4D Bioprinting Platform for Skin Regeneration in Diabetic Foot Ulcer Treatment
Purpose: To treat chronic wound, many allogenic skin substitutes have been invented. However, there are still many limitations to protect amputation for diabetes who are suffering from diabetic foot ulcer. Therefore, we developed the customized wound healing solution based on 4D bioprinting system platform for skin regeneration. Methods: By using 3D scanner, we measured the wound size and depth and converted to the file that could be used in the 4D bioprinter, Dr.INVIVO to manufacture customized scaffolds. Patient’s abdominal adipose tissue was harvested and minimally manipulated to adjust into the 4D bioprinter. After filtration of adipose tissue, we printed autologous dermal substitute and applied directly onto the cleaned wound site of the same patients. We monitored weekly the wound healing rate compared to the control group who got the standard of wound care with a normal dressing by measuring the wound size reduction and epithelialization. Results: All the tested patients showed significant reduction of wound size with re-epithelialization only after a couple of weeks from the single treatment of bio-printed adipose tissue. Compared to 5 cases in the control group with longer wound healing period, 11 cases in the test group showed complete wound closure at 4 weeks. The mean percent of wound area reduction in test group were 87.7% and 92.5% at 2 and 3 weeks, respectively. Three of nine (33.3%) and five of nine (55.5%) patients completely closed at 2 and 3 weeks, respectively and the mean time to closure for all wounds was 3.2 weeks. There were no adverse events related to the treatment during study. Conclusion: We demonstrated that a single treatment of autologous, minimally manipulated adipose tissue could trigger wound healing by accelerating re-epithelialization of the chronic wound site. Indeed, advanced 4D bioprinting technology is the best way to provide customized therapeutic solution for treating chronic wound such as diabetic foot ulcer.
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