One in 100 people in the UK have a significant facial difference, and this can have a profound effect on the mental health of patients. The Scar Free Foundation/ Health and Care Research Wales Programme of Facial Reconstruction and Regeneration Research at Swansea University will advance the development of 3D bioprinted facial cartilage (ears and noses), using human cells and plant based materials for future treatment of people in the UK and across the world who are either born without body parts or live with facial scarring as a result of burns, trauma or cancer. This will be combined with the world’s largest study of people living with facial scars to assess the psychosocial impacts on patients - in terms of experiences of anxiety or depression - so that effective healthcare strategies can be developed and appropriately targeted.
Patients living with loss of ear/nose have told researchers that existing plastic prostheses don’t feel ‘part of them’ and would prefer that their own tissue is used for reconstruction. The research programme will address this problem by creating a custom ‘cartilage’ scaffold which the patient’s own stem cells then grow onto, for facial reconstruction, to avoid the need to take cartilage from elsewhere in the body (which would lead to further scarring and can cause other complications). Cartilage is the main type of connective tissue seen throughout the body. It serves a variety of structural and functional purposes and exists in different types throughout our joints, bones, spine, lungs, ears and nose.
The research will be led by Professor Iain Whitaker - the only professor of plastic surgery in Wales - Chair of Plastic Surgery at Swansea University Medical School and Surgical Specialty Lead for Health and Care Research Wales. "The ability to successfully 3D print living tissue has been highlighted by the Royal College of Surgeons as one of the futures of surgery and the UK Government selected regenerative medicine as one of the ‘Eight great technologies’ to propel the UK to future growth. Successful translation of this research programme will transform the future of surgery, removing the need to transfer tissue from one part of the body to another and avoid the associated pain and scarring," Whitaker said. Although we are currently focused on cartilage, the scientific concepts and platform technologies our work is based on can be applied to tissue types such as blood vessel, nerve, bone, skin and fat which will enhance the impact significantly,” he added.
The pioneering programme will developed 3D bioprinted facial cartilage using human cartilage specific stem/progenitor cells and nanocellulose (derived from plants) as a ‘bioink’ for facial reconstruction. The project will include scientific studies to determine the ideal combination of cells to grow new cartilage, optimise nanocellulose bioinks for 3D bioprinting patient-specific cartilage constructs and show that they are safe, non-toxic and well tolerated by the immune system. This will lead to human clinical trials for facial reconstruction.
“We live in a society that seems increasingly pre-occupied by appearance. So there is a real need to understand the mental health consequences of facial scarring and their underlying causes. This ranges from societal responses, body image, gender, pre-existing mental health problems to what caused the scar," Professor Ann John, Professor in Public Health and Psychiatry at the Swansea University Medical School commented. "It’s vital we look at what might explain who, when and why people might be more strongly affected so we can do something about it early and develop new ways of managing and preventing these mental health issues."
Brendan Eley, Chief Executive of the Scar Free Foundation, said: “Giving surgeons the ability in the future to reconstruct people’s faces using their own cells without the need for further scarring is revolutionary. We know that scarring can have a long term emotional and physical impact on people and this study will also help us understand how facial scarring in particular affects mental health, leading to new treatments.”
“This pioneering programme has the potential to change the lives of people around the world. We’re pleased to be working in partnership with The Scar Free Foundation to fund world-leading research, which under the leadership of Professor Whitaker could make such a difference,” Michael Bowdery, Head of Programmes at Health and Care Research Wales, added.