Engineering Vascularized Transplantable Soft Tissue Free Flaps in Sheep Using the Arteriovenous Loop Technique

Falkner F, Mayer SA, Thomas B, Dimmler A, Heimel P, Schneider K, Kengelbach-Weigand A, Kramer AM, Schaefer RL, Panayi AC, Sleeman JP, Thiele W, Podesser B, Bergmeister H, Kneser U, Schmidt VJ, Bigdeli AK (2025)

Publication Type: Journal article

Publication year: 2025

Journal

Tissue Engineering - Part A Mary Ann Liebert

DOI: 10.1177/19373341251372950

Abstract

The aim of this study was to grow axially vascularized soft tissue flaps in sheep using the arteriovenous loop (AVL) technique to be transplanted for defect reconstruction. This technique may be a promising alternative to conventional free flaps to further reduce flap donor site morbidity. In this pilot study, AVLs (n = 12) were created in the groins of six sheep, placed into an isolation chamber, and embedded in Matriderm®. Tissue volume, vascularization, and cell proliferation were assessed on postoperative day (POD) 28 using immunohistochemical staining and microcomputed tomography (µCT). Four AVL free flaps were microsurgically anastomosed to the neck vessels in a standardized defect sheep model on POD 28. Defect closure and intrinsically vascularized scaffold-based bioengineered flaps (IVSBs) flap perfusion were studied by angiography and histology 10 days after transplantation. One IVSB flap was lost due to chamber infection. At POD 28, the remaining 11 IVSB flaps had filled the isolation chamber. Histological examination and µCT analysis of seven IVSB flaps verified homogeneous microvascular networks within the flaps. The mean number of microvessels, vessel volume, and the percentage of proliferating cells increased significantly over time. In the defect model, all four transplanted flaps showed macroscopically, angiographically, and histologically stable defect closure 10 days after transplantation, with homogeneous vascular integration into the surrounding tissue. This pilot study demonstrates that in a large animal model complex, defects can be reconstructed using free IVSB flaps with a clinically relevant tissue volume. These data provide the preclinical proof prior to human application.

Authors with CRIS profile

Annika Kengelbach-Weigand Department of Plastic and Hand Surgery

Involved external institutions

Ludwig Boltzmann Institut für Traumatologie / Ludwig Boltzmann Institute for Traumatology AT Austria (AT) BG Unfallklinik Ludwigshafen (BGU) / BG Hospital Ludwigshafen DE Germany (DE) Kantonsspital St.Gallen CH Switzerland (CH) St. Vincentius-Kliniken / Vincentius-Diakonissen-Kliniken / ViDia Christliche Kliniken Karlsruhe DE Germany (DE) Medizinische Universität Wien AT Austria (AT) Albert-Ludwigs-Universität Freiburg DE Germany (DE) Universitätsklinikum Mannheim / University Medical Centre Mannheim (Universitätsmedizin Mannheim) DE Germany (DE)

How to cite

APA:

Falkner, F., Mayer, S.A., Thomas, B., Dimmler, A., Heimel, P., Schneider, K.,... Bigdeli, A.K. (2025). Engineering Vascularized Transplantable Soft Tissue Free Flaps in Sheep Using the Arteriovenous Loop Technique. Tissue Engineering - Part A. https://doi.org/10.1177/19373341251372950

MLA:

Falkner, Florian, et al. "Engineering Vascularized Transplantable Soft Tissue Free Flaps in Sheep Using the Arteriovenous Loop Technique." Tissue Engineering - Part A (2025).

BibTeX: Download