Axially vascularized bone substitutes: a systematic review of literature and presentation of a novel model.
BACKGROUND
The creation of axially vascularized bone substitutes (AVBS) has been successfully demonstrated in several animal models. One prototypical indication is bone replacement in patients with previously irradiated defect sites, such as in the mandibular region. The downside of current clinical practice, when free fibular or scapular grafts are used, is the creation of significant donor site morbidity.


METHODS
Based on our previous experiments, we extended the creation of an arterio-venous loop to generate vascularized bone substitutes to a new defect model in the goat mandibula. In this report, we review the literature regarding different models for axially vascularized bone substitutes and present a novel model demonstrating the feasibility of combining this model with synthetic porous scaffold materials and biological tissue adhesives to grow cells and tissue.


RESULTS
We were able to show the principal possibility to generate axially vascularized bony substitutes in vivo in goat mandibular defects harnessing the regenerative capacity of the living organism and completely avoiding donor site morbidity.


CONCLUSIONS
From our findings, we conclude that this novel model may well offer new perspectives for orthopedic and traumatic bone defects that might benefit from the reduction of donor site morbidity.
Faculty of Medicine, Department of Head and Neck and Endocrine Surgery, University of Alexandria, ElKhartoom square, Elazarita, Alexandria, Egypt. dr_ae@hotmail.com
A M
AM
Eweida
A S
AS
Nabawi
H A
HA
Elhammady
M K
MK
Marei
M R
MR
Khalil
M S
MS
Shawky
A
A
Arkudas
J P
JP
Beier
F
F
Unglaub
U
U
Kneser
R E
RE
Horch
D000818:Animals; D001158:Arteries / Q000601:surgery*; D001861:Bone Regeneration; D018786:Bone Substitutes; D016025:Bone Transplantation; D004195:Disease Models, Animal; D008334:Mandible / Q000098:blood supply*; D013524:Surgical Flaps / Q000098:blood supply*; D000267:Tissue Adhesions; D054457:Tissue Scaffolds; D014656:Vascular Surgical Procedures; D014680:Veins / Q000601:surgery*
D018786:Bone Substitutes