Skin Research Institute of Singapore (SRIS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
Tissue Eng Part B Rev. 2022 Feb;28(1):160-181. doi: 10.1089/ten.TEB.2020.0339. Epub 2021 Feb 22.
Three-dimensional (3D) printed scaffolds have recently emerged as an innovative treatment option for patients with critical-sized skin wounds. Current approaches to managing life-threatening wounds include skin grafting and application of commercially sourced skin substitutes. However, these approaches are not without several challenges. Limited donor tissue and donor site morbidity remain a concern for tissue grafting, while engineered skin substitutes fail to fully recapitulate the complex native environment required for wound healing. The implementation of 3D printed dermal scaffolds offers a potential solution for these shortcomings. Spatial control over scaffold structure, the ability to incorporate multiple materials and bioactive ingredients, enables the creation of conditions specifically optimized for wound healing. Three-dimensional bioprinting, a subset of 3D printing, allows for the replacement of lost cell populations and secreted active compounds that contribute to tissue repair and recovery. The replacement of damaged and lost cells delivers beneficial effects directly, or synergistically, supporting injured tissue to recover its native state. Despite encouraging results, the promise of 3D printed scaffolds has yet to be realized. Further improvements to current material formulations and scaffold designs are required to achieve the goal of clinical adoption. Herein, we provide an overview of 3D printing techniques and discuss several strategies for healing of full-thickness wounds by using 3D printed acellular scaffolds or bioprinted cellular scaffolds, aimed at translating this technology to the clinical management of skin lesions. We identify the challenges associated with designing and optimizing printed tissue replacements, and discuss the future perspectives of this emerging option for managing patients who present with critical-sized life-threatening cutaneous wounds. Impact statement Chronic wounds and burn injuries often present with the full-thickness loss of skin, threatening the life of the patient and generating significant socioeconomic burden for these patients, their treating clinicians, and the wider community in which these patients live. Effective clinical management that permits damaged skin tissue to repair and restore its native functional state reduces the strain on health care systems. Three-dimensional (3D) printed scaffolds have been proposed as a potential solution and could be instrumental in facilitating the recovery and healing process. In this review, we will summarize the current research approaches, technologies, and limitations of 3D printed scaffolds as an efficient and effective approach to managing cutaneous wound healing.
三维(3D)打印支架最近已成为治疗临界大小皮肤伤口患者的一种创新治疗选择。目前治疗危及生命的伤口的方法包括皮肤移植和应用商业来源的皮肤替代物。然而,这些方法并非没有一些挑战。对于组织移植,有限的供体组织和供体部位发病率仍然是一个问题,而工程化的皮肤替代物未能完全再现伤口愈合所需的复杂天然环境。3D 打印真皮支架的实施为这些缺点提供了一个潜在的解决方案。支架结构的空间控制、能够结合多种材料和生物活性成分的能力,使得可以创建专门针对伤口愈合进行优化的条件。3D 生物打印是 3D 打印的一个子集,允许替换有助于组织修复和恢复的丢失的细胞群体和分泌的活性化合物。替换受损和丢失的细胞直接或协同地产生有益效果,支持受伤组织恢复其天然状态。尽管结果令人鼓舞,但 3D 打印支架的前景尚未实现。需要进一步改进当前的材料配方和支架设计,以实现临床应用的目标。本文综述了 3D 打印技术,并讨论了使用 3D 打印无细胞支架或生物打印细胞支架治疗全层伤口的几种策略,旨在将这项技术转化为皮肤病变的临床管理。我们确定了设计和优化打印组织替代品所面临的挑战,并讨论了这种新兴选择管理有危及生命的临界大小皮肤伤口患者的未来前景。
影响声明慢性伤口和烧伤通常会导致皮肤全层缺失,威胁患者的生命,并给这些患者、治疗他们的临床医生以及他们生活的更广泛社区带来巨大的社会经济负担。允许受损皮肤组织修复并恢复其天然功能状态的有效临床管理可减轻对医疗保健系统的压力。三维(3D)打印支架已被提议作为一种潜在的解决方案,并可能有助于促进恢复和愈合过程。在这篇综述中,我们将总结 3D 打印支架作为管理皮肤伤口愈合的有效和有效的方法的当前研究方法、技术和局限性。