THE FUTURE OF MEDICINE

3D printing could change the way youre healed.

It could help doctors create personalised treatments,
unique to each patient. Find out what new 3D printed
treatments could do for you...

Can you rebuild

my face?

Twenty tablets a day?

Can you print just one?

1. Tailored response...p7
2. Serious trauma...p8
3. A perfect fit...p9
4. Practice makes
perfect...p10
5. Achieving the
impossible...p11

1. Too many tablets...p1

2. From 20 to 1...p2
3. Printing with
precision...p3
4. Targeted tablets...p4
5. Quality control...p5
6. Future Vitamins...p6

Can you grow me

a new ear?
1. Regeneration...p12
2. Skull patch...p13
3. Breathe easy...p14
4. Printing ears...p15
5. Fingerprints...p16
6. Printing in surgery...p17

Image: Science Museum

Image: Flickr/JenTravelsLife

Image: Flickr/ahisgett

Image: Flickr/Newsbie Pix

Image: Flickr/stevendepolo

Contents

Can you print me

new skin?
1. Burning issue...p18
2. Skin printers...p19
3. Second skin...p20
4. Soldiers skin...p21

Can you print me a

new organ?
1. Waiting list...p22
2. Cell ink...p23
3. Plumbing...p24
4. Facing the challenges...p25
5. Decades of tests...p26
6. Look after yourself!...p27

THE FUTURE OF MEDICINE

Twenty tablets a day? Can you print just one?

1. TOO MANY TABLETS

Older people or those with long-term illnesses
such as HIV may have to take up to 20 tablets
a day.
Jayne Lawrence, Chief Scientist at the Royal
Pharmaceutical Society, thinks this is more
than just a minor inconvenience:
Studies show 3050% of people with a long-term
illness dont take their medication correctly, which
can render the treatment ineffective or cause
side effects. In 200607 this cost the NHS over
36 million.

Jayne Lawrence
Image: Jayne Lawrence

THE FUTURE OF MEDICINE

Twenty tablets a day? Can you print just one?

2. FROM 20 TO 1
Clive Roberts and his team at Nottingham
University think 3D printing may provide a solution:
My team is working on 3D printing tablets that
combine lots of different ingredients, designed to
treat you throughout the day. In the future your
doctor could formulate a tablet that had the exact
combination of medicines to treat your unique
condition, and print it off for you.
Sounds good, but how does it work?

Clives team made tablets with multiple

ingredients that treat chronic illnesses such
as arthritis, hypertension and cancer.
Image: University of Nottingham

3D printed tablets.
Image: Jennie Hills/Science Museum

THE FUTURE OF MEDICINE

Twenty tablets a day? Can you print just one?

3. PRINTING WITH
PRECISION
Shaban Khaled, a student on Clives research team,
explains how printing tablets works:
We use a simple printer to make 3D printed
tablets. Each nozzle has a different ingredient in
it and the printer precisely lays down tiny drops
of each material. We coat some ingredients in
materials that delay the release of the drug. This
gives us precise control over how the tablet works
after youve taken it.

In the future a 3D printer like this could be

in your doctors surgery or pharmacy.
Image: Flickr/roberthunt1987

THE FUTURE OF MEDICINE

Twenty tablets a day? Can you print just one?

4. TARGETED TABLETS
Clinician David Adlam believes bespoke treatments
will be vital in the future:
As scientists learn more about illnesses theyre
finding that each patients condition is caused
by multiple molecular and genetic changes. I see
a future where we target these changes with a
combination of treatments specific to each person.
The cost of using traditional manufacturing to
produce individual combination treatments would
be huge. 3D printing offers a potential solution.

Genetic tests show doctors the unique

differences in our genes that can cause us
to react to illnesses in different ways.
Image: Flickr/Mattes

THE FUTURE OF MEDICINE

Twenty tablets a day? Can you print just one?

5. QUALITY CONTROL
Mass-manufactured tablets are regulated and
tested. How will the quality of small numbers
of tablets printed in multiple local locations be
maintained? The Royal Pharmaceutical Societys
Jayne Lawrence thinks this will be difficult:
Its likely a pharmacist would print tablets as
theyre authorised to make medicines. But before
we get to that stage, 3D printed tablets will have
to be thoroughly tested to make sure theyre safe
and work properly.

