Skin Grafting on 3D Bioprinted Cartilage Constructs In Vivo

Abstract

Background:Three-dimensional (3D) bioprinting of cartilage is a promising new technique. To produce, for example, an auricle with good shape, the printed cartilage needs to be covered with skin that can grow on the surface of the construct. Our primary question was to analyze if an integrated 3D bioprinted cartilage structure is a tissue that can serve as a bed for a full-thickness skin graft.Methods:3D bioprinted constructs (10 × 10 × 1.2 mm) were printed using nanofibrillated cellulose/alginate bioink mixed with mesenchymal stem cells and adult chondrocytes and implanted subcutaneously in 21 nude mice.Results:After 45 days, a full-thickness skin allograft was transplanted onto the constructs and the grafted construct again enclosed subcutaneously. Group 1 was sacrificed on day 60, whereas group 2, instead, had their skin-bearing construct uncovered on day 60 and were sacrificed on day 75 and the explants were analyzed morphologically. The skin transplants integrated well with the 3D bioprinted constructs. A tight connection between the fibrous, vascularized capsule surrounding the 3D bioprinted constructs and the skin graft were observed. The skin grafts survived the uncovering and exposure to the environment.Conclusions:A 3D bioprinted cartilage that has been allowed to integrate in vivo is a sufficient base for a full-thickness skin graft. This finding accentuates the clinical potential of 3D bioprinting for reconstructive purposes.

Trends in Scientific Reports on Cartilage Bioprinting: Scoping Review

“…In general, they involve two concepts: cellular sources and biomaterials, including scaffolds and hydrogels. Onofrillo [33], Apelgren et al [31], and Leberfinger [24] prioritized the need to develop protocols for obtaining cells; they also recognized that, despite variable sources, all cells must maintain chondrogenic capacity, not cause morbidity at the donor site, expand easily in the culture without losing phenotype, and support the mechanical load in the joint case. Di Bella et al [34], You et al [35], and Wu et al [25] presented disparate technical aspects that should be improved, since they followed different research paths.…”

“…The surgical application studies focused on certain surgical approaches and identified specific technical improvements needed to obtain better results; improvements included an algorithm to ensure that the nasal implant is not degraded or subjected to excessive long-term pressure [29]; a process to guarantee the characteristics of the skin of the ear in plastic surgery [31]; and in otorhinolaryngology, the use of a membrane trachea coating and image processing to optimize surgical results [36].…”

“…The Biopen allows precise positioning of cells and biomaterials, rapid placement at the defect site, and minimal manipulation by the surgeon. Other authors advocate the predesign rather than in situ design of the implant: Yi et al [29], Apelgren et al [31], Li et al [36], Kaye et al [32], and Boushell et al [23]. These five studies focus on surgical applications in plastic surgery, otorhinolaryngology, and orthopedics.…”

“…The collected articles were organized by author, title, year, country, and type of article (see Table 2). The selected articles originated from the United States (4/13, 31%) [23-26], China (2/13, 15%) [27,28], Korea (2/13, 15%) [29,30], Sweden (2/13, 15%) [31,32], Australia (2/13, 15%) [33,34], and Canada (1/13, 8%) [35].…”

Combining Innovative Bioink and Low Cell Density for the Production of 3D-Bioprinted Cartilage Substitutes: A Pilot Study

“…MSC three-dimensional (3D) bioprinting is an emerging technology that is expected to revolutionize the field of regenerative medicine [6,20,[38][39][40], including hyaline articular cartilage engineering [41][42][43][44][45][46][47][48][49][50][51][52]. Previous tissue engineering approaches for cartilage repair usually failed to generate functional tissues recapitulating the zonal organization, extracellular matrix (ECM) content, and biomechanical properties of native cartilage.…”