Researchers Believe More Effective Dressings for Chronic Wounds Are on the Horizon to Address the ‘Silent Pandemic’
Millions of patients have chronic wounds, which are difficult to treat and can result in the need for amputation. Fortunately, researchers have now discovered a more effective treatment.
A novel antibiotic- and silver ion-free dressing that has demonstrated promising results in trials is welcome news for individuals with chronic wounds. Researchers from Australia and the UK recently revealed that a new approach utilizing a plasma-activated hydrogel can effectively eliminate bacteria, addressing challenges faced by current treatment methods for non-healing wounds.
Chronic wounds are wounds that do not heal in a timely manner or fail to heal within a specified period, typically one to three months. These types of wounds are commonly observed in patients with diabetes, putting them at high risk for recurrent infections.
Projections suggest that by 2030, there will be 578 million individuals with diabetes, marking a 36 percent increase from 2020. More than 30 percent of these patients may develop an ulcer at some point, with 60 percent of those ulcers becoming infected. In cases where infections do not respond to antibiotic treatment, amputation may be required.
Wounds can be caused by various factors such as trauma, mechanical pressure, or underlying health conditions like diabetes. Chronic wounds quickly become colonized by bacteria, which contributes to their inability to heal properly. Therefore, antibiotic therapy plays a crucial role in the treatment of chronic wounds.
Treating chronic wounds has long been a challenge for the healthcare industry. The process of wound healing involves multiple stages like hemostasis, inflammation control, tissue regeneration, and remodeling. In the United States, Medicare spends billions on wound treatments, with surgical wounds and diabetic ulcers being the most costly to manage.
In addition to cleaning, anti-inflammatory medications, and specialized dressings to protect and facilitate healing, patients may undergo procedures like debridement to remove dead tissue. Other treatment options may include compression bandages, hyperbaric oxygen therapy, or skin grafts. Successful treatment of chronic wounds in diabetic individuals also involves regulating glucose levels.
In a collaborative research effort by teams from the University of Sheffield, UK, and the University of South Australia, a cutting-edge plasma-activated hydrogel was utilized to eliminate harmful bacteria in wounds without relying on antibiotics and silver ions. While the study primarily focused on diabetic foot ulcers, the technology holds promise for other types of wounds and chronic infections.
The method, known as plasma-activated hydrogel therapy (PAHT), shows potential for managing severe wound infections. The study findings were published in the journal Advanced Functional Materials on Feb. 12.
PAHT utilizes cold plasma ionized gas and has shown promising results in previous studies. However, researchers encountered the challenge of loading hydrogels with sufficient concentrations of reactive oxygen and nitrogen species (RONS) for clinical effectiveness. To address this challenge, a new electrochemical method was used in the recent study to enhance hydrogel activation, resulting in a higher concentration of the hydrogel’s main antibacterial agent, hydrogen peroxide.
Laboratory experiments indicated that the hydrogel effectively controlled E. coli and P. aeruginosa, two bacteria commonly found in diabetic foot ulcers, and showed moderate efficacy against the common human pathogen S. aureus.
According to the researchers, the plasma-treated hydrogels do not necessarily need to directly eliminate all bacteria in the wound. It is anticipated that they will indirectly combat bacteria by stimulating immune cells.
One of the key advantages of the plasma-activated hydrogel is its adaptability to different healing stages. For example, a hydrogel treated with a higher concentration of active agent may be needed initially to manage infection but can be switched to a lower potency as healing progresses.
The team aims to validate the new PAHT dressing through in vivo studies. Clinical trials involving human patients and live animals are essential to confirm the treatment’s efficacy and safety, as well as to assess environmental influences on treatment outcomes.
‘An Urgent Need for Innovation’
Professor Rob Short from the University of Sheffield, a co-author of the study, emphasized the necessity for innovation in wound management due to the increasing prevalence of diabetes-related foot ulcers. He highlighted the neglected global pandemic surrounding this issue and stressed the importance of alternative treatments in wound care.
Professor Endre Szili from the University of South Australia, who led the study, pointed out that traditional treatments like antibiotics and silver-infused dressings are facing challenges due to antibiotic resistance and toxicity concerns related to silver. He highlighted the urgent need for alternative solutions in wound care to prevent amputations resulting from treatment failures.
PAHT technology offers a notable advantage as a universal wound treatment. It is environmentally friendly, utilizing natural components in air and water to produce active ingredients that degrade into non-toxic and biocompatible substances. These active ingredients can be released over an extended period, enhancing treatment outcomes.
