Week 6

Our time in New York City approaches its end at the close of our 6th week of being immersed. Last week, I talked about an alternative strategy to tissue grafting and flaps. The use of tissue grafts and flaps to fill defects in existing tissue is a tool that is widely employed by reconstructive and plastic surgeons. One surgery I witnessed this week demonstrated a prime example. In this case, the patient developed a tumor on their tongue that had to be excised. As with any typical head and neck procedure, this surgery would be relatively complicated with large of amounts of tissue either being removed or mobilized to completely remove the tumor. After the tumor was removed, the patient was missing most of their tongue, along with a large void inside their mouth and through their neck. To reconstruct the missing tissue, Dr. Spector mobilized a pectoral flap and rotated it into the position of the tissue defect, similar to a case I observed earlier in the summer. Additionally, part of the pectoral muscle was grafted to the missing portion of the tongue. The main reasons why these flaps are used is due to the blood supply being intact. One of the most important aspects of wound healing is an ample blood supply to deliver nutrients, cells, and antibiotics. Without these elements, any tissue replacement would fail and the wound wouldn’t heal. Because of this, one of the challenges associated with tissue engineering is to create fully vascularized constructs, the focus of Dr. Spector’s research. When our current technology allows us to create tissue replacements with existing vasculature, we may be able to avoid having to harvest tissue from another site of the body along with the possible complications.

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