DelNero_wk4
This week marks the halfway point to the summer, and
fortunately we reached a critical experimental milestone that will set us up
for a successful project end-game. This week we fabricated collagen scaffolds
with microscale features to accelerate cellular and vascular invasion in
acellular grafts in avascular wound beds, such as exposed bone, hardware, or
tendons. We hypothesized that a
network of conduits in the interior of the scaffold will facilitate lateral
invasion over the wound and improve the probability of successful healing. This
week we showed that our fabrication strategy successfully generated these
channels in continuity with surface-accessible micropores. We will implant
these scaffolds in vivo next week to evaluate the functional benefit of our
approach. Meanwhile, we will use the second half of the summer to scale-up
these networks in thick slabs with the hope of generating a vascularized
tissue-bed for artificial free flaps. This week I performed my own miniature
microsurgery anastamosing a rat femoral artery. It was very informative to
manipulate the tiny vessels and instruments, which require a challenging level
of dexterity and sensitivity. Based
on the quality of my sutures, it is certainly best that I am training to be a PhD
doc rather than an MD. Eventually we hope to integrate our constructs with the
animal vasculature, just as we have seen in autologous free flap operations
throughout the summer, so I’ll be practicing under the microscope!
In the clinic, we observed several noteworthy operations.
The first case was a young patient with neurofibroblastoma, which creates
spontaneous neural tumors. We watched the resection of a large mass on her
head, the implantation of an engineered synthetic bone plate in her skull, and the
closure with Dr. Spector. It was especially interesting to see how the plate
was designed to identically match the removed skull. I also had the chance to
see another flap operation and an angioplasty. Perhaps the most enlightening
clinical observation was the outcome of the two patients with abdominal wall
reconstruction last week. Two women experienced nearly identical hernias and
treatments with dramatically different outcomes: one woman was ready to go home
on Wednesday, while the other was in the ICU and delirious. It was an amazing
to realize how even an identical procedure may have such a profound range of
results.
As we launch into the second half of our immersion
experience, I am looking forward to continue participating in new experiences
in the clinic and hopefully generating some exciting experimental results in
the lab.
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