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Figure 1. PRISMA study selection diagram.
Figure 2. Utility of nanofibrillar biosynthetic scaffolds for lymphedema. VEGF: Vascular endothelial growth factor; VLNT: vascularized
lymph node transfer; LVA: lymphaticovenous anastomosis.
arterio-venous loop systems, and type 1 collagen nanofibrils [11,13,15-19] . In particular, nanofibrillar collagen
scaffolds, marketed as BioBridge (Fibralign Corporation, Union City, CA), have shown promise in
enhancing lymphatic regeneration when used alone or when seeded with stem cells. These scaffolds are a
class II device cleared through the 510(K) pathway, composed of medical grade type 1 monomeric collagen
fibrils that are aligned to create membranes with high mechanical tensile strength and a stable structure.
These scaffolds are fabricated into thin, ribbon-like structures that are implanted subcutaneously to bypass
areas of lymphatic obstruction caused by scar tissue/fibrosis.
