Created: February 20, 2020 07:15 PM
As many as 10,000 people in the United States die each year as a result of burn-related infections. That's because the most severe burn, third-degree, extends through every layer of skin.
Without that protective covering, the body is open to infection, which can lead to sepsis.
Such devastated skin may not be able to regenerate because the cells needed for repair have been destroyed.
Skin grafts can help, but there are limitations.
Now there's hope on the horizon. A 3-D technology is being developed at RPI.
In May 2013, Sa'fyre Terry was the sole survivor of a house fire in Schenectady that claimed much of her family. The Capital Region prayed for her survival and cheered as she healed from burns over most of her body.
Three years later, in October 2016 there were prayers for 16-year-old Niko DiNovo -- extensively burned following a devastating car accident, but tears almost a year and a half later when he succumbed to his injuries.
Surviving extensive burns to the body is perilous because skin - our largest organ - protects the rest of our body from infection. When it's compromised, we are at risk for sepsis.
Grafting skin onto the burned area requires surgically taking skin from another part of the body. However, skin grafts often shrink and taking skin from another body part means skin in that area has to re-grow. Moreover, if a patient is burned extensively, there may not be enough skin to graft.
Grafts grown in the lab are rudimentary - not nearly as complex as our skin is.
Enter the work of a research team at RPI headed by Associate Professor Dr. Pankaj Karande - dedicated to finding a way to 3-D print skin.
"So of course, printing anything that's going to be a living tissue, a living organ, is far more difficult," explained Karande.
More difficult than the solid objects we've come to associate with 3-D printing, like limbs and tools.
Dr. Karande's team looked to biology for a blueprint to assemble the right ingredients - including stem cells and nutrients.
Human skin discarded during surgery provides those raw materials.
"What we do is, we combine them into inks, we call them, bio-inks - and we fill up the cartridges of that printer with these bio-inks - which have the proteins, the growth factor, and cells - and then we print them. We start arranging them in a layer by layer fashion depending upon which cells go where in that particular tissue," noted Karande.
Once they cleared the first hurdle, keeping the cells alive during the stress of printing, it was on to the next challenge: making the product more complex, in short, more like skin. It's a major step beyond current skin graft material created in the lab.
"But it's very simplistic. It does not have some of the more complex features like hair follicles, for example, sweat glands," noted Karande.
Incremental steps of increasing complexity is how Karande describes the ongoing work. As they tackle those challenges, they also must overcome graft rejection, because the body will see it as something foreign - the same issue faced with any kind of organ transplant.
"One way we are doing that - and this is our work with our collaborators at Yale, is thinking about how to edit those cells so they do not have the specific immune markers so we can construct a skin graft that's more universal and can be pre-made before the patient arrives in the clinic," Karande said.
Karande's work was started almost nine years ago and it's anyone's guess how much longer will be needed.
None of the studies done with the 3-D printed skin so far has been done in humans, but Karande says results are encouraging.
The product they've created doesn't shrink as much as current skin grafts, which is key to mobility.
Imagine, as Karande does, sheets of 3-D printed skin that mimics our skin, can be printed and ready to be used to help burn victims like Sa'fyre and Niko heal - and better yet, thrive.
While the work is encouraging, there is no timetable as to when the 3-D printed skin grafts will be available.
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