Masquelet’s Induced Membrane Technique: A Narrative Review

Abstract

In recent times, Masquelet’s two-stage, induced membrane technique is gaining popularity, and the technique is as simple as debridement and bone grafting, with induced membrane being a source of growth factors and osteo-inductive factors which prevent resorption of the cancellous bone graft, induce new bone formation, and help in consolidation. This review aims to explore Masquelet’s Induced Membrane Technique. The Masquelet technique is a two-stage surgical procedure. The first stage of the procedure involves extensive debridement of the necrotic and infected soft tissue as well as infected bone. The second stage of the technique involves the removal of the spacer and filling the defect with a bone graft. The ideal time for this is when the soft tissues have healed and the membrane is of sufficient strength that it does not disrupt while removing the spacer. At two weeks, the membrane produces abundant vascular endothelial growth factor (VEGF) and transforming growth factor beta (TGF-β). VGEF secreted by macrophages plays an important role in angiogenesis, and TGF-β aids matrix protein synthesis and bone metabolism. Though Masquelt’s technique has evolved over time with innovations and expansion of its indications, the basic principle of creation of an environment (the induced biological membrane) which favours the growth of blood vessels or neo-vascularisation of the graft material placed inside it is a key to success.