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Smart bandage uses nanosensors to track how a wound is healing

Bandages are intended to keep a dressing secure and clean in order to reduce healing time and infection rate. However, they may be about to get a new use-case, courtesy of a project from the United Kingdom’s Swansea University Institute of Life Science.

What researchers there have been working on is a new smart bandage capable of tracking how a wound is healing and sending that data back to doctors, via 5G technology. To do this it would employ tiny “nanosensors” able to fit comfortably within the fabric of regular bandages.

The resulting smart bandage would allow doctors and caregivers to know exactly at which stage in the recovery process a wound is, thereby allowing them to tailor their treatment more accurately for the patient.

Read more here.

‘Miracle’ stem cell treatment heals burns without scarring

Pennsylvania state trooper Matt Uram was talking with his wife at a July Fourth party in 2009 when a misjudged spray of gasoline burst through a nearby bonfire and set him alight. Flames covered the entire right side of his body, and after he fell to the ground to smother them, his wife beat his head with her bare hands to put out his burning hair. It was only on the way to the ER, as the shock and adrenaline began to wear off, that the pain set in. “It was intense,” he says. “If you can imagine what pins and needles feel like, then replace those needles with matches.”

From the hospital, Uram was transferred to the Mercy Burn Center in Pittsburgh, where doctors removed all of the burned skin and dressed his wounds. It was on the border between a second- and third-degree burn, and he was told to prepare for months of pain and permanent disfigurement. Not long after this assessment, however, a doctor asked Uram if he would be willing to take part in an experimental trial of a new device.

The treatment, developed by German researcher Dr. Jörg Gerlach, was the world’s first to use a patient’s stem cells to directly heal the skin. If successful, the device would mend Uram’s wounds using his body’s ability to regenerate fully functioning skin. Uram agreed to the procedure without hesitation.

Five days after the accident, surgeons removed a small section of undamaged skin from Uram’s right thigh—about the size of a postage stamp—and used it to create a liquid suspension of his stem cells that was sprayed in a fine mist onto the damaged skin. Three days later, when it was time to remove the bandages and re-dress the wounds, his doctor was amazed by what he saw. The burns were almost completely healed, and any risk of infection or scarring was gone.

Read more here

How to benefit from electrical stimulation for the treatment of chronic wounds

One of the most amazing things about the human body is its ability to repair itself. Lacerations, punctures, abrasions all heal with little or no care. Chronic wounds, those that persist day after day, are a small subset of wounds but they compose a troublesome minority. They include, but are not limited to, diabetic foot ulcers (DFU), venous leg ulcers (VLU), and pressure ulcers (colloquially known as bedsores). These represent the body’s failure to fix itself.

Approximately 6.5 million Americans are affected by chronic wounds. Because of certain medical trends (aging populations, increased occurrence of diabetes, the rise in obesity), chronic wounds are becoming more common, occurrences increasing at around 8% per year. The US spends $25 billion annually treating these wounds, which are the most expensive complication following surgery. Wounds are a major source of bacteria that drive infection rates at hospitals.

Initial treatment of a chronic wound involves regular cleaning and covering the damaged area with wound dressings and bandages. In many instances, the physician will debride the dead or inflamed tissue, removing it by various methods ranging from plucking it away with tweezers to introducing maggots to the wound where they consume the damaged tissues.

However, some wounds still fail to heal. These ulcers require advanced therapies. These include:

  • Electrical stimulation
  • Negative pressure
  • Hyperbaric oxygen
  • Growth factors
  • Skin substitutes
  • Stem cells

Nursing home healthcare professionals will select the specific treatment best suited for their patients. A new treatment option using electrical stimulation, the Bioelectrical Signal Therapy (BST) Device from E-QURE may soon present a very cost and time-effective solution.

Read more of the article at McKnight’s

New Approach to Wound Healing Easy on Skin, Tough on Bacteria

Washington, D.C. — In a presentation  to the American Chemical Society meeting, Ankit Agarwal, a postdoctoral researcher at the University of Wisconsin-Madison, described an experimental approach to wound healing that could take advantage of silver’s anti-bacterial properties, while sidestepping the damage silver can cause to cells needed for healing.

