{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:17:31Z","timestamp":1790270251571,"version":"4.1.0"},"reference-count":22,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T00:00:00Z","timestamp":1741305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: An autologous minimally manipulated homologous adipose tissue (AMHAT) fabricated using three-dimensional (3D) bioprinting has shown potential in the treatment of diabetic foot ulcers and other chronic wounds. Methods: This study assessed the efficacy of AMHAT fabricated using 3D bioprinting for treating skin defects after a wide excision of skin cancer lesions where primary closure was not feasible. A total of 10 consecutive patients were included. The wounds were photographed and analyzed using AI, and the fat tissue harvested from the lower abdomen was processed into an AMHAT patch using a 3D bioprinter. The wound area was measured weekly until complete wound closure was achieved. Results: The area of the skin defects ranged from 1.77\u20136.22 cm2, averaging 2.72 cm2. Complete closure was achieved in 3\u20135 (average, 4.2) weeks. The residual area decreased from 52% after 1 week to 3% after 4 weeks. The scar appearance was esthetically favorable, with one patient showing mild nostril asymmetry. Furthermore, patient-reported outcome evaluation using the Japanese version of SCAR-Q for postoperative scars showed a very high level of satisfaction. Conclusions: The 3D bioprinted AMHAT accelerates wound healing with minimal scarring, offering an important option for skin defects where esthetics are a priority.<\/jats:p>","DOI":"10.3390\/jcm14061795","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T04:29:59Z","timestamp":1741321799000},"page":"1795","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Three-Dimensional Bioprinted Autologous Minimally Manipulated Homologous Adipose Tissue for Skin Defects After Wide Excision of Skin Cancer Provides Early Wound Closure and Good Esthetic Patient Satisfaction"],"prefix":"10.3390","volume":"14","author":[{"given":"Reina","family":"Matsumura","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo 160-0023, Japan"},{"name":"Division of Plastic Surgery, Kumagaya Geka Hospital, Saitama 360-0023, Japan"},{"name":"Division of Plastic Surgery, Fukaya Red Cross Hospital, Saitama 366-0052, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8788-7684","authenticated-orcid":false,"given":"Hajime","family":"Matsumura","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo 160-0023, Japan"},{"name":"Division of Plastic Surgery, Kumagaya Geka Hospital, Saitama 360-0023, Japan"},{"name":"Division of Plastic Surgery, Fukaya Red Cross Hospital, Saitama 366-0052, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Kawai","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo 160-0023, Japan"},{"name":"Division of Plastic Surgery, Kumagaya Geka Hospital, Saitama 360-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1145-7893","authenticated-orcid":false,"given":"Jeehee","family":"Kim","sequence":"additional","affiliation":[{"name":"ROKIT HEALTHCARE, Seoul 08514, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Chae","family":"Lee","sequence":"additional","affiliation":[{"name":"ROKIT HEALTHCARE, Seoul 08514, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1498-8107","authenticated-orcid":false,"given":"Yeongseo","family":"Yu","sequence":"additional","affiliation":[{"name":"ROKIT HEALTHCARE, Seoul 08514, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo 160-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9850-5095","authenticated-orcid":false,"given":"Kazuki","family":"Shimada","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo 160-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takako","family":"Komiya","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo 160-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.det.2019.02.003","article-title":"Management of skin cancer in the elderly","volume":"37","author":"Renzi","year":"2019","journal-title":"Dermatol. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"104485","DOI":"10.1016\/j.oraloncology.2019.104485","article-title":"Surgical management of non-melanoma skin cancer of the head and neck","volume":"100","author":"Kansara","year":"2020","journal-title":"Oral. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S125","DOI":"10.1017\/S0022215116000554","article-title":"Non-melanoma skin cancer: United Kingdom national multidisciplinary guidelines","volume":"130","author":"Newlands","year":"2016","journal-title":"J. Laryngol. Otol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"105622","DOI":"10.1016\/j.oraloncology.2021.105622","article-title":"Two-stage surgery for the treatment of nonmelanoma skin cancer of the face: Change of surgical strategy during COVID-19 pandemic","volume":"123","author":"Pagliuca","year":"2021","journal-title":"Oral. