An inexpensive biopolymer dressing to help heal chronic wounds

Tens of millions of patients around the world suffer from persistent and potentially fatal wounds. These chronic wounds, which are also a major cause of amputation, have treatments, but the cost of existing dressings can prevent them from reaching the people who need them.

Today, a Michigan State University researcher is leading an international team of scientists to develop a practical, inexpensive biopolymer dressing that helps heal these wounds.

Existing efficient technologies are far too expensive for most health care systems, severely limiting their timely use. Economically accessible, practical and efficient technology is needed. “

Morteza Mahmoudi, Assistant Professor, Michigan State University College of Human Medicine and Precision Health Program

To develop this new technology, Mahmoudi drew on years of experience and expertise, having researched advanced materials to heal heart tissue, fight infections and support the immune system. But the team also kept an eye on costs, working to develop a product that could be made available to as many patients as possible, even in markets with limited resources.

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

With his last work, published on July 19 in the review Molecular Pharmaceuticals, Mahmoudi is getting closer to this goal. He works with partners in the UK who have set up a company to oversee the development and approval of the new technology.

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

Together with his collaborators, Mahmoudi conducted a small pilot trial of the dressing with 13 patients with chronic wounds, all of whom were cured, he said.

Patients with advanced chronic wounds – those who do not respond to traditional therapies – are estimated to number more than 45 million worldwide, making it one of the world’s most pressing and urgent health care needs. , said Mahmoudi.

The United States is home to about 5% of this population, but over 90% of sales of “active” wound care technologies occur in the United States. It basically means the rest of the world is being left out, Mahmoudi said.

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

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

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

Patients with diabetes may be faced with restricted blood flow and other factors that slow their immune response, compromising the body’s ability to heal the wound on its own. They may also have nerve damage which lessens the pain of the wound and may delay patients seeking treatment. When wounds heal more slowly and stay open longer, bacteria are more likely to cause infections and lead to serious complications. Frankly speaking, there are a lot of things that go wrong with a chronic wound.

“Chronic wounds are among the most complicated things doctors have to deal with,” Mahmoudi said. “If you want to make a bandage that works, it has to solve all of these problems. And to be relevant to the majority of patients around the world, it must also be easy to use, convenient, and inexpensive.

There are many technologies available to promote healing in chronic wounds, but those that can stimulate tissue regeneration are usually derived from harvested natural tissue. This is complex and expensive, resulting in products that cost over $ 1,000, putting them out of reach for many patients and healthcare systems.

To tackle these issues, Mahmoudi has drawn on extensive experience in the development of new materials for biomedical applications. By designing a product that could be made from readily available biopolymers, production costs can be kept low and the team could add various other materials to improve healing.

The team begins with a flexible framework of nanofibers – extremely thin strands – of natural polymers, including collagen, a structural support protein found in our skin and cartilage. The framework provides a three-dimensional scaffolding that promotes cell migration and the development of new blood vessels, essentially mimicking the function of the extracellular matrix, the natural support system found in healthy living tissue.

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

Within this framework, the team 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 immune system to join in the load. (The team’s experiences with these elements have been documented in previous publications in Nature Nanotechnology and Trends in Biotechnology).

The dressing also degrades over time, meaning that no one would have to change or remove it and potentially make the wound site worse. And at around $ 20 apiece, Mahmoudi believes the dressings – if approved by regulatory bodies – will be affordable, even for resource-strapped health systems dealing with these serious injuries.

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

For this previous project, however, he was not developing any new technology. He was interviewing hundreds of healthcare workers in the United States, asking them what they wanted and what they needed in a bandage.

“We developed this dressing to solve the problems they encountered. One of the clinicians told me, “When you see too many products on the market, it means none of them are working,” said Mahmoudi, a Spartan determined to manufacture work.

More than 20 researchers joined Mahmoudi on this project, representing around 15 different research institutes, including Harvard Medical School; Emory University; Georgia Tech; Rutgers State University; McGill University; University of Siegen in Germany; and the University of Santiago de Compostela in Spain.