Practice Innovations
Current advanced wound care solutions, such as skin substitutes, oxygen therapies, and negative pressure therapies, have significantly progressed the field. However, these technologies lack personalization to individual patients, tailoring for specific wounds, utilization of patients' stem cells for chronic wound healing, and often require multiple applications.
This study presents the initial clinical case of utilizing 3D-printed adipose tissue matrix grafts, personalized, and customized for patients with chronic wounds (lower leg venous ulcer ~50cm2). The method employs an FDA-cleared 3D adipose tissue printer, which creates a patient-wound-specific graft following 30days of monitoring.
Methods:
In this case, a 3D-adipose printer was employed to fabricate a personalized graft for a patient-specific vascular lower extremity wound of approximately fifty cm2. After a 30-day monitoring period and successful angioplasty to restore blood flow to the impacted lower extremity, the wound underwent debridement, and an AI-enabled camera software facilitated the transfer of the wound bed image to the printer. Manual liposuction aspirate (10-30mls) from the navel was then collected and processed. Polycaprolactone was utilized to print an outline of the wound bed, subsequently filling it with the processed liposuction aspirate. The graft underwent solidification through two bioink procedures involving fibrinogen and thrombin.
The grafting methodology closely adhered to the standard skin substitute grafting procedure, with a notable departure being the application of a single adipose tissue matrix graft instead of the conventional weekly grafting approach spanning 8-12weeks.
Results:
The patient achieved complete wound closure and healing within 8-10weeks of application of the adipose graft.
Discussion:
3D-printed adipose tissue matrix grafts derived from the patient's own tissue offer a highly effective solution for wound healing, with the entire process taking 60-90 minutes. The use of a single graft reduces the need for routine visits to the surgical facility, enhancing patient compliance.
The increased biocompatibility and the presence of the patient's own stem cells contribute to the graft's efficacy. Adipose tissue contains a significantly higher number of stem cells compared to bone marrow, making it an attractive option for wound healing (chu et. al,). Additionally, the use of AI software to tailor the graft shape maximizes edge juxtaposition, potentially accelerating the wound healing timeline.
While further cases are necessary for comprehensive validation, initial results suggest that 3D-printing personalized and customized grafts for wounds is a practical reality. The potential impact on patient compliance, cost-effectiveness, and overall wound care merits systematic adoption and documentation.