Regeneration and repair of human digits and limbs: fact and fiction.

Shyh‐Jou Shieh,Tsun‐Chih Cheng

doi:10.1002/reg2.41

Abstract

A variety of digit and limb repair and reconstruction methods have been used in different clinical settings, but regeneration remains an item on every plastic surgeon's “wish list.” Although surgical salvage techniques are continually being improved, unreplantable digits and limbs are still abundant. We comprehensively review the structural and functional salvage methods in clinical practice, from the peeling injuries of small distal fingertips to multisegmented amputated limbs, and the developmental and tissue engineering approaches for regenerating human digits and limbs in the laboratory. Although surgical techniques have forged ahead, there are still situations in which digits and limbs are unreplantable. Advances in the field are delineated, and the regeneration processes of salamander limbs, lizard tails, and mouse digits and each component of tissue engineering approaches for digit‐ and limb‐building are discussed. Although the current technology is promising, there are many challenges in human digit and limb regeneration. We hope this review inspires research on the critical gap between clinical and basic science, and leads to more sophisticated digit and limb loss rescue and regeneration innovations.

Highlights

Numerous tissue defects that need repair and reconstruction are the daily fare of plastic and reconstructive surgeons
The success rates of surgical repair and reconstruction of human digit and limb injuries have climbed in step with the technological advances in modern surgical instruments, microscopes, and surgical techniques, some stubbornly irreparable and unreplantable digit and limb injuries remain
Most patients are satisfied with their prostheses and their utility, and with their good prosthetic skills, they do not use their prostheses for more than about half of the activities of daily living (Ostlie et al 2012). To deal with this clinical issue, scientists propose creating digits and limbs in the laboratory using the regenerative approaches of developmental biology and tissue engineering

Summary

Introduction

Numerous tissue defects that need repair and reconstruction are the daily fare of plastic and reconstructive surgeons. To deal with this clinical issue, scientists propose creating digits and limbs in the laboratory using the regenerative approaches of developmental biology and tissue engineering. A great deal of work has been done to advance the tissue engineering approach to human digit and limb regeneration (Isogai et al 1999; Vacanti et al 2001; Wang et al 2009), but there are still numerous undisclosed obstacles that need to be dealt with.

Results

Conclusion