Wound care
Exploring the potential of electrical stimulation, doctors tap into the body’s natural healing pulses to guide cell growth and combat infections, paving the way for innovative medical interventions.
Technology (3T) Group puts it: “In the case of chronic or complex wounds the use of conventional methods requires constant and lengthy care adding to the time and resource burden of the NHS.” The City, University of London researcher is certainly not wrong in what he’s saying. From changing dressings to keeping wounds dry, it’s estimated that a single diabetic ulcer costs $50,000 a year to treat, even as medical professionals are kept from more productive tasks. Yet now, together with colleagues at City, Rabbani is investigating a solution. Alongside a host of other global researchers, he’s using the power of electrical stimulation to heal chronic wounds, using the current to encourage the body to fix itself. It goes without saying that the consequences here could be revolutionary – if, that is, the devices involved are developed with sensitivity and care.
Not just flesh wounds $28bn AAFP 34
The minimum estimated cost of wound care for US Medicare recipients. The upper estimate is $96bn.
Sparked by everything from pressure injuries and burns to simple cuts, wounds are a common feature of medical life. But chronic wounds are different. Gaining that dubious distinction if they don’t heal in orderly stages, or else remain unresolved for more than three months, they can be truly debilitating. That’s especially true, explains Dr Robin Martin scientific consultant on wound healing and reconstructive surgery, given most chronic wounds aren’t found in hospitals. “Apart from certain interventions,” explains the wound expert and consultant, “most provide a big burden on community health care systems.” This makes sense: by definition long-lasting, the health service can’t possibly treat every wound in-house. Yet if they’re out of sight, chronic wounds are certainly not out of mind, requiring frequent visits from nurses and other experts. That’s inevitably expensive. Quite aside from
the NHS’s outlay, one 2014 study found that wound care for US Medicare recipients cost anywhere from $28bn to $96bn. It doesn’t help, meanwhile, that the treatment of chronic wounds traditionally tends to focus more on mitigation rather than cure. Though there are plenty of techniques available here – cleaning and dressing; antimicrobial washes; removing dead or inflamed tissue in a process called debridement – they’re all basically aimed at keeping a wound stable. But what about actually fixing the underlying problem? Until recently, medical professionals were stumped. Over the past few years, however, they’ve started exploring the uses of electrical stimulation. Exploiting the same pulses the body uses to heal independently (known as ‘endogenous bioelectricity’), doctors can use current to focus cells, encouraging them to proliferate in certain parts of the body, or else prod them in particular directions. Ideally, electrical stimulation should also combat infection, destroying microbes in a wound while preserving the harmless tissue below. To be clear, this technology is not entirely novel, with doctors having been aware of its potential since the 1960s. The problem, suggests Dr Iasonas Triantis, co-lead of the 3T Group at City, is that the electrical stimulation strategy and set-up used in applications like TENS or physiotherapy, often used in wound care studies, aren’t necessarily suitable for healing chronic wounds. For Martin, slow adoption can equally be understood by medical philosophy. Because electrical stimulation is an invisible process, he suggests that many doctors saw it as “magical and mystical” – and were understandably sceptical of the process. Another challenge has typically been electrical stimulation devices themselves. Cumbersome and complex,
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