Creating And Transferring An Innervated, Vascularized Muscle Flap Made from An Elastic, Cellularized Tissue Construct Developed in Situ

Reanimating facial structures following paralysis and muscle loss is a surgical objective that would benefit from improved options for harvesting appropriately sized muscle flaps. The objective of this study was to apply electrohydrodynamic processing to generate a cellularized, elastic, biocomposite scaffold that could develop and mature as muscle in a prepared donor site in vivo, and then be transferred as a thin muscle flap with a vascular and neural pedicle. First an effective extracellular matrix (ECM) gel type was selected for the biocomposite scaffold from three types of ECM combined with poly(ester urethane)urea microfibers and evaluated in rat abdominal wall defects. Next, two types of precursor cells (muscle-derived and adipose-derived) were compared in constructs placed in rat hind limb defects for muscle regeneration capacity. Finally, with a construct made from dermal ECM and muscle-derived stem cells, proto-flaps were implanted in one hindlimb for development and then microsurgically transferred as a free flap to the contralateral limb where stimulated muscle function was confirmed. This construct generation and in vivo incubation procedure might allow the generation of small-scale muscle flaps appropriate for transfer to the face, offering a new strategy for facial reanimation. This article is protected by copyright. All rights reserved.