A new £1.7m project designed to find new treatments for debilitating and potentially deadly diabetic foot ulcers launches today.
The project, which is being led by Lancaster University and involves researchers from the University of Bath, will examine the potential use of plasma (electrically excited gas) jet technology and bacteria-killing dressings in the treatment of wounds that are resistant to antibiotics.
The researchers hope plasma-activated Antimicrobial Hydrogel Therapy (PAHT) will revolutionise the treatment of diabetics who develop foot ulcers from biofilms.
Biofilms are thick slimy layers formed by bacteria and sugars clustering together. Once biofilms become established, an infection becomes resistant to antibiotics and the bacteria involved become notoriously hard to remove from the wound bed.
Diabetic foot ulcers are a major disabling complication for patients with diabetes (both type 1 and type 2). Current treatment involves removing dead tissue (debridement) and cleaning the wound, but it is difficult to get antimicrobial substances to penetrate deep into the wound.
It is hoped that the technology being tested in the PAHT project will allow deep wound cleaning and enhanced healing with less need for debridement. Ulcers will be treated with plasma jet technology combined with novel gel wound dressings, known as the hydrogel dressings. These dressings, which contain antimicrobial molecules, are being engineered at the University of Bath. A second aim of the project is to address the problem of antibiotics resistance within the population.
Lead investigator Professor Rob Short, from Lancaster University’s Material Science Institute, said: “Wound infections are responsible for an estimated 37,000 deaths each year in the EU, costing €7bn annually. Infections can lead to permanent disability, decreased quality of life and premature death for patients.”
He added: “We believe this treatment could have significant impact on the huge numbers of patients who require limb amputations or suffer premature death as a result of infections.”
Explaining the contribution of his team, Professor Toby Jenkins from the Department of Chemistry at the University of Bath, said: “By applying a cold plasma jet to the hydrogel dressing, we’ll be able to trigger the release of the antimicrobial agents deep into the wound. We’ll also raise the oxygen levels in the wound which will further promote healing and restrict bacterial growth.
“We believe this treatment has the potential to make a real impact on the lives of patients living with chronic wounds within a few years.”
Biofilms delay healing and contribute to diabetic foot ulcers being reinfected after they’ve been cleaned. The bacteria in these wounds are mostly in a biofilm state. Because of this, even a mild injury can start a foot ulcer in someone with diabetes. These slow-to-heal wounds are aggravated by the poor blood circulation and loss of sensation experienced by some diabetics.
Around 10% of diabetics who develop an ulcer will eventually require lower limb amputation as a result of tissue and bone infection. The prognosis for amputees is poor: 44% die within five years.
The PAHT project involves researchers from Lancaster University, the University of Bath, Glasgow University, the University Hospitals of Morecambe Bay NHS Foundation Trust and the UK-based wound care company ConVatec.
For more information on biofilms: The National Biofilms Innovation Centre
This research is funded by the Engineering and Physical Sciences Research Council (EPSRC). For more information visit UK Research and Innovation.