Significantly, combat burn injuries are not included in the published statistics. Modern warfare continues to deliberately develop incendiary munitions (the Journal of the Royal Army Medical Corps tell us so) and this results in intentional and unintentional burns much more devastating than those usually seen in domestic settings.
In both contexts, the problem in dealing with serious burns is the difficulty in obtaining sufficient grafts to cover affected areas. However, technology borrowed from the 3D printing bureau is coming to the rescue.
Attempts to produce artificial skin have a long history. A much hyped attempt, based on shark cartilage, and reported in 1981, didn’t live up to expectations. More recently, methods of culturing skin cells to spray onto wounds have been showing more promise. However, there remained one key weakness. Skin is not just an expanse of uniform cells, but has structure – blood vessels, sweat glands and so on.
3D printed skin
This is where 3D printing is enabling an enormous breakthrough. The advent of the 3D printing service means we now have both the experience and the equipment to scan a wound and spray on the new cell cultures in a constructive way, layering at least some of the natural 3D complexity of real skin. The cells can be made from the victim’s own skin, from donors or from placental stem cells – all of these are in trials currently.
A recent military-funded project, called AFIRM, used a hi-res scanner to determine wound size and depth and built a printer, using “inks” of different kinds of skin cells. They say they hope to release that technology within 5 years.
Meanwhile, another team at the Charles III University of Madrid have independently achieved a similar breakthrough. 3D bio-fabrication replicates the natural structure of the skin, including the external epidermal layer with its stratum corneum, and a thicker deeper layer, the dermis, with fibroblasts, to produce the collagen that gives it elasticity (one of the big shortcomings of traditional transplants).
One of the bio-engineering firms participating in the Charles III project – BioDan Group, has already announced plans to commercialise the technology as soon as it can pass clinical trials and gain EU approval.
However, it will probably be taken up first for purposes of producing flat sheets of skin suitable for medical and cosmetic research, which will at least begin to reduce the large numbers of animals used in testing in both these arenas. The more laborious and complex application of it directly onto wounds will require both more development and more red tape.
The company Open Bionics 3D already uses its 3D printing service to create sculpted prosthetic limbs, which is helping to revolutionise that area of medical science.