Astonishing scar-free surgery prints living skin right into wounds

The skin of the head and face is vital to protecting the structures underlying it. It’s also integral to our identity. Full-thickness skin damage caused by traumatic injury to or extensive surgery on the face or head – to remove a cancerous tumor, say – can negatively impact a person’s confidence and self-esteem.

Despite advances in plastic and reconstructive surgery, repairing full-thickness skin loss on the head and face using skin grafts is challenging. It can result in scarring, permanent hair loss, and graft failure. But now, researchers from Pennsylvania State University (Penn State) have become the first to 3D print full-thickness, living skin with hair-growing potential during surgery on rats, immediately correcting a significant skin deficit on the animals’ heads.

“Reconstructive surgery to correct trauma to the face or head from injury or disease is usually imperfect, resulting in scarring or permanent hair loss,” said Ibrahim Ozbolat, the study’s corresponding author. “With this work, we demonstrated bioprinted, full-thickness skin with the potential to grow hair in rats. That’s a step closer to being able to achieve more natural-looking and aesthetically pleasing head and face reconstruction in humans.”

They started with fat (adipose) tissue from patients undergoing surgery, extracting the network of molecules and proteins – the extracellular matrix – that provide the tissue with structure and stability. This formed one component of the bioink. The second component was stem cells taken from the fat tissue. The third was a clotting solution containing fibrinogen, to help the other components bind to the injury site. Each component was loaded into separate compartments in the bioprinter.

Image source: Kang et al. (2024), Bioactive Materials.