Digital Protocol for the Bioprinting of a Three-Dimensional Acellular Dermal Scaffold

The gold standard for treating secondary intent wounds is skin grafting, but this is limited by patient conditions (i.e. diabetes, vascular insufficiencies, and immunocompromised status), the availability of viable skin, and potential immune rejection. Decellularized acellular dermal scaffolds (ADS) are an alternative to skin grafts and are developed by removing cells from donor or animal sources, reducing the potential for rejection. Traditional decellularization processes have various limitations, producing ADS with altered three-dimensional (3D) structure, damaged proteins, and decreased tensile strength. Emerging technologies, like 3D bioprinting, can overcome challenges faced by traditional methods. This research aimed to provide a digital protocol for the generation of a 3D acellular dermal scaffold for 3D bioprinting. One optimized porcine extracellular matrix (ECM)-based ADS (P3-S3), 8 mm × 2 mm in size, from a previous departmental study was captured by Micro–X-Ray Computed Tomography (Micro-XCT) at the South African Nuclear Energy Corporation (NECSA). The micro-XCT images were imported into the Amira-Avizo 2019.3 software (Thermo Fisher Scientific, Inc.) to generate a 3D ADS model using an image segmentation procedure. This 3D model was exported in stereolithography (STL) format and will be used for 3D bioprinting of the ADS. The development of bioengineered ADS constructs is integral to the advancement of wound healing technology.