Silver is widely used to prevent bacterial contamination in wound dressings, says Agarwal, “but these dressings deliver a very large load of silver, and that can kill a lot of cells in the wound.”
Wound healing is a particular problem in diabetes, where poor blood supply that inhibits healing can require amputations, and also in burn wards. Agarwal says some burn surgeons avoid silver dressings despite their constant concern with infection.
Using a new approach, Agarwal has crafted an ultra-thin material carrying a precise dose of silver. One square inch contains just 0.4 percent of the silver that is found in the silver-treated antibacterial bandages now used in medicine.
In tests in lab dishes, the low concentration of silver killed 99.9999 percent of the bacteria but did not damage cells called fibroblasts that are needed to repair a wound.
Agarwal builds the experimental material from polyelectrolyte multilayers — a sandwich of ultra-thin polymers that adhere through electrical attraction. To make the sandwich, Agarwal alternately dips a glass plate in two solutions of oppositely charged polymers and finally adds a precise dose of silver.
“This architecture is very easily tuned to different applications,” Agarwal says, because it allows exact control of such factors as thickness, porosity and silver content. The final sandwich may range from a few nanometers to several hundred nanometers in thickness. (One nanometer is one-billionth of a meter; a human hair is about 60,000 nanometers in diameter.)
Nicholas Abbott, a professor of chemical and biological engineering who advises Agarwal, says during the past decade, “about a bazillion papers have been published on polyelectrolyte multilayers. It’s been a tremendous investment by material scientists, and that investment is now ripe to be exploited.”
Read more at HealAlerts

Adjunctive Modalities in Wound Care: Laser Therapy

by Aletha Tippett MD

In looking at technology that helps in wound care, how many know about—and use—lasers? Cold lasers have been used by physical therapists for years, but cosmetic lasers can also be used. I have had tremendous success using laser therapy on wounds. Healing is much improved (and faster), with less scarring. I am not a technocrat. I’m much more old-fashioned, but the laser is a wonder.

Laser Technology in Managing Wounds

Years ago, I received a notice about a laser presentation, and was intrigued by the statement that lasers could stimulate collagen. As a new wound physician, I knew that collagen was an important protein in wound healing, so I went to the laser presentation and asked about collagen stimulation. The doctor presenting told me that the laser absolutely stimulates collagen – that’s how a cosmetic laser reduces wrinkles and lifts the skin. Fascinated, I attended every laser therapy presentation I could find, and attended a three-hour workshop for family medicine. At all presentations, I was told how a laser stimulates collagen, but no one I asked was aware of any wound treatment being done with laser technology. Of course, these were all cosmetic lasers. When I researched it further, I found that some physical therapists used “cold laser” for wound healing at a very low energy level.

I had seen dozens of lasers, and tried all of them. At the family medicine workshop, there were several lasers on display. The last one I saw was called Friendly Light (Aerolase). When I was testing it, I remarked that I couldn’t feel it. Every laser I had tested so far could be felt, sometimes painfully. That one could also be dialed down to a very low energy level (4-8 joules), making it almost like a cold laser.

So, I spent my $50,000 and bought a laser, an Nd:Yag that had a dial for altering the amount of energy used. I started using it on wounds, and it was remarkable. Wounds healed much faster (and with less scarring) using the laser – so this technology was definitely a good thing. Below are pictures of wounds treated using the laser:

lasers-in-wound-care-1
lasers-in-wound-care-2
 

Case: 47 year old with renal failure and sensory neuropathy with 3rd degree burns on foot. One laser treatment with 4 joules/cm2
 

Read more at WoundSource

Long-Term Outcome of Pediatric Traumatic Wound Repair: Suture Versus Tissue Adhesive

Summary

This project is an observational trial investigating wound cosmetic appearance after repair of traumatic skin lacerations in the head area of pediatric patients with two different approaches to skin closure: sutures versus tissue adhesive. Photographs will be taken at two follow-up visits after repair and later encryptedly assessed by external plastic surgeon using standard cosmetic assessment scales. The investigators hypothesize that cosmetic wound outcome will be equivalent in these two wound repair treatment options.

Description

Investigation of the long-term outcome of 400 pediatric patients with traumatic skin lacerations in the head area. After primary wound repair with suture or with tissue adhesive, eligible patients will be enrolled on the emergency department (baseline visit). The second follow-up visit will take place 5-10 days after the baseline visit and the third follow-up visit will be completed 6-12 months after trauma. At both follow-up visits, clinical examination and a brief interview will be performed. Foto documentation is completed at both the baseline and the follow-up visit.

Encrypted foto documentation will be evaluated by blinded external plastic surgeons. Primary Outcome is the cosmetic appearance using standard assessment scales, secondary outcomes are the occurrence of complications, cost-effectiveness and patient’s satisfaction.

