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Published on: February 24, 2016
Sandwiching Muscle Acellular Reconstruction Technique: An Early Feasibility Technique for Acute Skeletal Muscle
Andrew Mark Klapper1, Anthony N Dardano1, Gustavo M Huaman2
1From the Department of Surgery, Florida Atlantic University, Boca Raton, FL.
Plastic and Reconstructive Surgery. Global Open
|May 27, 2026
Summary
The novel sandwiching muscle acellular reconstruction technique (SMART) uses biologic scaffolds to bridge skeletal muscle defects. This technique shows early promise for functional reconstruction in trauma patients.
Area of Science:
- Regenerative Medicine
- Biomaterials Science
- Trauma Surgery
Background:
- Functional reconstruction of transected skeletal muscle is a significant surgical challenge.
- Full-thickness muscle loss often prevents primary repair, with current methods rarely restoring function.
- Existing techniques primarily focus on coverage rather than anatomical or functional restoration.
Purpose of the Study:
- To evaluate the early technical feasibility of the sandwiching muscle acellular reconstruction technique (SMART).
- To assess SMART's safety and efficacy in bridging acute full-thickness skeletal muscle defects in trauma patients.
- To establish a foundation for prospective studies on SMART using objective endpoints.
Main Methods:
- SMART utilizes dual extracellular matrix biologic scaffolds to bridge acute muscle defects.
- The technique was applied in three trauma cases involving distinct anatomical regions.
- Pre-application involved debridement and antibiotic irrigation, followed by construct application.
Main Results:
- All SMART repairs achieved immediate mechanical continuity.
- No infections or early construct failures were observed.
- Protected motion was tolerated clinically within 8-12 weeks post-repair.
Conclusions:
- SMART demonstrates early technical feasibility for stabilizing acute full-thickness skeletal muscle transections.
- The technique shows potential as a reconstructive solution for significant muscle loss in trauma.
- Further structured prospective evaluation with objective endpoints is warranted.
