Current Use of Biological Scaffolds in Plastic Surgery

Properly designed biodegradable scaffolds facilitate repair or regeneration of stromal tissues. Over the last 50 years, a variety of synthetic, semi-synthetic and decellularized scaffolds have been developed that provide surgeons with tools to reconstruct a wide array of structural defects. We reviewed the literature of biological degradable scaffolds in current clinical use in the US and highlight their design principles as well as products in common use. Host tissues populate scaffolds with inflammatory cells, fibroblasts, blood vessels, nerves and lymphatics. Cells lay down extracellular matrix macromolecules while enzymes degrade the scaffold. Over time the scaffold can be totally replaced by host tissues. 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 as well as support for lining replacements such bowel, bladder, mucosa and dura. The wide range of research being done in this field is likely to provide surgeons with more choices and improved materials to repair and regenerate stromal structures. 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: in addition they disclose no commercial or financial associations, personal or other relationships with other people or organizations that could inappropriately influence the reported manuscript or create a conflict of interest with the information presented. Corresponding author: Dennis P. Orgill, M.D., Ph.D., Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital - Harvard Medical School, 75 Francis St., Boston MA 02115, T: 617-525-7837, Email: dorgill@partners.org ©2018American Society of Plastic Surgeons