An engineered muscle flap for reconstruction of large soft tissue defects

Yulia Shandalov, Dana Egozi, Jacob Koffler, Dekel Dado-Rosenfeld, David Ben-Shimol, Alina Freiman, Erez Shor, Aviva Kabala, Shulamit Levenberg*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

121 Scopus citations


Large soft tissue defects involve significant tissue loss, requiring surgical reconstruction. Autologous flaps are occasionally scant, demand prolonged transfer surgery, and induce donor site morbidity. The present work set out to fabricate an engineered muscle flap bearing its own functional vascular pedicle for repair of a large soft tissue defect in mice. Full-thickness abdominal wall defect was reconstructed using this engineered vascular muscle flap. A 3D engineered tissue constructed of a porous, biodegradable polymer scaffold embedded with endothelial cells, fibroblasts, and/or myoblasts was cultured in vitro and then implanted around the femoral artery and veins before being transferred, as an axial flap, with its vascular pedicle to reconstruct a full-thickness abdominal wall defect in the same mouse. Within 1 wk of implantation, scaffolds showed extensive functional vascular density and perfusion and anastomosis with host vessels. At 1 wk posttransfer, the engineered muscle flaps were highly vascularized, were well-integrated within the surrounding tissue, and featured sufficient mechanical strength to support the abdominal viscera. Thus, the described engineered muscle flap, equipped with an autologous vascular pedicle, constitutes an effective tool for reconstruction of large defects, thereby circumventing the need for both harvesting autologous flaps and postoperative scarification.

Original languageEnglish
Pages (from-to)6010-6015
Number of pages6
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number16
StatePublished - 22 Apr 2014
Externally publishedYes


FundersFunder number
Seventh Framework Programme281501


    • Reconstructive surgery
    • Tissue engineering
    • Tissue regeneration
    • Vascularization


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