Relevance for the Practicing Surgeon

Although tissue engineering is far from being a widely applied clinical treatment, the field has taken steps closer toward clinical applications. With the recent shift of research efforts beyond the United States to Europe and Asia, the number of clinical studies has increased significantly. In addition to the clinically approved tissue-engineered skin and cartilage products, several promising clinical studies are currently in progress. The replacement of a human phalanx by a tissue-engineered construct showed good results, but generated questions about the therapeutic value and improvement compared with conventional treatments [71]. This discussion indicates that tissue engineering is not the solution to every medical problem requiring tissue replacement. Tissue engineering must be seen within the context of present-day medicine. Clinical applications must be chosen carefully and compared critically to existing treatment modalities. In addition to bone, urological tissue is in the early stages of clinical application [173]. The perhaps most advanced clinical trials are currently being conducted in Japan, and the promising results are indicative of the clinical potential of tissue engineering. The clinical success of tissue engineering will require an interdisciplinary approach and depend critically on continued collaborations between engineers, scientists, and clinicians.

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