Transformation of a prefabricated hydroxyapatite/osteogenic protein-1 implant into a vascularised pedicled bone flap in the human chest.
We describe the intramuscular transformation of a hydroxyapatite/osteogenic protein-1 (HA/OP-1) composite implant, into a vascularised pedicled bone flap useful for reconstruction of a hemi-mandible. Extraskeletal induction of a bone flap for transplantation was achieved without the addition of harvested bone, bone marrow, or stem cells. Five months after apparent clinical success, an MRSA infection of the graft led to its failure. The background to ectopically induced bone flaps is introduced, with our experience in a human case presented. The results from this emerging biotechnology are discussed in the light of limited human clinical experience.
Heliotis
M
M
Department of Maxillofacial Surgery, Queen Victoria Hospital, Holtye Road, East Grinstead, West Sussex RH19 3DZ, UK. chacma@btinternet.com
Lavery
K M
KM
Ripamonti
U
U
Tsiridis
E
E
di Silvio
L
L
D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D017886:Durapatite / Q000627:therapeutic use*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery; D016106:Methicillin Resistance; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery; D010012:Osteogenesis / Q000502:physiology; D010369:Pectoralis Muscles / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000379:methods; D013203:Staphylococcal Infections / Q000382:microbiology; D013524:Surgical Flaps / Q000098:blood supply; D013530:Surgical Wound Infection / Q000382:microbiology; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*
C525819:BMP7 protein, human; D055419:Bone Morphogenetic Protein 7; D019485:Bone Morphogenetic Proteins; D018786:Bone Substitutes; D016212:Transforming Growth Factor beta; D017886:Durapatite