Ben Schilling

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The Impact of Plastic Surgery Training on Family Planning and Prenatal Health

Plastic Reconstructive Surgery Nov

Authors: DA Bourne; W Chen; BK Schilling; E Littleton; KM Washington; C De La Cruz Background: Plastic surgery trainees who wish to start a family face challenges. This is the first study to collect data directly from residents and fellows to understand issues surrounding childbearing and to propose solutions. Methods: Following institutional review board approval, an anonymous survey was distributed to all current plastic surgery residents and fellows in the United States. Data regarding demographics, obstetrical complications, parental leave, breastfeeding, and use of assisted reproductive technology were collected. Results: The survey was completed by 307 trainees, for a resident response rate of 27.0 percent. Mean age of the responde

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A Report of Gender Bias and Sexual Harassment in Current Plastic Surgery Training: A National Survey

Plastic Reconstructive Surgery Jun

Background: Gender bias and sexual misconduct continue to pervade medicine. The authors hypothesize that gender bias and sexual misconduct disproportionately and negatively affect female plastic surgery trainees. Methods: A national survey of plastic surgery trainees (2018-19) was conducted using previously validated sexual harassment surveys adapted for relevance. Respondents were queried about experiences with workplace gender bias and harassment; personal and professional impact; and reporting practices. Analyses included chi-square, logistic regression, and ANOVA. Significance was accepted for values of p<0.05. Results: There were 236 responses (115 female; 20.1% response rate). Most respondents were Caucasian residents (n=123). The f

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The Future of Microsurgery: Vascularized Composite Allotransplantation and Engineering Vascularized Tissue

Journal of Hand and Microsurgery Apr

Authors: FM Egro, BK Schilling, JD Fisher, R Saadoun, JP Rubin, KG Marra, MG Solari Abstract: Background: Microsurgical techniques have revolutionized the field of reconstructive surgery and are the mainstay for complex soft tissue reconstruction. However, their limitations have promoted the development of viable alternatives. This article seeks to explore technologies that have the potential of revolutionizing microsurgical reconstruction as it is currently known, reflect on current and future vascularized composite allotransplantation (VCA) practices, as well as describe the basic science within emerging technologies and their potential translational applications. Methods: A literature review was performed of the technologies that may

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Injectable Allograft Adipose Matrix Promotes Adipogenic Tissue Remodeling in the Nude Mouse and Human

Plastic Reconstructive Surgery Jan

Authors: LE Kokai, BK Schilling, E Chnari, YC Huang, E Imming, A Karunamurthy, R Khouri, R D’Amico, KG Marra, JP Rubin Background: Adipose tissue reaches cellular stasis after puberty, leaving adipocytes unable to significantly expand or renew under normal physiologic conditions. This is problematic in progressive lipodystrophies, in instances of scarring, and in soft-tissue damage. Methods: A process comprising separate steps of removing lipid and cellular materials from adipose tissue has been developed, creating an ambient temperature-stable allograft adipose matrix. Growth factors and matrix proteins relevant to angiogenesis and adipogenesis were identified by enzyme-linked immunosorbent assay and immunohistochemistry, and subcutaneo

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Long-Gap Peripheral Nerve Repair Through Sustained Release of a Neurotrophic Factor in Non-human Primates

Science Translational Medicine Jan

Severe injuries to peripheral nerves are challenging to repair. Standard-of-care treatment for nerve gaps >2 to 3 centimeters is autografting; however, autografting can result in neuroma formation, loss of sensory function at the donor site, and increased operative time. To address the need for a synthetic nerve conduit to treat large nerve gaps, we investigated a biodegradable poly(caprolactone) (PCL) conduit with embedded double-walled polymeric microspheres encapsulating glial cell line–derived neurotrophic factor (GDNF) capable of providing a sustained release of GDNF for >50 days in a 5-centimeter nerve defect in a rhesus macaque model. The GDNF-eluting conduit (PCL/GDNF) was compared to a median nerve autograft and a PCL conduit conta

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Adipose Tissue-Derived Stem Cells: Sources and Therapeutic Applications

