Page 195 - Read Online

Horch et al. Towards the future of plastic surgery

hierarchically printed reporter/producer cells would interventions following lower leg reconstruction by free tissue
be that it could potentially produce antibodies in a transfer. Chirurg 1986;57:140. (in German)
clinically relevant amount and could be removed when 2. Hay EL, Shealy GJ, Hanel DP, Stoddard LC. Lower extremity salvage
no longer needed. Ravnic et al. [31] reported on recent 3. with microvascular free flaps. J S C Med Assoc 1985;81:311-6.
Hallock GG. Severe lower-extremity injury. The rationale for
successful attempts to generate beta-cells and how this microsurgical reconstruction. Orthop Rev 1986;15:465-70.
can be coupled with bioprinting technologies in order to 4. Walgenbach KJ, Voigt M, Andree C, Stark GB, Horch RE.
fabricate pancreas tissues, which holds great potential Management of hypovascularized wounds not responding to
for type 1 diabetes. They postulated that it would be conventional therapy by means of free muscle transplantation. Vasa
possible to integrate vascularization and encapsulation 2001;30:206-11.
in bioprinted tissues. This would lend other future 5. Ducic I, Rao SS, Attinger CE. Outcomes of microvascular
prospects, such as pancreas-on-a-chip or organoids on reconstruction of single-vessel lower extremities: limb salvage versus
a chip [31] . Our own group is actively investigating the 6. amputation. J Reconstr Microsurg 2009;25:475-8.
Daigeler A, Kneser U, Fansa H, Riester T, Uder M, Horch RE;
value of bioprinting to generate such arterialized 3D Deutschsprachige Gemeinschaft für Mikrochirurgie der peripheren
prevascularized containers which can then be loaded Nerven und Gefäße. Reconstruction of the vascular compromised
with protein producing cells. These cells are supposed lower extremity - report of the consensus workshop at the 35. Meeting
to continuously express functional substances and of the DAM (Deutschsprachige Gemeinschaft fur Mikrochirurgie
address specific functions in the recipient organism. der peripheren Nerven und Gefasse) 2013 in Deidesheim. Handchir
This interdisciplinary approach is a fine example of how Mikrochir Plast Chir 2014;46:248-55. (in German)
we can combine the knowledge, skills and expertise 7. Kneser U, Arkudas A, Beier JP, Dragu A, Stübinger A, Lang W, Horch
of plastic surgical microvascular techniques with the RE. Extended skin and soft tissue defects after vascular wounds: plastic
surgical concepts. Zentralbl Chir 2013;138:536-42. (in German)
science of bioengineering and biology. Therefore, it 8. Horch RE, Horbach T, Lang W. The nutrient omentum free flap:
seems promising to help our patients better than today revascularization with vein bypasses and greater omentum flap in
with customized solutions to overcome morbidities that severe arterial ulcers. J Vasc Surg 2007;45:837-40.
are rarely curable today. In summary, all the findings 9. Horch RE, Lang W, Arkudas A, Taeger C, Kneser U, Schmitz M,
from regenerative medicine and tissue engineering Beier JP. Nutrient free flaps with vascular bypasses for extremity
are now more and more merging into the new field of salvage in patients with chronic limb ischemia. J Cardiovasc Surg
biofabrication. This might well enrich our daily clinical (Torino) 2014;55:265-72.
practice of to the benefit of our patients by combining 10. Horch RE, Lang W, Meyer A, Schmitz M. Distal pedal bypasses
combined with free microsurgical flaps in chronic limb ischaemia for
the art of plastic surgery with basic science [32,33] . problematic wounds. Int Wound J 2016;13:425-6.
11. Horch RE, Walgenbach KJ, Voigt M, Stark GB. The free “emergency”
DECLARATIONS rectus abdominis flap transfer for coverage of complex hand injuries.
Langenbecks Arch Chir Suppl Kongressbd 1998;115:1194-6. (in
Authors’ contributions German)
Designed and wrote the manuscript, performed 12. Hallock GG. A paradigm shift in flap selection protocols for zones
literature research, produced the figures and finalized of the lower extremity using perforator flaps. J Reconstr Microsurg
2013;29:233-40.
the manuscript: R. E. Horch 13. Colen LB. Limb salvage in the patient with severe peripheral vascular
Discussed the content, read and corrected and disease: the role of microsurgical free-tissue transfer. Plast Reconstr
proofread the final manuscript: A. Weigand, H. Wajant, Surg 1987;79:389-95.
R. An, J.M. Sun, A. Arkudas 14. Walgenbach KJ, Horch R, Voigt M, Andree C, Tánczos E, Stark GB.
Free microsurgical flap-plasty in reconstructive therapy of diabetic
Financial support and sponsorship foot ulcer. Zentralbl Chir 1999;124 Suppl 1:40-4. (in German)
None. 15. Walgenbach KJ, Voigt M, Horch R, Stark GB. Surgically-induced
angiogenesis as basic principle in treatment ov hypovascularized
wounds--the nutritive flap. Langenbecks Arch Chir Suppl Kongressbd
Conflicts of interest 1998;115:1186-8. (in German)
There are no conflicts of interest. 16. Goldberg JA, Alpert BS, Lineaweaver WC, Buncke HJ. Microvascular
reconstruction of the lower extremity in the elderly. Clin Plast Surg
1991;18:459-65.
Patient consent 17. Lorenzetti F, Giordano S, Tukiainen E. Intraoperative hemodynamic
Not applicable. evaluation of the latissimus dorsi muscle flap: a prospective study. J
Reconstr Microsurg 2012;28:273-8.
Ethics approval 18. Ludolph I, Lehnhardt M, Arkudas A, Kneser U, Pierer G, Harder Y,
Horch RE. Plastic reconstructive microsurgery in the elderly patient.
Not applicable. Consensus statement of the German Speaking Working Group
for Microsurgery of the Peripheral Nerves and Vessels. Handchir
REFERENCES Mikrochir Plast Chir 2017;49:1-8. (in German)
19. Polykandriotis E, Schmidt VJ, Kneser U, Jianming S, Boccaccini AR,
1. Biemer E, Jaeger K. Drug treatment, after care and secondary Horch RE. Bioreactors in regenerative medicine--from a technical

188 Plastic and Aesthetic Research ¦ Volume 4 ¦ October 31, 2017