Scientists are poised to perform the first full-face transplant, but a group of surgeons at Stanford University School of Medicine, hopes to eliminate the need for the drastic surgery altogether by learning to regenerate facial skin with stem cells.

Geoffrey Gurtner, MD, an associate professor at Stanford, and his colleagues have applied for a Defense Advanced Research Projects Agency (DARPA) grant that would charge recipients with finding ways to treat soldiers injured in battle. DARPA seeks to develop an integrated package of technologies, some of which could be applied in the first 72 hours after an injury, and others to use during the rest of the rehabilitation phase.

Roxanne Guy, MD, president of the American Society of Plastic Surgeons, believes stem cells and regenerative medicine are likely the future of treating facial injuries, but it’s hard to tell when treatments might arrive.

“How long will it be before we can do those things successfully? I don’t know the answer,” says Guy. “But we’re definitely on the threshold of a breakthrough in that sort of science.”

One lead Gurtner and his colleagues are pursuing involves fetal wound healing. Scientists have known for decades that a fetus can heal without scarring, but they still don’t know the mechanism behind the process. It’s possible, says Gurtner, that the key lies in low oxygen levels within the womb.

Until scientists figure out regeneration, transplantation will likely be an increasingly common option for patients who have suffered severe facial injuries.

[www.wired.com, October 27, 2006]