Printing New Skin to Improve Burn Treatment Looks Promising
One of the most devastating injuries a person can suffer is a burn injury. Aside from the excruciating pain, severe burns disrupt the body’s skin, its outermost layer of protection from temperature changes and, more importantly, infection. Conventionally, severe burns are treated by skin grafts, where skin is removed from another part of a person’s body and placed over the burn. This in turn replaces the protective barrier and allows for the underlying skin to regenerate. The limitations of this procedure are obvious, as a person has only so much available skin to be used. Needless to say, innovation is highly welcomed to solve this issue.
The Wake Forest Institute for Regenerative Medicine is working to develop a system to print new skin directly onto burns for improved and faster healing.1 The printer contains ‘ink’ that consists of cells mixed with fibrinogen, type 1 collagen, and thrombin, which are then printed directly on the wound site using XYZ coordinates.1 The process has been successful when used on nude mice. Additionally, use of a wound scanner will allow the printers to collect all the data needed to created a three dimensional printing plan for the wound bed.1
Bioprinting technology is still in the early stages. Although most of the present-day printing is done by specially-adapted inkjet printers, microvalve printing, extrusion printing, and laser printing techniques have also been studied.2 Other scientists have been working to develop this technology for years. Lothar Koch, Ph.D. and his colleagues have shown that printing of cells does not harm their structure, and predicts that one day, other types of cells, including melanocytes, hair follicle cells, and Schwann cells, will be able to be integrated into the mix. This will allow for the generation of a complete skin replacement appropriate for any location on the human body.3
Koch’s study also determined that printing three dimensional products will not harm cells and will eventually enable the printing of endothelial cells, which are the cells that line the tiny vessels within the skin.3 In other words, the printed skin will have blood flow, further reducing healing time and increasing success rates.
Researcher Cameron Ferris and his team report that the development of bio-ink in microgel form solves the issues of cell settling and clumping, which can lead to occluded printing devices and non-uniform cell deposition. It also permits the utilization of commercially available printers, possibly allowing for more widespread use of the technology.2 They do report, however, that the technology is quite slow, which may limit its usage in non-hospital settings.
Recently, The Wake Forest Institute for Regenerative Medicine (WFIRM) has demonstrated success in both mouse and porcine (pig) subjects. They found that wound healing time was reduced to three weeks, compared with five weeks in control subjects.4 The hope is that the development of a readily available bioprinting technique that can cover wounds quickly, without having to harvest a patient’s unburned skin or use cadaver skin grafts, will greatly reduce the opportunity for infection and other burn wound complications.
1 Binder, K.W. 2011. In situ bioprinting of the skin. (Doctoral Dissertation). Retrieved Fromhttp://wakespace.lib.wfu.edu/bitstream/handle/10339/33425/Binder_wfu_0248D_10078.pdf
2 Ferris, C. J., Gilmore, K. J., Beirne, S., McCallum, D., Wallace, G. G. & in het Panhuis, M. (2013). Bio-ink for on-demand printing of living cells. Biomaterials Science. 1(2). DOI:10.1039/c2bm00114d
3 Koch, L., Deiwick, A., Schlie, S., Michael, S., Gruene, M., Coger, V., Zychlinski, D., Schambach, A., Reimers, K., Vogt, P. & Chichkov, B. (2012). Skin tissue generation by laser cell printing. Biotechnology and Bioengineering. 109(7). DOI: 10.1002/bit.24455
4 Wake Forest Institute for Regenerative Medicine. (2013). Printing skin cells on burn wounds. In Our Research Projects. Retrieved from http://www.wakehealth.edu/Research/WFIRM/Research/Military-Applications/Printing-Skin-Cells-On-Burn-Wounds.htm
William Rusnak writes about topics such as healthcare technology, medical billing software, biotechnology, and nutrition.
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