Funded Research Update: How 3D Bioprinting Could Transform Care for Burns and Trauma Patients

In this funded research update, we report on the progress of Mr Thomas Jovic's BMRF Pump Prime project, which is developing 3D bioprinted skin and cartilage substitutes for patients affected by burns, trauma, and congenital differences.

BMRF Pump Prime recipient Thomas Jovic

For patients affected by burns, cancer, or conditions such as microtia — a congenital condition in which the outer ear does not develop normally — reconstructive surgery often depends on the use of donor tissue taken from elsewhere on the body. While this approach can achieve good outcomes, it carries its own risks, including pain and scarring at the donor site and limited availability of suitable tissue.

Research supported by the Blond McIndoe Research Foundation is working to change this, by developing personalised, biologically active tissue substitutes using 3D bioprinting technology — with the long-term goal of creating bespoke structures such as ears, noses, and skin grafts grown from a patient's own cells.

Why this matters for patients

The physical challenges of conditions like microtia or severe burns are only part of the picture. Research has shown that children with craniofacial differences experience significantly higher rates of anxiety, depression, and social isolation than their peers, while burns survivors may face lifelong psychological impact and stigma. The ability to restore both form and function — with tissue that looks and behaves naturally — has the potential to be genuinely transformative for patients and their families.

Time spent by Mr Thomas Jovic with microtia patients and families during this project has reinforced the importance of developing reconstructive solutions that address not just the physical deficit, but the broader impact on wellbeing and quality of life.

Building biological ink

The central focus of Mr Jovic's BMRF Pump Prime project has been the development of bioinks — materials that can be loaded with living cells and used as the "ink" in a 3D bioprinter. His work centres on hyaluronic acid (HA), a substance naturally found in both skin and cartilage, making it biologically well-suited for use in reconstructive applications.

One of the fundamental challenges in this field is balancing biological compatibility with printability. Materials that are gentle enough to keep cells alive are often too soft to hold their printed shape; materials strong enough to print reliably can be harmful to cells. Addressing this balance has been a central focus of the project.

A significant achievement has been the successful development of a pure HA bioink with the properties needed for extrusion bioprinting — the process of pushing material through a fine nozzle to build up a structure layer by layer. Alongside this, the team has developed and tested nanocellulose-HA composite bioinks, which combine hyaluronic acid with nanocellulose — an ultra-fine fibre derived from plant material — to create a more mechanically robust material. By testing different concentrations of the two components, the research identified formulations that improve structural strength while preserving the biological activity needed to support living cells.

A key property demonstrated across all formulations is shear-thinning behaviour: the material flows freely when pressure is applied through the nozzle during printing, but firms up and holds its shape once extruded. This is an essential characteristic for any bioink, and confirming it across both the pure HA and composite formulations is a meaningful step forward.

From cells to tissue

Alongside bioink development, the project has advanced the biological side of the work considerably. Human cartilage cells were isolated from surgical waste tissue and successfully expanded in culture. In parallel, skin cells — including keratinocytes, which form the outer layer of skin, and dermal fibroblasts, which provide structural support beneath it — were isolated from tissue discarded during breast reconstruction surgery. Using surgical waste in this way provides an ethically sustainable source of human cells for research, without requiring additional procedures for donors.

Early tissue constructs combining these cells with the HA bioinks have shown encouraging signs of active tissue formation. Cartilage constructs demonstrated the characteristic cellular structures seen in natural cartilage, alongside early production of extracellular matrix — the biological scaffolding that gives tissue its strength and function. Cell survival was maintained across both cartilage and skin cell populations over a 21-day culture period, providing proof-of-concept that these bioinks can support genuine tissue growth in both applications.

The team has also been able to print increasingly complex anatomical structures, including prototype ear constructs and skin graft forms, with strong print resolution and shape retention — a practical demonstration of how far the technology has progressed.

Impact beyond the laboratory

This work sits within the broader 3D BIOFACE initiative at Swansea University, supported by the Scar Free Foundation and Health and Care Research Wales, and builds on Mr Jovic's prior doctoral research in cartilage tissue engineering. The BMRF grant has enabled a significant step forward in the translational development of this programme.

Three peer-reviewed publications have arisen from the project, and the work has been presented at a range of national and international conferences, including the International Society of Auricular Reconstruction in Toronto and the British Burns Association annual meeting.

Critically, the preliminary data generated through the BMRF award has directly enabled substantial follow-on investment. Mr Jovic has been awarded an Academy of Medical Sciences Starter Grant for Clinical Lecturers (£30,000) to continue and expand the programme into skin bioprinting and translational applications. He has also secured a Burns Fellowship from 2026–2027 at the laboratory of Professor Fiona Wood in Western Australia — one of the world's leading centres in burns research and regenerative medicine — creating significant opportunities to advance the translational development of this work internationally.

The vision that drives this research is a future in which patients requiring complex reconstruction no longer face the burden of donor site surgery, and in which a bioprinted ear or skin graft — made from their own cells, shaped to their own anatomy — is a genuine clinical option. For the patients and families Mr Jovic has worked alongside, that future cannot come soon enough.