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International Journal of Bioprinting Bioprinting in diabetic foot disease

Table 3. Studies on AMHAT combined with 3D-printing technology in DFU treatment
Biomaterials Design Result Year
Extracellular matrix (MA-ECM) prepared 40 subjects with DFUs randomly divided The test group showed complete wound closure 2021 [140]
from AMHAT by 3D bioprinting into test group (MA-ECM treatment) and within 4 weeks, while the majority of patients
control group (standard wound care) in the control group showed delayed wound
healing compared to the test group.
AMHAT dispensed by a 3D-bioprinting A single-arm pilot study of 10 consecutive Sixty percent of the patients showed complete 2022 [141]
device (Dr. INVIVO) patients with a history of chronic DFUs wound closure, and the mean time for closure
was 49.1 days (95% CI: 29.9–68.3). There were
no adverse events.
3D-AMHAT with fibrin gel A total of 10 patients with DFUs Seventy percent of the patients showed com- 2023 [139]
plete healing and no adverse events.
AMHAT in the customized shape of DFU A clinical prospective interventional pilot The total time for wound healing and scar for- 2023 [138]
wounds study of 20 patients with DFUs mation was reduced compared to grafting.

of chronic wound healing is a continued endeavor. Through Dr. Xiaoyan Jiang. This study is also partially supported by
continuously innovating bioink and scaffold materials, National Institutes of Health, National Institute of Diabetes
as well as developing new bioprinting strategies, such as and Digestive and Kidney Diseases (award number
in situ printing, embedded printing, and machine-assisted 1R01124789-01A1), and National Science Foundation
printing, bioprinted skin structures are becoming more (NSF) Center to Stream Healthcare in Place (#C2SHiP;
similar to natural skin structures and possess certain skin CNS Award Number 2052578 awarded to Prof. David G.
functions. There are already some bioprinted materials Armstrong).
with vascular structures, although vascularization remains
a challenge. These results suggest that bioprinting has Conflict of interest
broad application prospects in the treatment of chronic The authors declare no conflict of interest.
DFU wounds.
Nevertheless, the repair of tissue interfaces in deep Author contributions
DFU wounds poses a huge problem because the healing Conceptualization: Wuquan Deng and Fan Xu
of existing grafts at these tissue interfaces is not ideal. The Writing – original draft: Fan Xu, Shunli Rui, Cheng Yang,
existing bioprinting technology cannot meet the structural Xiaoyan Jiang, Wei Wu, Xianlun Tang, David G. Armstrong
and functional requirements of the skin tissue interface. Writing – review & editing: Yu Ma, Wuquan Deng
With the development of algorithms and artificial
intelligence, as well as the emergence of multisystem Ethics approval and consent to participate
integration and portable printing platforms, we believe
that this issue will be resolved in the future. Not applicable.

Acknowledgments Consent for publication
The diagrams were painted on the Figdraw website (codes: Not applicable.
UOORUe2842; UAIYUbb908).
Availability of data
Funding
Not applicable.
This study was supported by the Joint Medical Key Research
Programs of Chongqing Science and Technology Bureau References
and Health Commission Foundation (No. 2023ZDXM009),
the Natural Science Foundation of Chongqing Municipal 1. Mota C, Camarero-Espinosa S, Baker MB, et al., 2020,
Science and Technology Bureau (No. CSTB2022NSCQ- Bioprinting: From tissue and organ development to in vitro
MSX0489) awarded to Dr. Wuquan Deng and Dr. Shunli models. Chem Rev, 120(19): 10547–10607.
Rui, and the Chongqing medical scientific research project 2. Valot L, Martinez J, Mehdi A, et al., 2019, Chemical insights
(Joint project of Chongqing Health Commission and Science into bioinks for 3D printing. Chem Soc Rev, 48(15): 4049–
and Technology Bureau, No. 2020FYYX241) awarded to 4086.

Volume 9 Issue 6 (2023) 232 https://doi.org/10.36922/ijb.0142