significantly impacts a patient’s quality of life, and has limited treatment options. With better [...] Read more.

Lymphedema is characterized by progressive and chronic tissue swelling and inflammation from local accumulation of interstitial fluid due to lymphatic injury or dysfunction. It is a debilitating condition that significantly impacts a patient’s quality of life, and has limited treatment options. With better understanding of the molecular mechanisms and pathophysiology of lymphedema and advances in tissue engineering technologies, lymphatic tissue bioengineering and regeneration have emerged as a potential therapeutic option for postsurgical lymphedema. Various strategies involving stem cells, lymphangiogenic factors, bioengineered matrices and mechanical stimuli allow more precisely controlled regeneration of lymphatic tissue at the site of lymphedema without subjecting patients to complications or iatrogenic injuries associated with surgeries. This review provides an overview of current innovative approaches of lymphatic tissue bioengineering that represent a promising treatment option for postsurgical lymphedema. Full article

(This article belongs to the Special Issue Bioengineered Strategies for Surgical Innovation)

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15 pages, 1792 KiB

Open AccessReview

Surgical Applications of Materials Engineered with Antimicrobial Properties

by David P. Perrault, Ayushi Sharma, Jessica F. Kim, Geoffrey C. Gurtner and Derrick C. Wan

Bioengineering 2022, 9(4), 138; https://0-doi-org.brum.beds.ac.uk/10.3390/bioengineering9040138 - 26 Mar 2022

Cited by 6 | Viewed by 2936

Abstract

The infection of surgically placed implants is a problem that is both large in magnitude and that broadly affects nearly all surgical specialties. Implant-associated infections deleteriously affect patient quality-of-life and can lead to greater morbidity, mortality, and cost to the health care system. [...] Read more.

The infection of surgically placed implants is a problem that is both large in magnitude and that broadly affects nearly all surgical specialties. Implant-associated infections deleteriously affect patient quality-of-life and can lead to greater morbidity, mortality, and cost to the health care system. The impact of this problem has prompted extensive pre-clinical and clinical investigation into decreasing implant infection rates. More recently, antimicrobial approaches that modify or treat the implant directly have been of great interest. These approaches include antibacterial implant coatings (antifouling materials, antibiotics, metal ions, and antimicrobial peptides), antibacterial nanostructured implant surfaces, and antibiotic-releasing implants. This review provides a compendium of these approaches and the clinical applications and outcomes. In general, implant-specific modalities for reducing infections have been effective; however, most applications remain in the preclinical or early clinical stages. Full article

(This article belongs to the Special Issue Bioengineered Strategies for Surgical Innovation)

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14 pages, 2471 KiB

Open AccessReview

The History and Innovations of Blood Vessel Anastomosis

by William R. Moritz, Shreya Raman, Sydney Pessin, Cameron Martin, Xiaowei Li, Amanda Westman and Justin M. Sacks

Bioengineering 2022, 9(2), 75; https://0-doi-org.brum.beds.ac.uk/10.3390/bioengineering9020075 - 15 Feb 2022

Cited by 9 | Viewed by 5884

Abstract

Surgical technique and technology frequently coevolve. The brief history of blood vessel anastomosis is full of famous names. While the techniques pioneered by these surgeons have been well described, the technology that facilitated their advancements and their inventors deserve recognition. The mass production [...] Read more.

Surgical technique and technology frequently coevolve. The brief history of blood vessel anastomosis is full of famous names. While the techniques pioneered by these surgeons have been well described, the technology that facilitated their advancements and their inventors deserve recognition. The mass production of laboratory microscopes in the mid-1800s allowed for an explosion of interest in tissue histology. This improved understanding of vascular physiology and thrombosis laid the groundwork for Carrel and Guthrie to report some of the first successful vascular anastomoses. In 1916, McLean discovered heparin. Twenty-four years later, Gordon Murray found that it could prevent thrombosis when performing end-to-end anastomosis. These discoveries paved the way for the first-in-human kidney transplantations. Otolaryngologists Nylen and Holmgren were the first to bring the laboratory microscope into the operating room, but Jacobson was the first to apply these techniques to microvascular anastomosis. His first successful attempt in 1960 and the subsequent development of microsurgical tools allowed for an explosion of interest in microsurgery, and several decades of innovation followed. Today, new advancements promise to make microvascular and vascular surgery faster, cheaper, and safer for patients. The future of surgery will always be inextricably tied to the creativity and vision of its innovators. Full article

(This article belongs to the Special Issue Bioengineered Strategies for Surgical Innovation)

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