Point of care approaches to 3D bioprinting for wound healing applications

Abstract

In the quest to improve both aesthetic and functional outcomes for patients, the clinical care of full-thickness cutaneous wounds has undergone significant development over the past decade. A shift from replacement to regeneration has prompted the development of skin substitute products, however, inaccurate replication of host tissue properties continues to stand in the way of realising the ultimate goal of scar-free healing. Advances in three dimensional (3D) bioprinting and biomaterials used for tissue engineering have converged in recent years to present opportunities to progress this field. However, many of the proposed bioprinting strategies for wound healing involve lengthy in-vitro cell culture and construct maturation periods, employ complex deposition technologies, and lack credible point of care (POC) delivery protocols. In-situ bioprinting is an alternative strategy which can combat these challenges. In order to survive the journey to bedside, printing protocols must be curated, and biomaterials/cells selected which facilitate intraoperative delivery. In this review, the current status of in-situ 3D bioprinting systems for wound healing applications is discussed, highlighting the delivery methods employed, biomaterials/cellular components utilised and anticipated translational challenges. We believe that with the growth of collaborative networks between researchers, clinicians, commercial, ethical, and regulatory experts, in-situ 3D bioprinting has the potential to transform POC wound care treatment.

In Situ Bioprinting: Process, Bioinks, and Applications

“…27 Advancements in bioprinting technology can revolutionize point-of-care wound care treatment by providing customized and precise biomanufacturing platforms for wound dressings and tissue engineering scaffolds. 137 The use of 3D bioprinting in wound healing has led to the development of dressings and scaffolds that accurately simulate tissue structures and improve wound healing and skin treatment as mentioned in Table 2. 138 In situ bioprinting is an alternative strategy that can overcome challenges such as lengthy in vitro cell culture and the lack of credible point-of-care delivery protocols (Figure 3B).…”

3D Bioprinting and Its Role in a Wound Healing Renaissance

“…[ 182 ] The printed constructs are prepared in advance prior to further experimentation and application in vivo. [ 183 ] A streamlined bioprinting process in a clinical setting following this model might involve first scanning a patient's wound for its precise dimensions, with these measurements being subsequently used to construct a 3D CAD model for use with an in vitro bioprinter on‐site. [ 184 ] The resulting 3D bioprinted construct would then be a personalized wound treatment for the patient in question.…”

“…[ 184 ] There would be some delay in treatment associated with this approach, however, associated with the time to scan the patients wound, create the 3D model, and subsequently bioprint the personalized construct. [ 183 ]…”