Artikel
A novel textile scaffold for reconstruction of cranial defects
Ein neuartiger Textilträger zur Rekonstruktion von kraniellen Defekten
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Autoren
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M.F. Oertel
- Neurochirurgische Klinik, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen
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R. Wied
- Klinik für Zahn-, Mund-, Kiefer- und Plastische Gesichtschirurgie, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen
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Y. M. Ryang
- Neurochirurgische Klinik, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen
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O. Maciejewski
- Klinik für Zahn-, Mund-, Kiefer- und Plastische Gesichtschirurgie, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen
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D. Riediger
- Klinik für Zahn-, Mund-, Kiefer- und Plastische Gesichtschirurgie, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen
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J. M. Gilsbach
- Neurochirurgische Klinik, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen
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R. Smeets
- Klinik für Zahn-, Mund-, Kiefer- und Plastische Gesichtschirurgie, Universitätsklinikum, Rheinisch-Westfälische Technische Hochschule Aachen
| Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: Cranial defects have to be frequently reconstructed for aesthetic and protective indications in neurosurgery and oromaxillofacial surgery. We present a novel tissue-engineering technique for cranioplasty combining the advantages of clinically established bone replacement materials with the use of mesenchymal stem cells and textile scaffolds.
Methods: Adult mesenchymal stem cells were poured in a gel matrix, mixed with bone replacement materials, and seeded onto absorbable textile scaffold structures. The scaffolds are thermal fixated, flexible, fit well in the skull structures, could be osseous integrated at an early stage, and offering the possibility to reconstruct cranial defects as well as to implant a barrier between the different tissue layers. The barrier ossifies in the course of the degradation phase therewith presenting a mechanical protection for the underlying brain parenchyma allowing the retrieval of otherwise clotted and scarred strata of galea aponeurotica and dura mater, and facilitating reconstruction at the time of cranioplasty. Osteogene differentiation was analysed quantitatively by enzymatic photometric measurement of alkaline phosphatase activity, and measured qualitatively by staining of alkaline phosphatase and immunohistochemical detection of bone specific markers.
Results: An innovative tissue-engineering technique for reconstruction of cranial defects is presented. The expanded stem cells were vital over a cultivation period of 28 days after insertion. Neither cytotoxic nor proliferation inhibiting effects could be observed. Because of their thermal fixation, the textile scaffolds possess high primary stability with permanent interconnectivity pore structure, which is essential for the implant supply and vascular proliferation, and the possibility of a combination with differentiation and growth factors.
Conclusions: Our data suggests that the presented concept of combining textile space fabrics and mesenchymal stem cells with conventional bone replacement materials could simplify cranioplasty and represents an auspicious approach for improved and safe skull defect reconstruction.
