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With the advent of the era of tissue engineering (TE), experimental settings have been developed that allow for a defined environment with optimised cell growth conditions and/or the production of specific substitutes. These isolated systems have been termed "bioreactors". By translating the principles of bioreactors into an in vivo context, advances in biomaterial sciences and cell biology have been merged into an integrative research concept. Even today, in the age of regenerative Medicine (RegMed) the transfer of experimental in vitro findings into a clinical in vivo approach still remains a vast challenge. In order to fulfil these specific requirements bioreactors had to be defined anew. Latest advances in areas like reconstructive medicine (the arteriovenous loop as a means of organogenesis) or modern wound management (topical negative pressure therapy as a perfusion bioreactor) give new impulses towards the translation of Reg-Med concepts into the clinical routine.