In the past pharmacists made many

medicines. This could become a familiar
sight again with 3D printing.
Image: Flickr/pamelainob

THE FUTURE OF MEDICINE

Twenty tablets a day? Can you print just one?

6. FUTURE VITAMINS
Clive Roberts and his team can print complex
tablets. But it will be years before patients use them.
What applications does he think people could be
using sooner?
Theres a lot of regulation in medicine.
This technology could be used more quickly for
less potentially harmful tablets, like vitamins and
supplements. If you have allergies or cant eat certain
things, you might lack vital vitamins. We could
design you the perfect supplement.

Image: Flickr/Clean Wal-Mart

THE FUTURE OF MEDICINE

Can you rebuild my face?

1. TAILORED RESPONSE
When a patient comes into the emergency room,
surgeons and doctors need to act fast. After the
initial surgery to stabilise the patient, specialists
can then work on reconstructing the body.
This often involves lengthy and complex
reconstructive surgery, unique to each patient.
3D printing can provide implants and surgical
guides tailored to each unique case.

Image: Flickr/James Mutter

THE FUTURE OF MEDICINE

Can you rebuild my face?

2. SERIOUS TRAUMA
Adrian Sugar is a maxillofacial surgeon at
Morriston hospital in Swansea. He had a patient
come in after a serious motorbike accident with
multiple injuries.
The bones in my patients face, especially his left
eye socket, were crushed. Reconstructive surgery
to rebuild his face was going to be extremely hard.
Luckily, Adrian and his team work with researchers
at Cardiff Metropolitan University to make 3D
printed implants for facial reconstruction.

A computer rendering of the damaged skull

Image: Dominic Eggbeer, Sean Peel and
Peter Evans

THE FUTURE OF MEDICINE

Can you rebuild my face?

3. A PERFECT FIT
Dominic Eggbeer, the lead researcher at Cardiff,
explains what they did:
First the injury was scanned. We used this scan
to generate a computer model of the damaged
skull. My colleague Sean Peel and I then worked
with Adrian and his team to design an implant to
fix the damaged bone and replace bone which was
beyond repair. It was easy to print this implant in
strong metal material.

The computer rendering of the multi-part

implant Dominic, Adrian and their teams
designed.
Image: Dominic Eggbeer, Sean Peel and
Peter Evans

THE FUTURE OF MEDICINE

Can you rebuild my face?

4. PRACTICE MAKES
PERFECT
Planning the reconstruction on the computer
screen first allows Adrian to practise the surgery
in advance.
I can see that the reconstruction works on the
computer. I then print a physical model of the
damaged skull and replicate the surgery. This helps
us design the implants required. We can also design
guides to use in surgery that tell me exactly where
I need to cut and position the bones.
3D printed guides and implants can be used like
stencils to help surgeons cut and reposition bones in
precisely the right place to achieve the best results.

3D printed guides and implants.

Image: Science Museum

10

THE FUTURE OF MEDICINE

Can you rebuild my face?

5. ACHIEVING THE
IMPOSSIBLE
Normally, reconstructive implants are made by
bending metal plates into the right shape. 3D printed
implants can be more complex and tailored to each
patient. According to Adrian, his patients injury was
especially challenging:
The injuries were so severe it would be hard to
achieve significant improvement with freehand
reconstruction. The multi-part implant we designed
was an exact fit, so surgery was quicker and a much
better result achieved.

Traditional bent metal plates are

unlikely to be an exact fit.
Image: Morriston Hospital Maxillofacial
Unit, Swansea

11

THE FUTURE OF MEDICINE

Can you grow me a new ear?

1. REGENERATION
Researchers around the world are 3D printing
scaffolds and implants to replace, reconstruct and
regenerate parts of the body. It seems far-fetched
but these treatments have already been used in
thousands of patients. In the future we could use
them to grow new body parts.
Dietmar W Hutmacher, a leading tissue engineer,
and surgeon Jan-Thorsten Schantz used 3D
printing to treat a young girl with a hole in her skull.

