A skin wound is usually thought of as no big deal for the average person, but a number of diseases can cause or contribute to the severity of a wound in a way that requires the intervention of certain technologies for adequate healing.
Underlying conditions ranging from malnutrition and stress to metabolic syndrome predispose patients to chronic wounds that prompt the need for intervention to speed up a lacklustre healing process.
One academic paper recently delved into the scope of the problem and revealed that in the United States, 3% of the population over 65 years of age have open wounds, and 2% of the total population suffer from chronic wounds.
In monetary terms, Medicare cost projections for all wounds range from $28.1bn to $96.8bn, including costs for infection management, among which surgical wounds and diabetic ulcers were the most expensive to treat.
Medical professionals already use innovations like biological dressings and negative pressure therapy for wound healing, but here we look at the role several promising technologies could play in future clinical pathways.
Four technologies that could feature in the future of wound healing:
1. 3D-printed stem cells
The ability for stem cells to metamorphose into any cell type in the body is well documented and the basis for several treatment applications, including accelerated wound healing.
But back in February this year, a research team at the University of Toronto unveiled a handheld 3D printer that can deposit stem cells onto wounds embedded in a skin graft made of bioink to aid tissue healing.
It’s unclear how much use the technique could have for chronic wounds, as the focus of the research supporting the device was full-thickness burns – those that damage all three layers of the skin.
But one review of natural bioinks carried out in August this year concluded that they showed “excellent ability” to mimic the three-dimensional microenvironment structure of native skin tissue, and to promote cell adhesion, proliferation, migration, and mobility.
The researchers expect the handheld 3D printer to be in clinical settings within the next five years.
2. Collagen-based wound dressing
Before the prospect of a skin graft is discussed, wounds tend to be covered using a dressing, and depending on the severity, perhaps an advanced dressing made to promote healing.
But despite the range of materials used to make these dressing, current offerings cannot form antibacterial barriers and facilitate efficient healing at the same time.
The recent discovery of the healing and antimicrobial properties of human collagen VI enabled the development of a product with the potential to improve wound management.
The Swedish company Colzyx aims to address the unmet challenges in wound management with its novel bioactive wound dressing product, that both accelerates wound healing and at the same time exhibits clear antibacterial effects.
The company is currently in the research phase with the dressing, validating it with €3.6m ($4.3m) in funding, €2.5m ($3m) of which came from the European Union’s Horizon 2020 research and innovation program.
3. Fluorescence point-of-care imaging
Rather than treating the wound directly, fluorescence point-of-care imaging is a diagnostic tool that allows clinicians to get an accurate picture of bacteria quantity and virulence to tailor treatment plans per individual.
During the period of fluorescence imaging using the MolecuLight i:X, a recent 350-person study of patients with diabetic foot ulcers found the use of MolecuLight fluorescence point-of-care imaging increased the number of diabetic foot ulcer wounds healed within 12 weeks by 23%.
Implementation of fluorescence imaging was associated with a 49% decrease in the prescription of antimicrobial dressings and a 33% decrease in antibiotic prescriptions.
The handheld portable autofluorescence imaging device from MolecuLight is CE marked for sale in Europe and is currently being sold in Canada.
4. Bacteria-killing lasers
The skin provides a protective barrier to bacterial invasion, whereas a wound creates an entry point for bacteria to invade and reach the deeper layers of it.
The need to kill this bacteria arises because once present, it can form biofilm that resists treatments applied to aid wound healing, allowing it to continue to survive.
Wound debridement – the killing of bacteria and removal of necrotic (dead) tissue – is a key step in healing chronic wounds, most of which get infected in this way.
But where current methods include surgical intervention and advanced dressings that apply enzymes to rid the wound of debris, one company is working to commercialise a hand-held laser operated by a single health professional that kills the biofilm-producing bacteria.
Scandinavian company VulCur Medtech’s mission statement involves killing biofilm-producing bacteria in chronic wounds, thereby preventing amputations and unnecessary use of antibiotics.
The company received €1m ($1.2m) towards regulatory approval costs from the Eurostars-2 joint programme this year, adding to funding from the European Union’s Horizon 2020 research and innovation program.
