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Current Use of Biological Scaffolds in Plastic Surgery

Panayi, Adriana C., M.D.; Orgill, Dennis P., M.D., Ph.D.

Plastic and Reconstructive Surgery: January 2019 - Volume 143 - Issue 1 - p 209–220
doi: 10.1097/PRS.0000000000005102
Plastic Surgery Focus: Special Topics

Background: Properly designed biodegradable scaffolds facilitate repair or regeneration of stromal tissues. Over the past 50 years, a variety of synthetic, semisynthetic, and decellularized scaffolds have been developed that provide surgeons with tools to reconstruct a wide array of structural defects.

Methods: The authors review the literature of biological degradable scaffolds in current clinical use in the United States and highlight their design principles and products in common use.

Results: Host tissues populate scaffolds with inflammatory cells, fibroblasts, blood vessels, nerves, and lymphatics. Cells lay down extracellular matrix macromolecules, whereas enzymes degrade the scaffold. Over time, the scaffold can be totally replaced by host tissues.

Conclusions: The greatest use of scaffolds in plastic surgery is in skin replacement, breast reconstruction, abdominal wall reconstruction, and peripheral nerve repair. Other areas of importance are cartilage and bone replacement and support for lining replacements such as bowel, bladder, mucosa, and dura. The wide range of research being performed in this field is likely to provide surgeons with more choices and improved materials to repair and regenerate stromal structures.

Boston, Mass.

From the Division of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School.

Received for publication April 16, 2018; accepted July 26, 2018.

Disclosure: Dr. Orgill receives research funding through grants to Brigham and Women’s Hospital from ACell Inc., Integra LifeSciences, Inc. and the Musculoskeletal Transplant Foundation. He is a consultant for Integra LifeSciences Inc., the Musculoskeletal Transplant Foundation (MTF) and Geistlich Pharma North America Inc. All other authors declare no actual or potential conflict of interests. They disclose no commercial or financial associations, personal or other relationships with other people or organizations that could inappropriately influence the article or create a conflict of interest with the information presented.

Dennis P. Orgill, M.D., Ph.D., Department of Surgery, Division of Plastic Surgery, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, Mass. 02115,, Twitter: @Dennis_Orgill

©2019American Society of Plastic Surgeons