The Future of Wound Healing: Cost Effective and Personalized 3D Printing of Adipose Tissue Grafts Tailored to Each Patient's Needs and Wound

Introduction: Chronic wounds affect millions of US people and burden patients and healthcare systems. They need intensive care with multiple applications of advanced wound care solutions (e.g., skin substitutes, hyperbaric and negative pressure therapies), which have improved wound healing but have limitations: high cost, repeated visits, no personalization, and reimbursement challenges. We propose a novel approach using 3D-printed adipose tissue matrix grafts, personalized and customized for each patient and wound. We use an FDA registered 3D adipose tissue printer, creating a patient-wound-specific graft from the patient's own tissue in one application. We report successful treatment of initial cases with chronic ulcers and co-morbidities at lower cost than existing technologies.Methods:We employed a 3D adipose tissue printer system, to fabricate a personalized and tailored wound graft for lower extremity wounds. After a 30-day monitoring and successful balloon angioplasty to restore blood flow to the affected lower extremity (two weeks prior), the wound underwent debridement, and an AI-enabled system facilitated the transfer of the wound bed image to the printer. We collected and processed manual liposuction aspirate from the navel. We used polycaprolactone to print an outline of the wound bed, subsequently filling it with the processed adipose-aspirate. The graft underwent solidification either through a two bioink procedures involving fibrinogen and thrombin or a cooling methodology. Standard skin substitute grafting procedure was followed. With a notable difference a single adipose tissue matrix graft application instead of the conventional weekly approach spanning 8-12 weeks.Results:Both patients achieved complete wound closure and healing within 8-10 weeks of application of the adipose graft.Discussion: This study presents the use of 3D-printed adipose tissue matrix grafts for wound healing. These grafts are made from the patient's own tissue and are tailored to the wound shape using AI software. They have several benefits over conventional methods, such as skin substitutes or hyperbaric chambers. They can reduce the cost of treatment, the number of applications and follow-ups, and the risk of infection. They can also enhance the healing process by stimulating angiogenesis, inflammation modulation, and tissue regeneration. Adipose tissue is an ideal source of autologous grafts because it is abundant, easy to harvest, and rich in stem cells (Chu et al., 2019). More clinical trials are needed to verify the safety, efficacy, and long-term outcomes of this technique, which has a significant potential impact on wound care and patient quality of life.References:Chu DT, Nguyen Thi Phuong T, Tien NLB, Tran DK, Minh LB, Thanh VV, Gia Anh P, Pham VH, Thi Nga V. Adipose Tissue Stem Cells for Therapy: An Update on the Progress of Isolation, Culture, Storage, and Clinical Application. J Clin Med. 2019 Jun 26;8(7):917. doi: 10.3390/jcm8070917. PMID: 31247996; PMCID: PMC6678927.