Severe burns that remove skin from more than half the body require replacement of every skin layer with grafts harvested from intact areas, expanded in laboratory culture, and transplanted over months. Engineered single-layer epidermal grafts currently provide temporary protection against infection during healing. Converting patient skin cells into bioinks enables 3D printing of donor-matched, multilayered, full-thickness skin that reproduces pigment, vasculature and hair follicles. Experimental three-layered printed grafts integrated efficiently into pig skin. Conventional cell-culture methods also produce biologically faithful skin substitutes that improve clinical outcomes and toxicology and disease models, reducing animal testing.
Researchers such as Anthony Atala, a specialist in regenerative medicine at the Wake Forest University School of Medicine in Winston-Salem, North Carolina, have a different vision for burn treatment, in which grafts are made to order in the lab. Clinicians already use engineered single-layered epidermal grafts to protect tissue while it heals, but this is just a temporary measure to prevent infection during recovery.
By contrast, Atala aims to convert skin cells taken from patients into 'bioinks', which can then be 3D printed into donor-matched, multilayered tissues that replicate core functions of natural skin. "Why don't we engineer skin that is full thickness, so you can actually use that as a permanent graft - just like you would a patient's own graft?" he asks.
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