Tissue engineering for breast reconstruction

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  The original idea for this article (https://t.co/OHEmRvd49d) goes back to several years when the authors coming from different scientific horizons, were discussing exciting prospects of the emerging tissue-engineering chamber (TEC) devices for soft tissue reconstruction, thinking of how TEC devices could be improved in order to use them in clinical applications. TEC acts as a bioreactor that facilitates the autologous growth of embedded fat flap. The complementary expertise of the authors in the fields of plastic surgery (Pr. Guerreschi), cell biology (Pr. Marchetti and Dr. Danzé), polymers and 3-D printing technology (Dr. Payen), made it possible to develop the different approaches we used in this study. Thus, using several pre-clinical models, we identified few TEC criteria such as dome permeability and the presence of a flat base that are crucial to the optimum adipose tissue growth. In these conditions, we obtained a large volume of vascularized, viable and mature adipose tissue. Moreover, we used medical-grade bioresorbable polymers that disappear within 3 months and therefore limit the formation of chronic inflammation and fibrosis. Finally, we demonstrated that it is possible to use 3D-printing technology to create custom-made TECs that could be adapted to the individual characteristics of each patient. This article would not have been possible without the efforts of a group of motivated and hardworking clinicians, students and researchers.

Now, we are working on further developing the 3D-printed bio-resorbable TEC in order to translate these approaches to clinical practice such as breast reconstruction. To this end, we have recently created a startup called LATTICE MEDICAL (www.lattice-medical.com) that developp patented TEC devices to generate autologuous soft tissue. The main focus of these 3D-printed bio-resorbable TECs is to allow women recovering from mastectomy for breast cancer. The patented technology involves the use of autologous fat flaps taken near the breast area during the surgery, and then combined with a 3D-printed bio-resorbable TEC. The TEC is made up of a medical grade bio-resorbable polymer, turned into filaments to be 3D printed.

Patented TECs are composed of two specific parts, a scaffold enhancing the adipose regeneration and a shell giving the volume and the shape. The challenge of bio-resorbable TECs is that they need to provide volume and shape stability to allow for adipose tissue growth within the TEC followed by a rapid resorption to avoid chronic fibrosis. The objective is that patients recover a natural breast, without the persistence of  a long-term implant. The use of 3D-printing allows customization based on medical imaging data to best fit the anatomy of each individual. Bio-resorbable TECs thus make it possible to overcome the disadvantages associated with the current post-mastectomy reconstruction techniques, thus it might considerably improve the quality of life of the patients.

Written by Julien Payen & Philippe Marchetti
Correspondence: Julien.payen@lattice-medical.com or philippe.marchetti@chru-lille.fr

Philippe MARCHETTI

Professor, CHU de Lille, INSERM U1277, CNRS UMR9020

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