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Skin tissue engineering using 3D bioprinting: An evolving research field

  • Author Footnotes
    1 Joint first authorship.
    Sam P. Tarassoli
    Footnotes
    1 Joint first authorship.
    Affiliations
    Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Science, Swansea University Medical School, Swansea, UK
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  • Author Footnotes
    1 Joint first authorship.
    Zita M. Jessop
    Footnotes
    1 Joint first authorship.
    Affiliations
    Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Science, Swansea University Medical School, Swansea, UK

    Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
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  • Ayesha Al-Sabah
    Affiliations
    Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Science, Swansea University Medical School, Swansea, UK
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  • Neng Gao
    Affiliations
    Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Science, Swansea University Medical School, Swansea, UK
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  • Sairan Whitaker
    Affiliations
    Department of Dermatology, Royal Gwent Hospital, Newport, UK
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  • Shareen Doak
    Affiliations
    In Vitro Toxicology Research Group, Swansea University Medical School, Swansea, UK
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  • Iain S. Whitaker
    Correspondence
    Corresponding author. Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Sciences, Swansea University Medical School, Swansea SA2 8PP, UK.
    Affiliations
    Reconstructive Surgery & Regenerative Medicine Research Group, Institute of Life Science, Swansea University Medical School, Swansea, UK

    Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
    Search for articles by this author
  • Author Footnotes
    1 Joint first authorship.
Published:December 13, 2017DOI:https://doi.org/10.1016/j.bjps.2017.12.006

      Summary

      Background

      Commercially available tissue engineered skin remains elusive despite extensive research because the multi-stratified anisotropic structure is difficult to replicate in vitro using traditional tissue engineering techniques. Bioprinting, involving computer-controlled deposition of cells and scaffolds into spatially controlled patterns, is able to control not only the macro but also micro and nanoarchitecture and could offer the potential to more faithfully replicate native skin.

      Methods

      We conducted a literature review using PubMed, EMBASE and Web of Science for studies on skin 3D bioprinting between 2009 and 2016, evaluating the bioprinting technique, cell source, scaffold type and in vitro and in vivo outcomes.

      Results

      We outline the evolution of biological skin replacements, principles of bioprinting and how they apply to the skin tissue engineering field, potential clinical applications as well the current limitations and future avenues for research. Of the studies analysed, the most common types of bioinks consisted of keratinocytes and fibroblasts combined with collagen, although stem cells are gaining increasing recognition. Laser assisted deposition was the most common printing modality, although ink-jet and pneumatic extrusion have also been tested. Bioprinted skin promoted accelerated wound healing, was able to mimic stratified epidermis but not the thick, elastic, vascular dermis.

      Conclusions

      Although 3D bioprinting shows promise in engineering skin, evidenced by large collective investments from the cosmetic industry, the research is still in its infancy. The resolution, vascularity, optimal cell and scaffold combinations and cost of bioprinted skin are hurdles that need to be overcome before the clinical applicability can be realised. Small scale 3D skin tissue models for cosmetics, drug and toxicity testing as well as tumour modelling are likely to be translated first before we see this technology used in reconstructive surgery patients.

      Keywords

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