Researchers develop new 3D technique: innovation to treat diabetic foot ulcers

New DelhiDiabetes, a lifelong condition that causes a person’s blood sugar to rise too high, is in the top ten causes of death worldwide. Diabetic foot ulcers (DFU) are a serious complication of diabetes, affecting approximately 25% of diabetic patients. When identified, more than 50 percent are already infected and more than 70 percent of cases result in lower limb amputation. Queen’s University Belfast has released a new dressing treatment known as a scaffold to treat diabetic foot ulcers and also cost-effectively while improving patient outcomes.

The 3D printing method was first demonstrated in the 1980s and since then the field of 3D printing (3DP) and bioprinting has grown rapidly in recent years due to technological developments and a better understanding of the possibilities that these technologies can use, especially in the development of scaffolds for tissue engineering applications. When manufacturing 3D (bio)printed scaffolds, the user must first design a scaffold using computer-aided design (CAD).

Specialized software can then be used to cut the design before printing, providing a set of printing instructions for the printer; every 3DP manufacturer provides the software. 3DP offers a wide range of benefits, including the ability to produce comprehensive (scaffolding) designs of various sizes quickly and at low cost. In addition, 3D-bioprinted scaffolds have shown the ability to achieve high cell loading and maintain high cell viability, while also providing structural support to the wound.

The treatment strategy required for the effective healing of diabetic foot ulcers (DFU) is a complex process requiring several combined therapeutic approaches. As a result, there is a significant clinical and economic burden associated with the treatment of DFU. In addition, these treatments are often unsuccessful, often resulting in amputation of the lower extremities.

graphic abstract

This new study demonstrates results with significant implications for patient quality of life, as well as reducing costs and clinical burden in the treatment of DFU. Recent research has focused on drug-laden scaffolds to treat DFU. The scaffold structure is a novel vehicle for cell and drug delivery that enhances wound healing.

Springler Link Research

The research, published in Springer Link, was presented by Professor Lamprou at the Controlled Release Society (CRS) Workshop Italy.

Professor Dimitrios Lamprou, professor of biofabrication and advanced manufacturing at the Queen’s School of Pharmacy and corresponding author, explains: “These scaffolds are like windows through which doctors can constantly monitor healing. This avoids having to constantly remove them, which can cause infections and slow down the healing process.

file photo

Schematics showing (a) extrusion-based, (b) inkjet-based, and (c) laser-assisted bioprinting technologies

“The ‘frame’ has an antibiotic that helps to ‘kill’ the bacterial infection, and the ‘glass’ that can be prepared by collagen/sodium alginate can contain a growth factor to stimulate cell growth. The scaffold has two molecular layers that both play an important role in wound healing.”

What experts say

According to expert Ashok Jhingan, Sr Phycisian & Sr Director BLK Max, “The annual incidence of diabetic foot ulcers worldwide is between 9.1 and 26.1 million. About 15 to 25% of patients with diabetes mellitus will develop a diabetic foot ulcer in their lifetime. develop.

The majority of patients with diabetes who develop foot ulcers are men (more than two-thirds). In addition, most are between 40 and 70 years old. Older patients have significantly more complications than younger ones.

Diabetic peripheral neuropathy is a trigger in nearly 90% of diabetic foot ulcers. Chronically high glucose (blood sugar) levels damage nerves, including the sensory, motor, and autonomic nerves. Diabetic neuropathy also damages the immune system and impairs the body’s ability to fight infection.

Infection is a frequent (40%-80%) and costly complication of these ulcers and is a major cause of morbidity and mortality. It is considered the most common cause of diabetes-related hospitalization and remains one of the main avenues of lower limb amputation.

dr. Jhingan also states that diabetic neuropathy, structural foot deformity, and peripheral arterial occlusive disease are the most common risk factors for ulcer formation. also improve patient outcomes by researchers from Queen’s University Belfast.

The scaffolds, which are made by 3D bioprinting, gradually release antibiotics over a period of four weeks to help the wound heal. The Journal of Drug Delivery and Translational Research published the study. Diabetes is one of the top 10 causes of death worldwide. It is a lifelong condition that raises a person’s blood sugar levels.

A devastating consequence of diabetes, diabetic foot ulcers (DFU), affect about 25 percent of diabetic patients. More than 50 percent of the cases that are discovered are already infected and more than 70 percent of them require amputation of the lower limbs. To effectively treat DFU requires a complex treatment plan that includes several combined therapeutic approaches. As a result, the treatment of DFU carries a serious clinical and financial burden. Lower limb amputation is often necessary because these treatments are often unsuccessful.

This new study shows results that have significantly impacted patients’ quality of life and reduced the cost and clinical burden of treating DFU. Drug-loaded scaffolds have been the subject of recent research to cure DFU. The scaffolding structure is a new carrier for cells and drugs that improves wound healing.

Advantages and disadvantages of commonly used bioprint technologies

Bioprinting technology

Advantages: cons
Inkjet-based bioprinting

  • Cheap
  • High cell load and viability
  • High resolutions (up to 100 micrometers)
  • Suitable for scale-up activities
  • Enables direct printing of cells and other biologics
  • Suitable for in situ bioprint applications

  • Additional processing steps may be required (e.g. chemical cross-linking)
  • Polymer degradation has been associated with continuous inkjet bioprinting

Extrusion-based bioprinting

  • Cheap
  • Higher cell seeding than inkjet based technologies
  • High cell viability
  • Moderate (300-600 micrometers) to high (200 micrometers)
  • Suitable for the production of large-scale scaffolding
  • Enables direct printing of cells and other biologics
  • Generally requires low printing temperature and pressure
  • Suitable for printing high viscosity materials

  • High temperatures may be required for high viscosity materials, replacing the loading of biologics
  • Additional processing steps may be required (e.g. chemical cross-linking)

Laser-assisted bioprinting

  • High Speed ​​Printing
  • High resolution (10 micrometers)
  • High cell load
  • No mouthpiece needed to avoid clogging problems
  • Suitable for in situ bioprinting purposes

  • Time-consuming ribbon preparation for printing
  • More expensive than inkjet and extrusion-based technologies
  • Laser source is a potential disruption of cell viability

How to prevent foot ulcers?

dr. Ashok Jhingan says: – Wear clean, dry socks that do not have tight elastic bands, which can restrict blood flow to the foot. Doctors advise people with diabetes not to walk barefoot and to wear sandals, which expose your feet to splinters, concrete or sand, which can scratch or irritate the foot.
Keeping your diabetic wounds clean and free of infection is order number one. Some basic diabetic wound healing products include regular antibiotic ointments such as Polysporin or Neosporin.

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