A simple cut or burn may barely register as a concern for most people, but what if that wound never healed? Without the proper healing processes, even the smallest of wounds may take months to heal or turn into potentially fatal infections.
For the elderly and diabetic patients, impaired acute wound healing is a very real fear. Compromised blood vessels as a result of age or diabetes lead to poor blood, oxygen and nutrient supply—all of which impair normal healing processes and lead to chronic wounds.
Besides that, the chronic inflammation in wounds can stimulate the release of leukocytes and reactive oxygen species that impede healing and prematurely age cells. Higher pH and proteolytic enzyme activity levels at the wound site can also prevent a wound from healing the way it is supposed to.
However, not all of these factors are necessarily present in every chronic wound. As a result, it can be hard for a healthcare worker to decide on a suitable course for treatment.
To assist with the diagnosis and treatment of chronic wounds, researchers from A*STAR's Skin Research Institute of Singapore (SRIS) and Nanyang Technological University, Singapore (NTU) discussed a range of smart dressings that can react to and treat the different features of chronic wounds through novel drug combinations and delivery mechanisms.
“As there are often many things going wrong in a chronic wound, it is unlikely that a single treatment can fix all of them. Combinatorial treatments are thus most likely to help in the future,” said David Becker, the corresponding author of this review article in Advanced Drug Delivery Reviews.
Futuristic smart dressings can be integrated into the wound bed to replace lost tissue and stimulate cell growth, Becker said. The dressings act as a reservoir for the sustained release of drugs to the wound site for as long as needed, or even change their delivery profile throughout the healing process.
“For instance, a high pH could trigger the release of a buffer that can bring the pH back to normal,” he explained. “Current treatments deal with recognized problems as and when they occur in a wound, but different stages of the healing process might need different treatments.”
At the moment, Becker is collaborating with clinicians at Tan Tock Seng Hospital and engineers and chemists at NTU to develop an antisense-based drug that promotes chronic-wound healing. “This system is currently in clinical trials for the treatment of chronic corneal wounds,” he said.
The A*STAR-affiliated researcher contributing to this research is from the Skin Research Institute of Singapore (SRIS).