New strategies to repair polytraumatic injuries

Juliana Amaral Passipieri

War fighters suffer extensive loss of muscle tissue during traumatic craniofacial injuries. These volumetric muscle loss (VML) injuries are characterized by a degree of muscle tissue loss that exceeds the endogenous regenerative capacity of muscle resulting in permanent functional deficits. There are few options today for cosmetic and functional restoration of VML injuries. Moreover, all VML injuries are not equivalent, and represent a virtual continuum of magnitudes and complexities, that will likely be treated by a corresponding spectrum of technologies. The goal of this project is to restore muscle-nerve interfaces through complex biomaterial designs, as a route to foster improved muscle regeneration and function during larger tissue defect repairs following craniofacial and extremity trauma to wounded warriors. Nerve-muscle interfaces/integrations are not well understood and little attention is given in terms of how to reinnervate injured tissues. To this end we are developing a novel hybrid Muscle-Nerve Tissue Integration System (MuNTIS). Our overall goal is to develop new techniques to address the need for large muscle defect regeneration during prolonged periods of denervation (i.e., extensive muscle re-innervation). This work is part of the Craniofacial Regeneration program of the Armed Forces Institute of Regenerative Medicine (CF-13; AFIRM). Our key faculty collaborators are Kacy Marra at the University of Pittsburgh and David Kaplan from Tufts University.

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Figure 1: Schematic depiction of overall approach to simultaneously enhance nerve and muscle regeneration to improve functional outcomes in wounded warriors.