Tissue Engineering of Composite Soft Tissue Grafts for Craniomaxillofacial Reconstruction

Tissue-engineered composite soft tissue grafts are necessary to aid in the repair of complex soft tissue defects that are a result of trauma, tumor ablation, or congenital deformities. In the reconstruction of craniomaxillofacial soft tissue defects, one must consider the functional and esthetic aspects as well as anatomical restoration. Tissue engineering and regenerative medicine face several barriers that prevent translation of in vitro technology to the clinical arena: (1) the inability to create composite soft tissue structures that contain striated muscle, skin and mucosa with a mucocutaneous junction (lip), and (2) the difficulty to develop a perfusion system (blood vessels) to supply nutrition for large segments of tissue created in vitro. Lack of tissue perfusion significantly limits survival of in vitro-produced complex composite soft tissue implants. In this chapter, we present a unique and novel surgical approach that overcomes the tissue engineering barriers to complex composite soft tissue reconstruction by utilizing a prevascularized prelaminated microvascular-free flap for functional reconstruction of the lips.