The use of wet-to-dry dressings has been the standard treatment for many wounds for decades. However, this technique is frowned on because it has various disadvantages. In this process, a saline-moistened dressing is applied to the wound bed, left to dry, and removed, generally within four to...
By Michel H.E. Hermans, MD
The 2014 SAWC Fall conference took place in October in Las Vegas. As always, it was good to see colleagues, share thoughts and stories, stroll through the exhibition areas and attend the lectures. As usual, the meeting was well organized although given the size of the Vegas hotels, reaching it—even from your room within the conference hotel itself—provided enough walking exercise for a week.
Opportunities for Advancing Wound Care
A number of lectures were interesting, including those on stem cells, critical limb ischemia and surgery, and two on the consequence of not properly documenting patient behavior and wishes with regard to a patient wanting to be treated or not. There was quite a bit of information in the lectures on biochemistry, signaling, infection and biofilm – all hot topics at the moment.
However, all this knowledge does not seem to have led (yet) to new clinical applications, or in other words, more refined diagnoses or new treatments.
I am not saying that the current materials and techniques are not good, but there is still a lot of room for improvement. For example, how about being able to see within minutes what type of bacterium causes a flare-up of infection (culturing on a chip), instead of having to wait for the results from the lab? How about a non-mechanical technology to truly, consistently and permanently break down biofilm or a dressing that sends a signal when something is wrong with the wound, when it needs changing or when the circulation of the flap underneath becomes jeopardized? Obviously there is a protease measurement system but looking for elevated MMPs in a non-healing wound is a bit like putting the cart before the horse.
Taking the Lead: How Google is Advancing Medical Technology
I am not an engineer and consequently cannot judge how difficult it would be to develop these technologies. However, sensors are getting cheaper, smaller and more sophisticated all the time and communication with a smart phone is now ubiquitous. Apple will soon launch a watch that will monitor many aspects of one’s health, and Google is working on a "smart contact lens" that can help measure glucose levels in tears. It uses a "miniaturized" glucose sensor and a "tiny" wireless chip for communication, both embedded in the lens. Granted, measuring just one parameter is relatively easy compared to what would have to be measured to judge wound healing problems, but Google is also developing disease-detecting nanoparticles. The particles would be taken through a pill and, while in the circulation, would identify changes in somebody’s biochemistry: the particles' "outcomes" would be read by a wrist-worn sensor.
Obviously, the size of the wound care market is peanuts compared to the market for cardiac care or cancer treatment and the financial incentive of developing something new for wound care may not be as big. Still, the chronic wound care market has not seen major new innovations since NPWT, maggot therapy, hydrosurgery, HOCl, superabsorbents and silver dressings were invented, all at least 15 years ago. Now, all major companies have their own NPWT device and many also have jumped on another bandwagon, namely, placenta derived materials and dermal matrices. Again, these are positive developments since "biological dressings" have proven to hold significant promises, but they have been used in burn and trauma care for decades.
It is time for a new paradigm in wound care and I hope that future SAWCs will be brimming with truly innovative and improved approaches to both the diagnostic and therapeutic aspects of wound care.
Image courtesy of Agence France-Presse/Getty Images
About the Author
Michel H.E. Hermans, MD, is an expert in wound care and related topics, trained in general surgery, trauma care and burn care in the Netherlands. He has more than 25 years of senior management experience in the wound care industry. He has conducted a large number of clinical trials relating to devices and drugs aimed at wound care and related indications and diseases. Dr. Hermans speaks internationally and has authored many published works relating to wound management.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.