Historical review of bone prefabrication.

Abstract

Prefabricated tissue represents a bridge between traditional reconstructive surgery and tissue engineering. Initially used in the 1960s in reconstructive plastic surgery, in the 1980s it was also used in orthopedics. The term "prefabricated" indicates a process of neovascularization of a tissue by implanting a vascular pedicle inside the tissue itself; this tissue can be then reimplanted either at a short distance through the pedicle itself, or as a free graft by microvascular anastomosis. The purpose of prefabrication is to build a tissue (muscle, bone, skin, or composite) with characteristics as similar as possible to those of the defect to fill, thus minimizing morbidity in the donor site and improving the reconstructive effectiveness. We present a review of the literature that includes the main experiments performed until now in which a bone segment has been reconstructed using scaffolds and growth factors in relationship to the local blood supply or to the use of a vascular pedicle.