The development of a full functional foreskin tissue is a challenging project as the skin tissue itself is not attached along its full length, to an organ. Therefore, the constructed tissue relies only on vessels of patient tissue to accept the newly attached tissue-engineered skin.
At present, we are considering a proposal from the Centre Hospitalier Universitaire Vaudois , CHUV Lausanne, Switzerland, aiming towards the possibility of creating and/or repairing circumcised foreskin tissue using tissue regeneration.
The present concept involves the use of stem cells and donor cells from scrotal skin which would allow a very elastic and thin construction. This coupled with stem cells in a technique combined with tissue engineering for the glabrous skin (outer foreskin) and mucuosa (inner foreskin tissue). We believe this could provide a functional foreskin .
The use of different growth factors (HGF) and possibly PTEN inhibitors have the possibility of allowing for peripheral nerve regeneration into the construct from the patient’s existing tissue. Depending on how much of the glabrous skin and mucuosa is needed to be replaced, the construct would be tailored to the individual.
As it seems very difficult and/or not very practical to develop at present an ” in vivo” functional construct for foreskin regeneration, the foreskin construct will be grown “in vitro” and would be inserted at the circumcision scarline surgically. This construct, in theory, would integrate with the existing tissue.This technology requires only one surgical intervention for reconstruction.
The present status of these techniques is:
Scrotal tissue coupled with muscle tissue has been successfully used to create skin grafts.
The swiss group is working on developing pure and usable tissue lines applicable to this project.
The main focus of this proposed project is to address the adaptability of traditional surgical techniques combined with a cellular therapy/tissue engineering approach to aid in tissue reconstruction and repair.
We hope to meet these goals within a two year period of time and to evaluate whether it is possible to produce an “off-theshelf” functional foreskin replacement using stem cells and donor cells.