Plastic Surgery Section

The Plastic Surgery Section at the Clinic for Trauma, Hand and Reconstructive Surgery offers the entire spectrum of plastic and reconstructive surgery in cooperation with the Hornheide Specialist Clinic - with a special focus on reconstructive microsurgery.

Head: Univ.-Prof. Dr. med. Tobias Hirsch 
Link: https://www.ukm.de/index.php?id=plastische-chirurgie
Link: https://fachklinik-hornheide.de/fachabteilungen/plastische_chirurgie_muenster/info/index_ger.html

Specialist hotline: 0251 83-51499

 

Experimental Plastic Surgery

In Experimental Plastic Surgery, the focus is on translational research projects in the field of reconstruction, regeneration and transplantation of complex tissues. The focus here is on "vascularized composite allografting", the autologous transplantation of stem cells for skin and soft tissue replacement, as well as the use of innovative flap plastic covering procedures with microvascular connection.

Head: Dr. med. Maximilian Kückelhaus

  • Team

    Wissenschaftliche Mitarbeiter

    Dr. med. Philipp Wiebringhaus, MHBA         

    Charalampos Varnava                                    

    Nils Gebur                                                     

    David Kampshoff                                          

    Dr. med. Henning Knors                                 

    Dr. med. univ. Matthias Aitzetmüller              

    Alexander Dermietzel                                       


    Doktorandinnen

    Cand. med. Julie Klose                                 

    Cand. med. Chiara Mewe                          

    Cand. med. Johanna Thiele                        

    Cand. med. Burcu Yeni                                  

                    

  • Projects

    Translational use of epidermal stem cells for skin regeneration

    A recent treatment we carried out using epidermal stem cells (ESCs) on a young patient who was critically ill with epidermolysis bullosa led us to a highly innovative therapeutic concept: ESCs are obtained from a small skin biopsy, which have enormous potential for regeneration and reproduction. These are isolated, cultivated and processed into a transplant. Once the culture has been created, larger graft areas can be repeatedly produced, which enable the entire body surface to be covered. These transplants differ fundamentally from all transplants in clinical use. The isolated stem cells are the lifelong starting point for skin regeneration and, in contrast to keratinocytes, can guarantee permanent, regenerative defect coverage due to their reproductive potential. Their cultivation in pure culture while maintaining the stem cell capabilities is extremely demanding to this day. Therefore, the provision of ESCs in the required quality and quantity is only mastered by a small number of institutes worldwide. One of them is under the direction of our cooperation partner Professor Michele De Luca in Modena, Italy.

    The patient treated by us developed a new epidermis after transplantation of the ESCs, which is far superior to a defect covering by split-thickness skin grafting. With a transplanted body surface of over 80% with participation of almost all large and small joints, there is no scarring with contractures allowing for full, pain-free movement. One year after the initial transplantation, hair growth and re-oiling of the skin can even be seen, which makes permanent daily dexpanthenol treatment, such as after split-thickness skin transplantation, unnecessary. If these results can be transferred to burn injuries, this would lead to a significantly faster and more extensive convalescence of the affected patients and thus reduce the overall treatment costs as well as accelerate or even enable full reintegration into the social environment and professional life.

     

    Vascularized composite allograft

    Treating injuries involving multiple layers of functional tissue is one of the great tasks of plastic surgery. Due to the fact that conventional reconstructive surgery in the case of pronounced defects in complex structures has its aesthetic and functional limits, the field of vascularized composite allografts (VCA) has developed. Composite tissue is the term used to describe structures that are made up of different base tissues. For example, the face and extremities contain muscles, skin, bones, tendons, cartilage, vessels, nerves and other tissues. In this context, VCA defines the transplantation of a vital functional unit (e.g. hand or face) composed of different tissues from a donor to a recipient. To date, over 200 VCAs have been performed worldwide to reconstruct a wide variety of anatomical structures such as the face, upper and lower extremities and the abdominal wall.

    In close collaboration with the Center for Reconstructive & Restorative Surgery Research at Harvard Medical School in Boston, USA, our research group is investigating a microsurgical model that sheds light on the occurrence of chronic rejection reactions. The data obtained are intended to provide information about the long-term behavior of VCA transplants after a successful operation.

     

    Establishment of a stem cell-colonized alginate implant for autologous soft tissue replacement

    The project deals with the establishment of an implant made of alginate which is colonized with adipogenic stem cells and is to be used to fill in large tissue defects. Particular attention is paid to the sprouting of blood vessels into the implant (vascularization).

     

  • Publications

    Selected Publications

    Klietz ML, Kückelhaus M, Wiebringhaus P, Raschke MJ, Hirsch T, Aitzetmüller MM. Der Einfluss von Gewinnung und Verarbeitung auf das Regenerationspotenzial von Fettstammzellen und die Adipozytenvitalität [The influence of harvesting and processing on the regenerative potential in fat grafting].Handchir Mikrochir Plast Chir. 2021 Aug;53(4):412-419. German. doi: 10.1055/a-1306-0566. Epub 2021 Feb 2. PMID: 33530127.

    Kueckelhaus M, Puscz F, Dermietzel A, Dadras M, Fischer S, Krezdorn N, Pomahac B, Hirsch T. Extracorporeal Perfusion in Vascularized Composite Allotransplantation: Current Concepts and Future Prospects.  Ann Plast Surg. 2018 Jun; 80(6):669-678.

    Hirsch T, Rothoeft T, Teig N, Bauer JW, Pellegrini G, De Rosa L, Scaglione D, Reichelt J, Klausegger A, Kneisz D, Romano O, Secone Seconetti A, Contin R, Enzo E, Jurman I, Carulli S, Jacobsen F, Luecke T, Lehnhardt M, Fischer M, Kueckelhaus M, Quaglino D, Morgante M, Bicciato S, Bondanza S, De Luca M. Regeneration of the entire human epidermis using transgenic stem cells.  Nature. 2017 Nov 16;551(7680):327-332.

    Hirsch T, Laemmle C, Behr B, Lehnhardt M, Jacobsen F, Hoefer D, Kueckelhaus M. Implant for autologous soft tissue reconstruction using an adipose-derived stem cell-colonized alginate scaffold.  J Plast Reconstr Aesthet Surg. 2017 Aug 16. pii: S1748-6815(17)30335-2.

    Klietz ML, Kückelhaus M, Kaiser HW, Raschke MJ, Hirsch T, Aitzetmüller M.Stammzellen in der Regenerativen Medizin – Translationale Hürden und Möglichkeiten zur Überwindung [Stem cells in regenerative medicine - from bench to bedside].Handchir Mikrochir Plast Chir. 2020 Aug;52(4):338-349. German. doi: 10.1055/a-1122-8916. Epub 2020 Apr 7. PMID: 32259866.

    Kueckelhaus M, Dermietzel A, Alhefzi M, Aycart M, Fischer S, Krezdorn N, Wo L, Maarouf O, Riella L, Abdi R, Bueno E, Pomahac B: Acellular hypothermic extracorporeal perfusion extends allowable ischemia time in a porcine whole limb replantation model.  Plast Reconstr Surg. 2017 Apr;139(4):922e-932e.

    Kueckelhaus M, Turk M, Kumamaru KK, Wo L, Bueno EM, Lian CG, Alhefzi M, Aycart MA, Fischer S, De Girolami U, Murphy GF, Rybicki FJ, Pomahac B. Transformation of Face Transplants: Volumetric and Morphologic Graft Changes Resemble Aging After Facial Allotransplantation.  Am J Transplant. 2016 Mar;16(3):968-78.