Volume 33, Issue 4 e70056
REVIEW ARTICLE

3D Bioprinting Skin Equivalents: A Methodological Perspective on Human Keratinocyte and Fibroblast Models for Wound Repair and Regeneration

Juliana Amorim dos Santos

Juliana Amorim dos Santos

Laboratory of Oral Histopathology, School of Health Sciences, University of Brasilia, Brasília, Brazil

Department of Periodontics and Oral Medicine, Epithelial Biology Laboratory, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA

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Mylene Martins Monteiro

Mylene Martins Monteiro

Laboratory of Oral Histopathology, School of Health Sciences, University of Brasilia, Brasília, Brazil

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Caio C. Silva da Barros

Caio C. Silva da Barros

Department of Periodontics and Oral Medicine, Epithelial Biology Laboratory, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA

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Larissa Di Carvalho Melo

Larissa Di Carvalho Melo

Laboratory of Oral Histopathology, School of Health Sciences, University of Brasilia, Brasília, Brazil

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Ricardo D. Coletta

Ricardo D. Coletta

Department of Oral Diagnosis, School of Dentistry, State University of Campinas, Piracicaba, Brazil

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Rogerio M. Castilho

Rogerio M. Castilho

Department of Periodontics and Oral Medicine, Epithelial Biology Laboratory, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA

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Cristiane H. Squarize

Cristiane H. Squarize

Department of Periodontics and Oral Medicine, Epithelial Biology Laboratory, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA

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Eliete Neves Silva Guerra

Corresponding Author

Eliete Neves Silva Guerra

Laboratory of Oral Histopathology, School of Health Sciences, University of Brasilia, Brasília, Brazil

Correspondence:

Eliete Neves Silva Guerra ([email protected])

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First published: 28 June 2025

Funding: Amorim dos Santos was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior/Coordination for the Improvement of Higher Education Personnel—Brazil (CAPES), CAPES/PRINT (Edital N 41/2017, File #88887.694581/2022-00). C. Squarize and R. Castilho's work was funded by the National Institute of General Medical Sciences (R01GM143938).

ABSTRACT

Three-dimensional (3D) bioprinting is a promising approach to developing reliable tissue substitutes for translational research. The great interest in creating skin substitutes still faces challenges considering its structural and cellular complexity. Despite significant advancements, the lack of reproducible protocols and different translational barriers limit the clinical applicability of current methods. This review aims to provide guidance for future studies and improve methodological replication on wound repair and regeneration. Following the PRISMA 2020 guidelines, a search was conducted on MEDLINE/PubMed, EMBASE, and Web of Science. Inclusion criteria focused on 3D bioprinter constructs with human keratinocytes and fibroblasts for wound healing. Authors screened titles and abstracts, followed by full-text documents. Data extraction was conducted and cross-checked by two others using customised table sheets. Eighteen studies met the inclusion criteria, primarily focusing on skin substitutes, with no studies found on oral mucosal models. Geographic distribution was predominantly China (44.4%) and the United States (27.7%), with notable international collaborations. Most studies used extrusion-based bioprinting, with gelatin-based hydrogels as the most frequent components in the bioinks (61.6%). Other common materials included fibrinogen (38.8%) and alginate (33.3%), while some studies incorporated human serum and silk to enhance functionality. Constructed skin substitutes included epidermal layers with keratinocytes and dermal layers with fibroblasts, with some incorporating endothelial and follicle papilla cells for added complexity. Analyses included morphology, cell viability, histology, proliferation, protein and gene expression, and transepidermal electrical resistance. Many studies (61.1%) validated results through animal model implantation, primarily in mice. This review underscores the global interest and collaborative efforts in 3D bioprinting for skin wound healing and regeneration. However, we also emphasise the need for standardised protocols to improve replicability and enhance translational potential for clinical applications. Belike, future studies using computational modelling or machine learning should refine these technologies.

Conflicts of Interest

The authors declare no conflicts of interest.

Data Availability Statement

The data that supports the findings of this study are available in the supplementary material of this article.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.