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Intraoperative Bioprinting Meets Microsurgery: Accelerating Vascularization For Tissue Reconstruction
Jessica Collins El-Mallah, D.O.1, Miji Yeo, PhD
2, Summer Horchler, DO
3, Olivia Waldron, BS
4, Mary Landmesser, BS
3, Dishary Banerjee, BS
1, MIngjie Sun, MD
4, Ibrahim Ozbolat, PhD
2, Dino J. Ravnic, DO
1.
1Penn State Hershey Medical Center, Hershey, PA, USA, 2Penn State University, State College, PA, USA, 3Penn State Hershey College of Medicine, Hershey, PA, USA, 4Penn State College of Medicine, Hershey, PA, USA.
PURPOSE: Intraoperative bioprinting (IOB) of scaffolds offers a new frontier in reconstructive surgery. Scaffold success relies on rapid vascularization, which can be enhanced through endothelial cell seeding. We have described micropuncture (“MP”), a surgical technique in which the recipient blood vessel wall is precisely disrupted to expedite scaffold vascularization. In this study we examine the combined effects of MP and cell-seeding in a collagen-based bioink at short and long timepoints, hypothesizing that the combination will promote vascularization that continues with time.
METHODS: In a rat model MP was performed on femoral vessels on one hindlimb while the other served as control. Bioink scaffolds with or without rat aortic endothelial cells (“cell”) were printed over the vessels using an extrusion bioprinter. On POD10 or 40, fluorescence angiography was performed and vascular metrics were evaluated with artificial intelligence.
RESULTS: All experimental groups demonstrated significantly increased vascular surface area compared to the POD10 bioink only control, and these results were augmented with time. The greatest vascularization was observed in the Bioink+Cell+MP group at POD40.
The addition of MP alone also significantly augmented vascular development (Figure 1).
CONCLUSION: This study introduces a new approach that combines MP and IOB to create vascularized tissue. Both MP and cell seeding show potential as effective pro-angiogenic strategies. Future research will focus on utilizing these techniques to develop in-situ flaps for tissue reconstruction.
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