Abstract
Recent advances in regenerative medicine place us in a unique position to improve the quality of engineered tissue. We use auricular cartilage as an exemplar to illustrate how the use of tissue-specific adult stem cells, assembly through additive manufacturing and improved understanding of postnatal tissue maturation will allow us to more accurately replicate native tissue anisotropy. This review highlights the limitations of autologous auricular reconstruction, including donor site morbidity, technical considerations and long-term complications. Current tissue-engineered auricular constructs implanted into immune-competent animal models have been observed to undergo inflammation, fibrosis, foreign body reaction, calcification and degradation. Combining biomimetic regenerative medicine strategies will allow us to improve tissue-engineered auricular cartilage with respect to biochemical composition and functionality, as well as microstructural organization and overall shape. Creating functional and durable tissue has the potential to shift the paradigm in reconstructive surgery by obviating the need for donor sites.
Highlights
The combined efforts of cell biologists, material scientists, tissue engineers and reconstructive surgeons and associated converging technologies [1] in the 21st century have put us in an enviable position compared with our predecessors
Maturation process Whilst tissue-specific stem cells ensure the production of auricular cartilage, the neo-cartilaginous structure formed is immature in phenotype
Auricular reconstruction is an ideal example of how refinement in surgical techniques over many years can give excellent results in expert hands
Summary
The combined efforts of cell biologists, material scientists, tissue engineers and reconstructive surgeons and associated converging technologies [1] in the 21st century have put us in an enviable position compared with our predecessors. We will use the lessons learnt from auricular cartilage tissue engineering to illustrate how combining additive manufacturing and regenerative medicine for tissue-engineering purposes can be used to create functional and durable tissue with potential to shift the paradigm in reconstructive surgery.
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