Wound care must adapt – What’s missing with today’s approach and how technology will get us there
Little has changed in how we treat serious wounds, despite the great advances in medical technology over recent decades. For centuries, we have relied on the same essential form of fabric-based dressings to protect and heal wounds and burns. However, these can often exacerbate the situation. Traditional dressings such as gauze bandages, foam dressings and adhesive pads require frequent replacement to protect wounds from infection and assess healing progress, which often causes further trauma to the patient and disruption to the recovery process. Major complications are wound infections, which require separate treatment and further extend hospitalization time and the recovery period and may also result in bad scarring.
Traditional therapies are insufficient for complex wounds
The inefficiencies of traditional dressings are perhaps most evident when it comes to treatment of complex wounds, such as severe burns, chronic wounds and injuries to areas that are hard to dress, including the hands or face.
Patients suffer the initial pain, shock and fear when the incident happens, followed by the consistent anxiety, pain and discomfort of treating and dressing the wound and frequent hospital visits throughout the recovery process.
They are often forced to endure restricted movement for a time, particularly for wounds in hard-to-dress areas with complex geometry and morphology, such as the joints of arms and legs, the neck area, the hands and between the fingers – take for example the all too familiar “boxing glove” style bandages, or the “mummy” look facial burn patients often experience. Then there are the additional impediments to patients’ daily lives and social interactions, such as the inability to shower and properly wash when using traditional dressings, or the impact on emotional wellbeing and confidence with injuries in exposed areas or that require heavy facial dressings.
There have been some improvements in recent years, with technologically advanced solutions offering alternatives to traditional common dressings that can help the healing process by not having to be replaced as frequently. However, they also need to be shaped to accommodate the wound area. This can be very challenging for medical teams and painful for the patient, specially where it involves the aforementioned hard-to-dress areas and complex wound geometries. These dressings also need to be held in place – either with staples, adhesives, bandages or sutures. All of which can slow the healing process, add to the discomfort and require ongoing medical attention.
While these advanced solutions are making a difference, wound care has generally been late to adopt new technologies. This is why physicians complain that they are not satisfied with the tools at their disposal and why patient advocates feel that the concerns of patients in wound management is often disregarded.
Electrospinning is the future of wound care, but it has limitations
Electrospinning technology – using electrostatic forces to create a nanofibrous synthetic skin-like matrix – has already started to gain recognition as a potentially excellent alternative for wound dressing. It can be a highly advantageous solution as certain additives can be ‘interwoven’ into the fibers, such as antibacterial, silicon or collagenous additives or even cell-based therapies to further enhance the matrix performance and healing process.
However, the few electrospun dressing solutions that do exist still carry some of the common disadvantages of traditional dressings. Manufactured on industrial scale machines, they are restricted in offering a ‘one-size-fits-all’ solution, being supplied to hospitals in set templates which then need to be cut to size by medical teams and still require adhesives and secondary dressings to secure them to the wound.
What is required is the ability to deliver a fully personalized solution whereby the fibers are imprinted directly onto the wound. One that can follow the contours of the body perfectly, adhering directly to the wound and mostly require no secondary dressing.
Portability will facilitate personalization
Portable hand-held electrospinning systems will provide the necessary personalization to enhance treatment and healing processes, shorten recovery time, and improve mobility. The nanofibers can adhere directly to the wound and the matrix formed by the fibers provides a scaffold which biologically mimics the structure of human tissue. This can be enhanced with antibacterial and other therapeutic additives to further assist the healing process. Being just a few microns thick, the dressing is able to flex with the skin, reducing pain, and does not require constant replacement as its transparency allows care teams to review progress through the matrix. Of no less importance, patients can return to their regular lives sooner, be it work, physical activities or something as simple as taking their daily shower. The psychological effect of this can be enormous, significantly improving the patient’s quality of life during this challenging time.
These next generation nanofibrous dressings allow the wound to heal while new skin is regenerated underneath. They could also ‘piggy-back’ other technologies, such as cell-regeneration therapies. This can further speed-up the healing process, avoid surgical procedures, reduce the need for ongoing pain relief, and limit the emotional trauma. The result being a reduction of both physical and mental scars.
This is not some futuristic vision. Portable electrospinning technologies are already emerging and can give medical providers – surgeons, ER doctors and nurse practitioners – the very tools they are calling for. In time, this portability could take wound treatment outside of surgical wards for use by emergency medical responders, or even (eventually) for use in businesses or homes. Only through the adoption of cutting-edge technologies we can create personalized wound treatments in a way that meets the needs of the medical teams and also significantly improve the patient-experience and quality of life.
Photo: SDI Productions, Getty Images