A preliminary study for an intraoperative 3D bioprinting treatment of severe burn injuries.

Background: Intraoperative three-dimensional (3D) fabrication of living tissues could be the next biomedical revolution in patient treatment. Approach: We developed a surgery-ready robotic 3D bioprinter and demonstrated that a bioprinting procedure using medical grade hydrogel could be performed using a 6-axis robotic arm in vivo for treating burn injuries.Results: We conducted a pilot swine animal study on a deep third-degree severe burn model. We observed that the use of cell-laden bioink as treatment substantially affects skin regeneration, producing in situ fibroblast growth factor (FGF) and vascular endothelial growth factor (VEGF), necessary for tissue regeneration and re-epidermalization of the wound. Innovation and Conclusion: We described an animal study of intraoperative 3D bioprinting living tissue. This emerging technology brings the first proof of in vivo skin printing feasibility using a surgery-ready robotic arm-based bioprinter. Our positive outcome in skin regeneration, joined with this procedure's feasibility, allow us to envision the possibility of using this innovative approach in a human clinical trial in the near future.