PRELAMINATION - GROWING TISSUES FOR TRANSPLANT

Doctors at Johns Hopkins have successfully grown an ear on a woman's arm.

Sherrie Walters', 42, ear was grown on her arm to replace one removed after developing basal cell carcinoma in 2008.

The illness meant that she had her ear, a piece of her skull and her ear canal removed.She is now the first person ever to have their ear regrown using cartilage taken from her rib.

The team of surgeons, led by Dr. Patrick Byrne, an associate professor in otolaryngology-head and neck surgery at the Johns Hopkins University School of Medicine, took rib cartilage to shape a new ear.

In an experimental procedure, it was placed under the skin and let grow for four months before being transplanted into her head approximately six months ago.The decision to place the ear under the skin on the forearm was an unprecedented procedure.

"We implanted the ear near the wrist and just let it live there so all the skin could grow".

WHAT IS PRELAMINATION?  Involves manipulation of the flap 

prior to transfer and creating a multilayered flap prior to transfer.

 Especially for head and neck reconstruction.

A man from China's Fujian province has had a new nose grown on

 his forehead following a traffic accident last year.

The 22-year-old man suffered severe nasal trauma and his 

subsequent treatment caused his nasal cartilage to corrode. 

Surgeons came up with the idea of growing a nose on his forehead.

After nine months of growth, surgeons say that the the nose is in 

good shape and the transplant.

What are the layers, and why is each layer important?

Take the nose, for example. If the damage from disease or injury goes all the way through, then all three layers must be replaced: the skin on the outside, the cartilage, and the soft lining inside. The forehead skin tends to be the best match for the outside skin from an area called the paramedian forehead flap.Cartilage creates a three-dimensional form that will resemble a nose, and the choice to take it from the rib cage is pretty straightforward. A lot of nuance and challenge comes from the internal layer, the lining of the nose.

So how do you help ensure a good blood supply?

Prelamination, or implantation of tissue or cartilage to a skin flap while preserving blood supply, provides that inner layer. You put a skin graft on the undersurface of the skin flap, then allow it to heal under the surface of the forehead, so you've created two layers. You can then split the layers and put cartilage grafts inside, like a sandwich.

SOURCE: GLOBALPOST.COM
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