2155-PUB: Diabetic Foot Ulcer Regeneration Platform Based on 4D Bioprinting Technology

Abstract

Diabetic foot ulcers have a significantly negative impact on patients and are highly prone to contamination, which can lead to amputation. The best possible wound management treatment was essential for diabetic foot ulcers. However, since 4D bio printing is the best way to recapitulate complex and functional human tissue and organ, we have developed the therapeutic 4D bio printer called INVIVO to use in skin regeneration. To find advanced treatment method particularly for wound healing, we tested our own 4D bio printing system with autologous fat tissue for DFU treatment. The extracellular matrix (ECM) derived from Nano-fat consisting of supportive proteins, growth factors and cytokines, has been reported as an important player to provide efficient 3D environments during cell proliferation and differentiation. In the clinical study, we printed autologous ECM (MA-ECM) with bio-inks to apply onto the chronic wound site. Most of DFU patients showed significant reduction of wound size with distinct epithelization only after a week treatment. Therefore, we suggest 4D bio printing system with MA-ECM as an alternative method for dressing materials that successfully promote the mechanism of skin reconstruction for DFU treatment. Reduction in size of wound was measured using ImageJ NIH software and almost all the subjects revealed complete closure of wound maximum of 2∼5 weeks post MA-ECM membrane application. The present study provided a significantly higher healing rate of the subjects and the primary outcome of our study complete epithelization with wound closure was achieved. The autologous fat by nature is loaded with adipocytes and growth factors which could have played a vital role in the healing of non-healing diabetic wounds. Therefore, we suggest 4D bio printing system with MA-ECM as an alternative method for chronic wound healing that successfully promote the mechanism of skin reconstruction for DFU treatment.