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Oral presentation

"Tissue Engineering is the application of the principles and methods of engineering and the life sciences toward the fundamental understanding of structure / function relationships in normal and pathological mammalian tissues and the development of biological substitutes to restore, maintain, or improve functions" (Definition Tissue Engineering. National Science Foundation, Lake Tahoe, USA, 1988).

In other words, Tissue Engineering can best be described as "rebuilding damaged tissue". By fulfilling this purpose, Tissue Engineering is an interdisciplinary domain that combines Engineering and Materials science with Medicine. The goal is to restore damaged tissue or improve its function. As regards skin, damaged tissue can, for example, mean that a patient suffers from a chronic wound that will not heal. A frequent form of this is the so-called "open leg" due to chronic venous insufficiency. Cartilage, for example, can be damaged by a sports injury or arthrosis. However, cartilage itself has no healing tendency, as already stated by Hunter in 1743: "From Hippocrates to the present age it is universally allowed that ulcerated cartilage is a troublesome thing and that, once destroyed, is not repaired." Therefore, the autologous cartilage transplantation (ACT), up to today clinically used for more than 10 years, has become a clinical standard for some special indications.

All autologous Tissue Engineering products are regulated in Germany as not licensable medicinal products. This means, the precondition for the production and marketing is a manufacturing authorisation according to the German Drug Law (AMG), which includes the complete fulfilment of the Good Manufacturing Practise (GMP) – Guidelines according to the AMG. However, there are different regulatory stand point of view in other European Countries including the Eastern European Countries, which at present, places the European Tissue Engineering industry and therefore also the products possibly available throughout Europe at a disadvantage to the US where a new joint device/pharmaceutical directive is currently under discussion.

The principle behind Tissue Engineering is simple: first, the doctor removes a few cells from the patient and these are then multiplied by cultures in a certified laboratory. At the end of the cultivation period the multiplied cells can then be embedded in a scaffold. In this way, a complete living tissue substitute grows that the doctor can then transplant back into the patient.

Damaged tissue, for example "open leg", often means that a patient suffers from the condition for a long period, at times in fact for several years. The quality of everyday life is substantially impaired by such a chronic problem. And chronic illnesses are also a great strain on the healthcare system. Tissue Engineering endeavours to provide new treatment methods where customary methods do not deliver the required success or where to date no alternative therapies exist.

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