Bioactives for Advanced Woundcare

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Bioactives for Advanced Woundcare
Dr Robin Martin PhD, Programme Manager,
Advanced Wound Management, York, Research Centre
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What is Advanced Woundcare?

• Advanced Woundcare is defined as therapies that
  seek improved outcomes over simple absorbent
  coverings (e.g. gauze)
• Advanced Woundcare is applicable to delayed
  healing wounds wounds that exist for a
  significant time e.g. Chronic wounds (DFU, VLU,
  PU)
• Wound prevalence linked to age and lifestyle
  demographics.

Chronic wounds
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Acute injury also gives rise to delayed healing
Acute wounds with delayed healing

• Burn wounds, such as scalds in children that are
  delayed in healing can give rise to a lifetime of
  healthcare issues

• Delayed healing surgical wounds (dehisced) are
  increasing due to trends in clinical practice
  patient demographics.

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Advanced Woundcare is a significant market

• 2005 AWM market 2.2 billion, growing at 10
• Global revenues in 2005 375 million

All revenue growth numbers are on an underlying
basis
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Match clinical needs/technology/customer

• All 3 elements have to match

All surgical incisions Traumatic injuries Delayed
healing surgical Chronic wounds
clinical needs
technology
customer
Patients Governments Insurance
Wound cover Injected substance Topical
substance Medical device
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What proportion of the total healthcare costs?

• Bioactive wound treatments cant cost too great a
  proportion of the total costs of a procedure
• Very effective treatments may increase the total
  costs allocated by customers for this procedure

Treatment for clinical need
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Bioactives for Advanced Woundcare

• Different approaches
• Understand how normal wound healing works and add
  more (growth factors, extra cellular matrix,
  cells)
• Understand why a wound has stopped healing and
  try to block these inhibitory factors (MMPs,
  inflammatory cytokines)

Single magic bullets havent worked so far.
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TIME principles of wound healing

• An approach to the principles of clinical best
  practice in wound management based on recognising
  barriers to healing.

• T Tissue
• I Infection
• M Moisture
• E Edge

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Bioactives anything that has a biological
effect

• Tissue (enzymes, surgical cutting tools, devices
  to speed removal of dead tissue)
• Infection (antimicrobial, anti-inflammatory
  materials, substances or devices that target
  biofilms or microbial balance)
• Moisture (devices that control exudate or change
  its composition MMP activity)
• Edge (materials that promote tissue replacement
  scaffolds, epithelial stimulators, mechanical
  stimulation negative pressure)

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ACTICOAT Nanocrystaline silver
Physical vapor deposition of silver onto nylon
dressing in special atmosphere. Greater surface
area to volume ratio increases the number of
chemical reactions possible in a shorter period
of time high density of silver in a form where
it can deliver sustained antibacterial effect.
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SEM of Nanocrystalline Silver Membrane
Surface View
Cross section
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Bioactive (intervention) therapies have many
effects
3 species bacteria applied to wounds Acticoat or
AgNO3
100 take auto SSG Acticoat wounds 0 take Ag
NO3
MMPs reduced by Acticoat
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