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1097\/PRS.0b013e3181b17b8f","article-title":"Improvement of skin quality after fat grafting: Clinical observation and an animal study","volume":"124","author":"Mojallal","year":"2009","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"121","DOI":"10.15283\/ijsc.2015.8.2.121","article-title":"Adipose tissue\u2014Adequate, accessible regenerative material","volume":"8","author":"Kolaparthy","year":"2015","journal-title":"Int. J. Stem Cells"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"822","DOI":"10.3332\/ecancer.2018.822","article-title":"Adipose tissue stem cells in regenerative medicine","volume":"12","author":"Miana","year":"2018","journal-title":"Ecancermedicalscience"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Chae, H.J., Lee, S., Son, H., Han, S., and Lim, T. (2022, January 18\u201324). Generating 3D bioprintable patches using wound segmentation and reconstruction to treat diabetic foot ulcers. Proceedings of the IEEE\/CVF Conference on Computer Vision and Pattern Recognition, New Orleans, LA, USA.","DOI":"10.1109\/CVPR52688.2022.00257"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1177\/15347346211045625","article-title":"Management of diabetic foot ulcer with MA-ECM (minimally manipulated autologous extracellular matrix) using 3D bioprinting technology\u2014An innovative approach","volume":"23","author":"Kesavan","year":"2024","journal-title":"Int. J. Low. Extrem. Wounds"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e4588","DOI":"10.1097\/GOX.0000000000004588","article-title":"Autologous minimally manipulated homologous adipose tissue (AMHAT) for treatment of nonhealing diabetic foot ulcers","volume":"10","author":"Armstrong","year":"2022","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Namgoong, S., Yoon, I.J., Han, S.K., Son, J.W., and Kim, J. (2022). A pilot study comparing a micronized adipose tissue niche versus standard wound care for treatment of neuropathic diabetic foot ulcers. J. Clin. Med., 11.","DOI":"10.3390\/jcm11195887"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"E22","DOI":"10.25270\/wnds\/21136","article-title":"Graft of 3D bioprinted autologous minimally manipulated homologous adipose tissue for the treatment of diabetic foot ulcer","volume":"35","author":"Yasti","year":"2023","journal-title":"Wounds"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Bajuri, M.Y., Kim, J., Yu, Y., and Shahul Hameed, M.S. (2023). New paradigm in diabetic foot ulcer grafting techniques using 3D-bioprinted autologous minimally manipulated homologous adipose tissue (3D-AMHAT) with fibrin gel acting as a biodegradable scaffold. Gels, 9.","DOI":"10.3390\/gels9010066"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1055\/a-2263-7957","article-title":"Using 3D Bioprinted Autologous Minimally Manipulated Homologous Adipose Tissue for Limb Salvage in Treating Diabetic Foot Ulcer","volume":"51","author":"Yoon","year":"2024","journal-title":"Arch. Plast. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.promfg.2019.02.188","article-title":"Recent Trends in Bioprinting","volume":"32","author":"Moldovan","year":"2019","journal-title":"Procedia Manuf."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.gendis.2017.10.002","article-title":"3-D bioprinting technologies in tissue engineering and regenerative medicine: Current and future trends","volume":"4","author":"Bishop","year":"2017","journal-title":"Genes Dis."},{"key":"ref_17","unstructured":"Rasband, W.S. (2025, January 05). ImageJ, Available online: https:\/\/imagej.nih.gov\/ij\/."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e14822","DOI":"10.1111\/iwj.14822","article-title":"Effectiveness of SCAR-Q for assessment of incisional scar after implant-based reconstruction in breast cancer patients: Can it be a tool for incision selection?","volume":"21","author":"Suzuki","year":"2024","journal-title":"Int. Wound J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4874035","DOI":"10.1155\/2020\/4874035","article-title":"Utility of a new artificial dermis as a successful tool in face and scalp reconstruction for skin cancer: Analysis of the efficacy, safety, and aesthetic outcomes","volume":"2020","author":"Lembo","year":"2020","journal-title":"Dermatol. Res. Pract."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"129","DOI":"10.25270\/wnds\/23135","article-title":"Evaluating micronized adipose tissue niche and artificial dermis grafts following nonmelanoma skin cancer excision: A pilot study","volume":"36","author":"Yun","year":"2024","journal-title":"Wounds"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Parikh, N., Hu, K.G., Allam, O., Lewis, K., Ihnat, J.M., Rancu, A.L., Boroumand, S., Persing, J.A., and Alperovich, M. (2024). Using the SCAR-Q to evaluate morbidity of scars in craniosynostosis repair. Cleft Palate Craniofac J.","DOI":"10.1177\/10556656241272473"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"NP416","DOI":"10.1093\/asj\/sjac043","article-title":"Evaluating symptomatic and psychosocial well-being after keloid treatment with SCAR-Q","volume":"42","author":"Kim","year":"2022","journal-title":"Aesthet. Surg. J."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/6\/1795\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:48:48Z","timestamp":1760028528000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/6\/1795"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,7]]},"references-count":22,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["jcm14061795"],"URL":"https:\/\/doi.org\/10.3390\/jcm14061795","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,7]]}}}