Dietmar, in Australia, and Jan-Thorsten, in

Germany, collaborate across the world to
develop new regenerative treatments.
Image: Queensland University of Technology,
Australia/Rechts der Isar University Hospital,
Germany

12

THE FUTURE OF MEDICINE

Can you grow me a new ear?

2. SKULL PATCH
How does it work? Dietmar explains:
We print a scaffold that is the exact shape of the
missing bone. Once the porous scaffold has been
implanted, new bone grows into it. Over a couple
of years the scaffold will degrade away to leave
behind new, healthy bone.
This type of scaffold has been used in thousands of
patients to regenerate the skull, pelvis or jawbone.
Dietmar and Jan-Thorstens team arent the only
ones to have success with 3D printed treatments...

In this MRI scan of the skull you can see

the bone regrowing over time.
Image: Queensland University of Technology,
Australia/Rechts der Isar University Hospital,
Germany

13

THE FUTURE OF MEDICINE

Can you grow me a new ear?

3. BREATHE EASY
Doctor Glenn Green hit the headlines when he
teamed up with biomedical engineer Scott Hollister
to print part of a windpipe.
A six-week-old boy had been rushed to hospital
after his windpipe collapsed. Glenn and Scott
designed and 3D printed a tube to hold the babys
airway open.
After a few years the tube will dissolve. By then
his windpipe should have grown strong enough
to function normally.

The 3D printed windpipe model and

supportive tube.
Image: Glenn Green and Scott Hollister,
Michigan University

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THE FUTURE OF MEDICINE

Can you grow me a new ear?

4. PRINTING EARS
Glenn and Scott are now printing scaffolds to grow
ears and noses.
We use a scan of your other ear to print a scaffold
thats the right shape and size. Its covered in a
mixture of your cells and implanted under the skin.
Over time your cells will travel into the scaffold and
new tissue will form.
These scaffolds have been trialled successfully in
animals. Glenn and Scott hope to start clinical trials
in the next ten years.

3D printed ear and nose scaffolds.

Image: Jennie Hills/Science Museum

15

Glenn Green and Scott Hollister.

Image: Michigan University

THE FUTURE OF MEDICINE

Can you grow me a new ear?

5. FINGERPRINTS
Anthony Atala, from the Wake Forest Institute for
Regenerative Medicine, is a leader in regenerative
medicine working at the cutting edge of bioprinting
research.
Were working on growing fingers. We can print
scaffolds to grow bone. Fingers have muscles,
tendons and joints so we need to print with
different types of cells to form these components.
Our goal is to learn how to print and assemble
these different parts, or print them all together.

A 3D printed finger scaffold.

Image: Jennie Hills/Science Museum

16

Anthony Atala.
Image: Wake Forest Institute for
Regenerative Medicine

THE FUTURE OF MEDICINE

Can you grow me a new ear?

6. PRINTING IN SURGERY
When you print with cells its hard to keep them
alive in the scaffold. They need to be implanted
very quickly so your body can keep the cells
alive. Tissue engineer John Hunt thinks the best
solution is to 3D print in hospital.
In the future scaffolds could be printed in
surgery, using a mixture of body-friendly
materials and your own cells. These could be
implanted into you immediately.

3D printers could be another bit of kit in the

operating theatre.
Image: Flickr/Andy G

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THE FUTURE OF MEDICINE

Can you print me a new skin?

1. BURNING ISSUE
James H Holmes IV is a burn surgeon. He hopes
3D printing technology could revolutionise the
way burns are treated:
Skin grafts are used to treat people with severe
burns. Healthy skin from another part of the body
is removed and transplanted over the burn. This
is an extremely painful procedure that can leave
significant scarring. Printing new skin over a burn
would be far less painful for my patients.

James H Holmes IV.

Image: Wake Forest Institute for
Regenerative Medicine

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THE FUTURE OF MEDICINE

Can you print me a new skin?

2. SKIN PRINTERS
A research team at the Wake Forest Institute
for Regenerative Medicine are using 3D printing
technology to print skin cells to heal burns.
John Jackson leads research team at Wake Forest:
We use a special 3D printer to print inks
containing different kinds of skin cells. If you had
a severe cut or burn wed scan it to find out how
deep it is different kinds of skin cells are found
at different depths. Wed use the printer to apply
layers of the right cells to cover the wound.

