Burn injuries represent a major clinical burden in both civilian and military settings. Burns constitute 5-20% of military casualties and carry an overall mortality rate of 4.9%. The cost to treat these wounds in civilian populations approach a staggering $2 billion per year in the US alone. The standard treatment for severe burn injuries is tangential debridement and skin grafting. However, grafting requires sufficient amounts of healthy skin, and in burn patients the availability of skin can be limited by extensive skin loss at the time of injury. In military operational theaters, burn injuries are particularly challenging to treat: burns are often accompanied by traumatic wounds that require immediate attention, burn wounds are almost always contaminated as a result of the injury mechanism, and the surrounding tactical environment rather than the medical need of the patient dictates the timing of evacuation of the patient to a definitive care setting.
Donor skin can provide temporary closure of wounds and is often used clinically. Even so, it is limited by availability, immune rejection, and the risk of disease transmission. Engineered skin offers a promising alternative to donor skin grafts. However, current bioengineered skin prototypes are unable to provide prolonged coverage and do not promote a healthy wound bed or induce skin regeneration. Given the clinical burden of burn wounds, there is an immense need to develop skin graft alternatives.
To address this need for better skin graft alternatives, bioprinting techniques can be used to accurately engineer tissue with precise 3D organization. The goal of the current proposal is to bioprint skin constructs that contain the primary cell types and layers of normal skin. We will create excisional injuries on the backs of swine and apply our bioprinted constructs. If successful, our bioprinted skin could provide a permanent wound closure option for military and civilian burn victims. This is particularly relevant to military theatres, where easily accessible donor bioprinted skin could be used to provide rapid tissue coverage and limit the complications associated with open wounds. Patient specific skin could also be developed for scar revision surgeries of the face, scalp, and hands of patients with severe burns. Thus, this innovative approach could help relieve the clinical burden of burn injuries, result in decreased scaring and morbidity with improved quality of life for military and civilian patients who suffer from these ailments.