title: Combining regenerative medicine strategies to provide durable reconstructive options: auricular cartilage tissue engineering.
abstract: Recent advances in regenerative medicine place us in a unique position to improve the quality of engineered tissue. We use auricular cartilage as an exemplar to illustrate how the use of tissue-specific adult stem cells, assembly through additive manufacturing and improved understanding of postnatal tissue maturation will allow us to more accurately replicate native tissue anisotropy. This review highlights the limitations of autologous auricular reconstruction, including donor site morbidity, technical considerations and long-term complications. Current tissue-engineered auricular constructs implanted into immune-competent animal models have been observed to undergo inflammation, fibrosis, foreign body reaction, calcification and degradation. Combining biomimetic regenerative medicine strategies will allow us to improve tissue-engineered auricular cartilage with respect to biochemical composition and functionality, as well as microstructural organization and overall shape. Creating functional and durable tissue has the potential to shift the paradigm in reconstructive surgery by obviating the need for donor sites.
authors.affiliation: Reconstructive Surgery & Regenerative Medicine Research Group, Swansea University Medical School, Room 509, ILS2, Swansea, SA2 8SS, UK. zitajessop@gmail.com.|The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, SA6 6NL, UK. zitajessop@gmail.com.
authors.forename: Zita M
authors.initials: ZM
authors.lastname: Jessop
authors.affiliation: Reconstructive Surgery & Regenerative Medicine Research Group, Swansea University Medical School, Room 509, ILS2, Swansea, SA2 8SS, UK. umaidr@googlemail.co.uk.|The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, SA6 6NL, UK. umaidr@googlemail.co.uk.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Javed
authors.affiliation: Department of Orthopaedics, University Medical Center Utrecht, Utrecht, 3584 CX, The Netherlands. Otto@students.uu.nl.|Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. Otto@students.uu.nl.
authors.forename: Iris A
authors.initials: IA
authors.lastname: Otto
authors.affiliation: Reconstructive Surgery & Regenerative Medicine Research Group, Swansea University Medical School, Room 509, ILS2, Swansea, SA2 8SS, UK. combellack@gmail.com.|The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, SA6 6NL, UK. combellack@gmail.com.
authors.forename: Emman J
authors.initials: EJ
authors.lastname: Combellack
authors.affiliation: Reconstructive Surgery & Regenerative Medicine Research Group, Swansea University Medical School, Room 509, ILS2, Swansea, SA2 8SS, UK. morga1985@hotmail.co.uk.|The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, SA6 6NL, UK. morga1985@hotmail.co.uk.
authors.forename: Siân
authors.initials: S
authors.lastname: Morgan
authors.affiliation: Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. Breugem@umcutrecht.nl.
authors.forename: Corstiaan C
authors.initials: CC
authors.lastname: Breugem
authors.affiliation: Reconstructive Surgery & Regenerative Medicine Research Group, Swansea University Medical School, Room 509, ILS2, Swansea, SA2 8SS, UK. archer@swansea.ac.uk.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Archer
authors.affiliation: KhanLab, Swansea University, ILS2, Swansea, SA2 8SS, UK. khan@swansea.ac.uk.
authors.forename: Ilyas M
authors.initials: IM
authors.lastname: Khan
authors.affiliation: Division of Plastic Surgery, University of Mississippi Medical Center, Jackson, Mississippi, 39216, USA. lineaweaver@jmsburncenters.com.
authors.forename: William C
authors.initials: WC
authors.lastname: Lineaweaver
authors.affiliation: Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. Kon@umcutrecht.nl.
authors.forename: Moshe
authors.initials: M
authors.lastname: Kon
authors.affiliation: Department of Orthopaedics, University Medical Center Utrecht, Utrecht, 3584 CX, The Netherlands. Malda@umcutrecht.nl.|Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Domplein 29, 3512 JE, Utrecht, The Netherlands. Malda@umcutrecht.nl.
authors.forename: Jos
authors.initials: J
authors.lastname: Malda
authors.affiliation: Reconstructive Surgery & Regenerative Medicine Research Group, Swansea University Medical School, Room 509, ILS2, Swansea, SA2 8SS, UK. iainwhitaker@fastmail.fm.|The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, SA6 6NL, UK. iainwhitaker@fastmail.fm.
authors.forename: Iain S
authors.initials: IS
authors.lastname: Whitaker
mesh_terms: D000818:Animals; D054644:Ear Auricle / Q000502:physiology; D004425:Ear Cartilage / Q000502:physiology*; D006801:Humans; D009928:Organ Specificity; D019651:Plastic Surgery Procedures; D012038:Regeneration; D044968:Regenerative Medicine; D023822:Tissue Engineering
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