Now you See It, Now You Don’t: Remedies for the Large, the Small and Everything In-Between

When you think about wounds, the scenario probably goes a little something like this:  chopping knife and onions, slip of the hand, band aid.  Even though your experience correlates to that of the general population, you really should know at least a little more about the subject matter.

Wounds of all shapes and sizes are all caused by some type of trauma to the protective barrier the skin, or other body tissue, forms against its external environment.  Open wounds include lacerations, punctures, incisions, abrasions and avulsions, where blood escapes from the body.  Closed wounds include strained or torn muscles and bruises, where no blood escapes from the body and bleeding may occur under the skin.
Wound healing is a complex cellular process by which skin, or other body, tissue repairs itself after trauma. The deeper the wound, the longer it takes to heal, with the typical wounds requiring about 3 weeks, excluding scarring.  Chronic wounds, however, are wounds that do not heal for a period of at least 3 months.  They can be open on the external or internal surface of the body and include ulcers like stomach ulcers and bed sores.
The greatest concern regarding open wounds is the potential for serious bacterial infections.  Between 5% and 10% of patients hospitalized in industrialized countries develop a healthcare-associated infection. It not only increases mortality and morbidity rates, but healthcare-associated infections diagnosed in intensive care units alone account for 15% to 20% of hospital spending.  A key focus area for the treatment of wounds is therefore infection prevention.
Technology has been applied in this area since before the word existed.  In the 1700s silver (yes, the metal) started being used on chronic wounds and it has played a major role in the development of wound care since.  Over the past 20 years, topical cream and foam dressings containing silver have promoted wound healing and decreased infection.  Its success is based on that fact that silver agents attach to the bacterial wall and block the respiratory cycle of the bacteria – basically choking it to death – and thereby reducing competition for nutrients attempting to heal the wound.
Ushering in the new technological age, Xiaolei Wang, and colleagues at NanChang University, have invented smart bandages which take silver one step beyond. Wang used silver nanoparticles (nanomedicine article two weeks ago) that promote faster absorption, to develop antibacterial materials which are enclosed in the lining of capsules.  The capsules have a switch to control the containment or release of the anti-bacterials upon manipulation.  To demonstrate the capsules’ features, Wang’s team incorporated them into simple Band-Aids. Once the wearer presses down on the Band-Aid, the silver particles are released, and the color of the Band-Aid changes from white to orange to indicate that it has been activated, and the bacteria choking has commenced.
Infection prevention is not the only area in which technology is changing the game.  Another is wound healing.  Photochemical tissue bonding is when light is applied to a wound to stimulate healing.  Until recently it could only be used for the treatment of superficial wounds.  A new technique has been developed by researchers at the University of St Andrews and Harvard Medical School. By inserting biodegradable optical fibers, instead of traditional glass or plastic materials into the body, light to heal internal wounds locally can be delivered deeper into the body. Not only will it help heal wounds faster, but it will also provide doctors with the ability to heal wounds from the inside and without scarring.
In addition to infection prevention and wound healing, these emerging technologies will also change how all stakeholders in the healthcare industry look at wound care:
•    Flexible biosensors can be embedded into wound dressings to detect bacteria that lead to infections early, and also to maintain pressure and temperature for optimal healing,
•    As an alternative treatment for antibiotic resistant infections, new tissue can be biologically engineered, and
•    And 3D technology can be used to create skin grafts or dressings that mimic the wound bed structure for improved healing.
With these technologies being the tip of the iceberg which simply wet your appetite, there is always the Deutscher Wundkongress, which will be held from 11 – 13 May this year in Bremen, Germany.  Apart from it being the very best time of the year for a visit to the North of the country, the sessions will evaluate experiences with different types of up-to-date wound healing technologies and devices, evaluated in the light of solid scientific evidence and in a cost-effectiveness perspective.

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