Read more at BioPortfolio

Breaking silos: Effective wound healing means treatment across the continuum

Around 6.5 million patients in the U.S. suffer from chronic wounds, such as pressure injuries or ulcers. Treatment costs $25 billion each year, representing a sizable and growing problem. Despite the wide impact of chronic wounds, it’s rare to see specialized, effective wound care delivered across the care continuum.

A chronic non-healing wound is a surrogate marker for illness. These patients require holistic management of their co-morbidities and continuity across care settings.

Despite this, a great deal of emphasis has been placed on treating wounds as singular events, managed topically with expensive dressings and support surfaces. This is only a small part of wound healing.

As a physician focused solely on wound care, I have learned that we must shift the focus from simply treating the wound to treating the wounded patient. The impact in the post-acute care setting in particular is worthy of evaluation and discussion, as up to 29% of patients in long-term care facilities will experience a pressure ulcer, posing serious legal, financial, and staffing implications.

For those providers working outside long-term care, there is little understanding of challenges facing LTC providers. Acute providers do not often ask, for example, how are my LTC partners reimbursed? How are they staffed? What are the requirements and regulatory pressures they face? Asking these questions would facilitate a more productive dialogue with a focus on collaborative prevention, rather than waiting until a chronic wound occurs in the LTC setting.

Creating an integrated wound care community

To address the needs of the present and growing population of patients with chronic wounds, Healogics developed an integrated wound care community model, to coordinate the wound healing process across all care settings. The program utilizes Healogics Specialty Physicians, a subspecialty group of physicians and providers with extensive training solely focused on wound care.

HSPs provide expert inpatient consultation and ensure safe transition of patients out of the hospital into the appropriate care setting. Because HSPs see the patient regardless of post-discharge venue, patients receive the same quality of care whether they are going home, to a skilled-nursing, assisted living, or LTC setting. Because chronic wounds are surrogate markers for illness, we have realized it’s essential to have an integrated, multi-setting, and multi-disciplinary process to treat the patient and their co-morbidities.

Data collected at a pilot IWCC site in the Midwestern U.S. from 2014 to 2016 revealed very positive trends for chronic wound patients. In the acute care setting, the average length of stay decreased from 9.41 days to 5.64 days, and total cost of care per patient was reduced from $10,670 to $7,248.

We’re excited by these promising results, which were revealed at the American College of Wound Healing and Tissue Repair Conference last December. We look forward to refining and expanding the model by helping our partners in acute and LTC settings standardize their practices, use evidence-based clinical guidelines, mobilize technologies and processes, and pay critical attention to patient safety and value-based outcomes.

When it comes to wound healing, no venue of care should operate alone—an integrated solution that creates continuity for the patient is critical. There are four things LTC facilities can do to break down the silos:

Read more at McKnight’s

NYU docs are using machine learning to stop a stealthy disease before it’s too late

Lymphedema causes unsightly swelling in the arms and legs. But researchers Mei Fu and Yao Wang have an idea for catching early symptoms sooner.

Researchers at NYU’s Tandon School of Engineering have teamed up with those from the university’s Rory Meyers College of Nursing to develop a machine-learning algorithm that could help detect a lymphatic system disease before doctors are able to.

There is no cure for lymphedema, only physical exercises that can keep the symptoms in check.

Early detection of the disease would allow for physical therapy that could theoretically stop the disease’s progress enough to never allow it to develop.

“Machine learning will help us to develop an algorithm to determine a patient’s status or predict if they will have a measurable symptom later on,” explained Mei Fu, an associate professor at NYU’s Rory Meyers College of Nursing, by telephone last week. “Each time the patients enter the data, the algorithm will teach itself. Later on, machine learning will probably help us say which treatment is better for which kind of patients.”

Read more at Technically Brooklyn

Doctor-turned-businesswoman uses technology to help diabetics save their feet

When Dr. Breanne Everett began training to become a plastic surgeon she was shocked by the number of foot problems, including amputations, she was seeing among diabetic patients. She decided to look for a solution.

That led the 32-year-old physician to put her medical training on hold and make the transition into business and technology.

She invented a device to alert diabetic patients before a sore spot on their foot turned into a wound that could cause severe complications.

The Calgary company she founded — Orpyx — developed pressure-sensitive insole technology to feed information to patients and prevent the kinds of wounds that can lead to amputations in diabetics with peripheral neuropathy, which can cause numbness in the feet.

The company’s smart-sole foot protection system is attracting attention around the world with ongoing clinical trials in both the U.S. and U.K. The product is available through the company, which calls it the only device of its type on the market.

Read more at Ottawa Citizen