Elsevier Encyclopedia of Tissue Engineering and Regenerative Medicine

Authors: BK Schilling & KG Marra Since their discovery and characterization, adipose-derived stem cells (ASC) have shown exceptional potential for regenerative clinical therapies. Recent investigations have advanced the knowledge of their pluripotent differentiation pathways in vitro, and have provided new insights into the mechanisms by which ASCs communicate within their microenvironment in vivo. Their secretory paracrine and trophic factors have gained considerable traction as key mediators, particularly in immunomodulation. Given the ease of acquisition relative to other adult stem cells, considerable international effort is being invested toward indications for ASC therapies in the clinic, further developing the field of translational

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Preclinical Optimization of a Shelf-Ready, Human-Derived, Decellularized Allograft Adipose Matrix

Tissue Engineering Part A Feb

Authors: G Giatsidis, J Succar, A Haddad, G Lago, C Schaffer, X Wang, BK Schilling, E Chnari, H Matsumine; DP Orgill Autologous adipose tissue grafting is a popular strategy for soft tissue reconstruction; yet its clinical outcomes are often suboptimal. Lack of metabolic and architectural support at recipient sites affects the capacity of cellularized autologous grafts to survive after transplantation. Allograft adipose matrices (AAMs) are composed of extracellular matrices of adipose tissue. They can provide critical biophysical cues and create a supportive microenvironment for autologous graft survival. Using murine models, we have optimized the in vivo use of an injectable AAM obtained from human cadaveric tissue and processed to remove

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Adipose Stem Cells Enhance Nerve Regeneration and Muscle Function in a Peroneal Nerve Ablation Model

Tissue Engineering Part A May

Authors: JA Passipieri, J Dienes, J Frank, J Glazier, A Portel, KP Venkatesh, JM Bliley, D Grybowski, BK Schilling, KG Marra, GJ Christ Severe peripheral nerve injuries have devastating consequences on the quality of life in affected patients, and they represent a significant unmet medical need. Destruction of nerve fibers results in denervation of targeted muscles, which, subsequently, undergo progressive atrophy and loss of function. Timely restoration of neural innervation to muscle fibers is crucial to the preservation of muscle homeostasis and function. The goal of this study was to evaluate the impact of addition of adipose stem cells (ASCs) to polycaprolactone (PCL) nerve conduit guides on peripheral nerve repair and functional musc

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Comparison of Clinically Relevant Adipose Preparations on Articular Chondrocyte Phenotype in a Novel In Vitro Co-Culture

Stem Cells and Development Oct

Authors: LE Kokai, J Chen, D Wang, S Wang, FM Egro, BK Schilling, H Sun, A Ejaz, JP Rubin, JA Gusenoff, N Vo, K Onishi, and G Sowa Abstract: Adipose therapeutics, including isolated cell fractions and tissue emulsifications, have been explored for osteoarthritis (OA) treatment; however, the optimal preparation method and bioactive tissue component for healing has yet to be determined. This in vitro study compared the effects of adipose preparations on cultured knee chondrocytes. De-identified human articular chondrocytes were co-cultured with adipose preparations for 36 or 72 h. Human adipose tissues were obtained from abdominal panniculectomy procedures and processed using three different techniques: enzymatic digestion to release stromal

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Adipose-Derived Stem Cells Delay Muscle Atrophy after Peripheral Nerve Injury in the Rodent Model

Muscle Nerve Jan

Authors: BK Schilling & MA Schusterman, D Kim; AJ Repko, KC Klett; GJ Christ; KG Marra Introduction: Injuries to peripheral nerves cause distal muscle atrophy. The effects of adipose‐derived stem cell (ASC) injections into a muscle after injury were examined. Methods: A 1.5 cm defect in the rat sciatic nerve was created, resulting in gastrocnemius muscle atrophy. The nerve defect was repaired with autograft; DiR‐labeled ASCs were injected into the gastrocnemius immediately postoperatively. Quantitation of gross musculature and muscle fiber area, cell survival, fibrosis, lipid deposition, inflammation, and reconstructive responses were investigated. Results: ASCs were identified in the muscle at 6 weeks, where injections showed increased mu

