A team is developing a new cost-effective way to heal chronic wounds

Tens of millions of patients worldwide suffer persistent and life-threatening injuries. For these chronic wounds, which are also a major cause of amputation, there are treatments, but the cost of existing dressings can prevent them from reaching people who need it.

Now a Michigan State University researcher leads an international team of scientists to develop a practical, low-cost biopolymer dress up this helps to heal these wounds.

“Existing efficient technologies are too expensive for most health care systems, which limits their timely use,” said Morteza Mahmoudi, assistant professor at Michigan State University College of Human Medicine and the Health Program. of precision. “Economically accessible, practical and effective technology is needed.”

To develop this new technology, Mahmoudi took advantage of years of experience and expertise, having studied advanced materials to heal heart tissue, fight infections and support immune systems. But the team also monitored the cost, working to develop a product that could be made available to as many patients as possible, even in limited resource markets.

“My goal is always to do something that works and is practical,” Mahmoudi said. “I want to see my research as clinical products that help patients.”

With his latest work, published on July 19 in the magazine Molecular pharmaceuticals, Mahmoudi is closer to that goal. He works with UK partners who have set up a company to oversee the development and approval of new technology.

“We are building an experienced and expert team in the UK who will be able to effectively market the dressing,” Mahmoudi said. “The company has just won a very competitive Eurostar grant to accelerate product development.”

Working with his collaborators, Mahmoudi conducted a small pilot trial of the wound with 13 patients with chronic wounds, all cured, he said.

It is estimated that patients with advanced chronic injuries (those who do not respond to traditional therapies) exceed 45 million worldwide, making this one of the most urgent and urgent health care needs in the world, he said. Mahmoudi.

In the U.S. there are about 5 percent of that population, but more than 90 percent of sales of “active” wound care technologies occur in the U.S. That essentially means the rest of the world is left out, Mahmoudi said.

Venous leg ulcers and pressure ulcers associated with immobility in elderly and paralyzed patients are also the leading causes of chronic injuries, but perhaps the best known examples of this type of injury are diabetic foot ulcers. Worldwide, there are more than 400 million people living with diabetes and some studies have estimated that up to a quarter of these patients will develop foot ulcers during their lifetime.

Even with the high level of care available in the United States, more than 30% of patients who develop a diabolical foot ulcer will die within five years of its onset. As a reference, this percentage is higher than breast, prostate, and colon cancer.

Diabetic foot ulcers also illustrate many of the reasons why chronic wounds can be so difficult to treat.

Patients with diabetes can treat restricted blood flow and other factors that slow down their immune response, compromising the body’s ability to heal the wound on its own. They can also damage the nerves that cushion the pain of the wound and can delay patients from seeking treatment. When wounds heal more slowly and stay open longer, bacteria are more likely to cause infections and cause serious complications. Simply put, there are many things that go wrong in a chronic injury.

“Chronic injuries are some of the most complicated things doctors have to deal with,” Mahmoudi said. “If you want to make a dressing that works, you have to solve all these problems. And to be relevant to most patients in the world, it has to be easy to use, practical and economical as well.”

There are many technologies available to support chronic wound healing, but those that can stimulate tissue regeneration are often derived from harvested natural tissues. This is complex and expensive, resulting in products that cost more than $ 1,000, which puts them out of the reach of many patients and health systems.

To tackle these problems, Mahmoudi gained extensive experience in developing new materials for biomedical applications. By designing a product that can be made from readily available biopolymers, production costs can be reduced and the equipment could add other materials to improve curing.

The team starts with a flexible frame of nanofibers (very thin threads) of natural polymers, including collagen, a structural support protein found in the skin and cartilage. The frame provides a three-dimensional scaffold that promotes cell migration and the development of new blood vessels, essentially replicating the function of the extracellular matrix, the natural support system found in living, healthy tissue.

“It’s important that the physical and mechanical properties of the dressing are really close to that of the skin,” Mahmoudi said. “To heal, new cells have to feel right at home.”

In this framework, the equipment can incorporate proteins, peptides and nanoparticles that not only stimulate the growth of new cells and blood vessels, but also fight bacteria by encouraging the patient’s own immune system to bind to the load. (The team ‘s experiences with these elements were documented in publications prior to Nanotechnology of nature i Trends in biotechnology).

The dressing also degrades over time, which means no one should change or remove it and potentially aggravate the wound site. And with about $ 20 per piece, Mahmoudi believes the dressings, if approved by regulatory agencies, will be affordable even to resource-intensive health care systems that face the treatment of these serious ones. wounds.

While there are many existing wound care products, Mahmoudi is optimistic that the new dressing will stand out thanks to its low cost, high performance and other research he did years ago.

For this previous project, however, I was not developing any new technology. He was interviewing hundreds of health care workers in the United States, asking them what they wanted and what they needed in a wound dressing.

“We developed this dressing to solve the problems they had. One of the clinicians told me, ‘When you see too many products on the market, that means none of them work,'” said Mahmoudi, a researcher driven to do things that work.