Living things need support. A growing vine needs to climb on its posts. Flowers grow on their beds, fertilized and nourished in their allotted spaces. Same goes with the human body, being complex and fragile at the same time ; tissues and organs are supported by connective tissues to be able to function normally.

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Some organs have cells which are able to regenerate when injured. The natural support of these cells is the extracellular matrix proteins which holds them in place. In cases of severe organ damage, we can opt to get these organs from donor organs, but unfortunately some organs, as the skin, cannot be donated. In such cases, we try to heal the organs or support it with artificial substitutes such as conduits. Conduits are artificial passages connecting or channeling fluids between two organs or two parts of an organ .

On these basis, scientists have pioneered researches regarding bio-scaffolding which involves introduction of an artificial substances on which cells or tissues grow in place of an injured or defective tissue. Bio- scaffolding is a crucial part of tissue engineering as it provides the support needed for growing tissues.

These bio-scaffolds can be obtained from natural sources or engineered artificially. An excellent example of natural bio-scaffold is mammalian tissues. Some wounds are difficult to heal with conventional medical support so Dr. Neil H. Strauss and Dr. Richard J. Brietstein conducted a study in which they utilised acellular fetal bovine dermal repair scaffold to heal complex wounds with exposed bones and tendons .

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Decellularized mammalian tissues with intact extracellular matrix compound as collagens is recently reported to be a tremendous help to treat complex wounds. This is very beneficial as complex wounds may easily get complicated with infections or hideous scars if healing of epithelium is impaired. The bio-scaffold provides a tissue bulk on which epithelial regeneration can take place successfully.

Another success in the field of medical research is the use of urinary bladder matrix to treat open wounds. Deep skin wounds were reported to have healed successfully , and researchers also used it to help bone healing. Urinary bladder matrix have helped tissue remodelling and epithelialization which is crucial in the healing process .

Bacterial cellulose is also a widely researched bio-scaffold material by scientists which provides nanocellulose material for tissue engineering purposes. Other uses of it in biomedicine includes topical wound dressing and drug delivery. Gluconacetobacter xylinus (= Acetobacter xylinum) is the bacteria researched as a novel source of scaffold material due to its material properties and degradability. There are many researches associating it with vascular tissue engineering, bone tissue engineering and tissue engineering of urinary conduits in patients having their bladder removed partly or wholly. But to date, there is still much work and researches needed to make this bacterial cellulose a panacea for healing difficulties.

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Apart from naturally obtained compounds in bio-scaffold, scientists have attempted to engineer artificial bio-scaffold material. Bioabsorbable vascular scaffolds (BVS/BAS) is currently being developed to replace vascular stents for conditions as obstructive coronary artery disease. Originally and to date, metallic stents are being used for this condition. The drawbacks of metallic stents are their rigidity that alters with normal vascular functions, also they can induce long-lasting vascular inflammation and they are liable to mal apposition, augment atheromas or even thrombus. BVS/BAS have the advantages of providing the support needed then is absorbed without the permanent metal stent. They may be capable of restoring normal vascular functions without the problems caused by metallic stents.

Another light at the end of the tunnel is the nanofiber scaffolds for the purpose of healing of musculoskeletal and orthopedic injuries. Clinically, surgical treatment of musculoskeletal injuries offers a range of transplantation of autografts/allografts and use of synthetic substitutes composed of metals, ceramics and/or polymers. However, each options comes with their respective limitations. Tissue engineering is also being researched but its requirements of donor organs components remains a major limitations. Thus, electrospun nanofiber material is now considered a hope in this field.

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The world is constantly revolving. In the future, we may be successful in engineering a whole new functioning organ utilising bio-scaffolding. Not to mention, these bio-scaffold materials will perhaps be able to be produced in a massive manner with the success of bio-printers. Imagine printing a fully functioning heart from scratch, impressive right ? This could save many lives in years to come.

As Muslim doctors, our paramount hope is to have our own Muslim scholars in this field. We the young doctors, shall mould the future with our own bare hands. Success is always possible for those who persevere insya-ALLAH.

‘’The human intelligence has two wings; religion and science, without both wings, a man cannot soar to impressive heights in knowledge. ‘’ –Dr Akef Khuwailid.

 

 

Rasyidah Anuar Musaddad is a student of Kasr Al Ainy faculty of medicine, Cairo University and a journalist at The Karyawan Unit for PCK. This article is written as an update of the modern medical practice.