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Design and Fabrication of a 3D-Printed Perfusion Device for Tissue Engineering Applications

Tissue Engineering Part A Mar

Authors: BK Schilling, K Lamberti, MJ Snowden, K Byrd, JS Baker, C Komatsu, MG Solari, KG Marra Tissue decellularization for generating extracellular matrices has become a staple of regenerative medicine in the recent decades, extending from the research setting to clinical usage. Although methods and protocols for tissue decellularization are abundant throughout the literature, they can be time intensive and typically require specific overhead in terms of equipment. To reduce these barriers to entry, a functional and reproducible prototype of a tissue infusion/perfusion device (TIPD) has been designed and fabricated using three-dimensional printed parts in conjunction with commercially available components. This TIPD forms a system compos

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Clinical Evaluation of an off-the-shelf allogeneic matrix for Soft Tissue Reconstruction

PRS Global Open Jan

Authors: LE Kokai, WN Sivak, BK Schilling, A Karunamurthy, FM Egro, MA Schusterman, DM Minteer, P Simon, JP Rubin Background: Biomaterials derived from human adipose extracellular matrix have shown promise in vitro and in animal studies as an off-the-shelf adipogenic matrix for sustained volume replacement. Herein, we report the results of a randomized prospective study conducted with allograft adipose matrix (AAM) grafted into the pannus of presurgical abdominoplasty patients 3 or 6 months before scheduled surgery. This is the first report of a longitudinal histologic analysis of AAM in clinical use. Methods: Ten healthy patients undergoing elective abdominoplasty were recruited to receive AAM before surgery. Enrolled subjects were rand

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Adipose stem cells for peripheral nerve engineering

Scientific Principles of Adipose Stem Cells Sep

Authors: BK Schilling, GE Panagis, JS Baker, KG Marra Abstract: US healthcare expenditures remain in the hundreds of billions of dollars for treating peripheral nerve injury (PNI) every year, and therapies that advance the standard of care are critically necessary. Further, there is a profound socioeconomic impact resulting from PNI, as four of every 10 individuals experiencing these injuries do not return to work 1 year postoperatively owing to residual complications. As the prevalence and acceptance of clinical cellular therapies continue to increase, cell-based treatments that complement or augment current care for nerve injury are being introduced. The use of adipose-derived stem cells (ASCs) may be the ideal candidate for such investi

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Improved Testing and Design of Intubation Boxes During the COVID-19 Pandemic

Annals of Emergency Medicine Sep

Authors: DM Turer & CH Good, BK Schilling, RW Turer, NR Karlowsky, LA Dvoracek, H Ban, JS Chang, JP Rubin Study objective: Throughout the coronavirus disease 2019 pandemic, many emergency departments have been using passive protective enclosures (“intubation boxes”) during intubation. The effectiveness of these enclosures remains uncertain. We sought to quantify their ability to contain aerosols using industry standard test protocols. Methods: We tested a commercially available passive protective enclosure representing the most common design and compared this with a modified enclosure that incorporated a vacuum system for active air filtration during simulated intubations and negative-pressure isolation. We evaluated the enclosures by usi

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Biodegradable Silk Catheters for the Delivery of Therapeutics across Anatomical Repair Sites

Journal of Biomedical Materials Research Part B Apr

Authors: J Brown, L Tozzi, BK Schilling, A Kelmendi-Doko, A Truong, MJ Rodriguez, ES Gil, R Sucsy, J Valentin, B Philips, KG Marra, JP Rubin, DL Kaplan Biodegradable silk catheters for the delivery of therapeutics are designed with a focus on creating porous gradients that can direct the release of molecules away from the implantation site. Though suitable for a range of applications, these catheters are designed for drug delivery to transplanted adipose tissue in patients having undergone a fat grafting procedure. A common complication for fat grafts is the rapid reabsorption of large volume adipose transplants. In order to prolong volume retention, biodegradable catheters can be embedded into transplanted tissue to deliver nutrients, gro

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