John Jackson says the skin printer could

reduce healing time from eight to three weeks.
Image: Wake Forest Institute for Regenerative
Medicine

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THE FUTURE OF MEDICINE

Can you print me a new skin?

3. SECOND SKIN
John Jackson sees real benefits for patients with
severe burns:
A skin printer would be important for people with
severe burns who dont have enough healthy skin
left to do a skin graft. If used quickly it will reduce
the risk of the burn wound getting infected. And
I can use the patients own cells in the printer, so
the new skin wont get rejected.

A patch of skin one-tenth the size of the burn

will grow enough skin cells for skin printing.
Image: Wake Forest Institute for
Regenerative Medicine

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THE FUTURE OF MEDICINE

Can you print me a new skin?

4. SOLDIERS SKIN
Burns account for about 10% of casualties in
warzones. Skin printers are quite small and
portable. They could be used for soldiers in the
field who cant get to a hospital easily.
The team at Wake Forest are working with the US
Department of Defence to bring this technology
to soldiers who need it within the next five years.

Image: Flickr/isafmedia

21

THE FUTURE OF MEDICINE

Can you print me a new organ?

1. WAITING LIST
The average waiting time for a new organ is 142
days. Even if youre lucky enough to get a donation
your body may reject it.
Scientists around the world are working on solving
the organ donation problem by using 3D printing
to build human tissues and organs.

Image: Science Museum

22

THE FUTURE OF MEDICINE

Can you print me a new organ?

2. CELL INK
Kevin Shakesheff from the University of
Nottingham researches organ printing:
I want to print with inks that contain all the
different cell types that make up an organ, and
use these inks to print a whole organ. These
printed organs could be made from the patients
cells so there is no issue of rejection.
There are a number of challenges to overcome
before 3D printed organs can become a reality.

The printer would precisely lay down each

cell type where it needs to be to recreate the
complex structure of human organs.
Image: Wake Forest Institute for Regenerative
Medicine

23

THE FUTURE OF MEDICINE

Can you print me a new organ?

3. PLUMBING
Tissue engineer Gordana Vunjak-Novakovic thinks
organ researchers need to perfect the plumbing!
Scientists can currently print tiny patches of tissue.
The challenge is scaling these up to the size of an
organ. Small patches of tissue can absorb nutrients
from the outside to stay alive. Bigger patches, like
an organ, need internal plumbing blood vessels
to feed them from the inside and keep them alive.
Will a 3D printed organ really be possible?

This tiny 3D printed piece of liver tissue could

be used to test new drugs.
Image: Organovo, Inc.

24

THE FUTURE OF MEDICINE

Can you print me a new organ?

4. FACING THE CHALLENGES

Dietmar W Hutmacher pioneered scaffold printing.
He anticipates that organ printing will be possible
despite the challenges:
Bioprinting has come a long way in a short time.
The field is only ten years old. In that time we have
printed scaffolds, cells, and small patches of tissue.
Scientists have found they can now print blood
vessels. I think in the next few decades printed
organs will become a reality.

Printed blood vessels bring printed organs

a step closer.
Image: Jennie Hills/Science Museum

25

THE FUTURE OF MEDICINE

Can you print me a new organ?

5. DECADES OF TESTS
Brian Derby from the University of Manchester
thinks were a long way from working 3D printed
human organs:
We have to know printed organs will work and
keep working. We cant just pop something inside
someone and hope it will work. Even if we can print
a whole organ there will be at least a decade of
testing before this comes close to reality.

Brian Derby.
Image: Science Museum/Chocolate Films

26

THE FUTURE OF MEDICINE

Can you print me a new organ?

6. LOOK AFTER YOURSELF!

Should you stop worrying about staying healthy
and simply print replacement parts?
No. Tissue engineer John Hunt had this to say:
Even if we print new organs, unlike a donated
organ, it will be a long while before scientists know
how long theyll last. Manufactured organs should
not be replacement parts that keep us going
forever. We still need to look after ourselves!

Image: Flickr/MayorofSandwell

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