Advanced infection detection and treatment for burns patients

Vital funding from the University’s EPSRC IAA Open Call fund is helping Professor Toby Jenkins and his team of researchers from the Department of Chemistry to bring their SmartwoundTM technology closer to market.

The technology comprises a simple wound swab which, when placed in indicator solution, changes colour to a bright, fluorescent green if pathogenic bacteria are present in the wound. The novel approach will allow better identification of which patients need antibiotics – and those who don’t – and help reduce the use and cost of unnecessary antibiotics.

The challenge

Loss of the protective epidermis after a burn, a natural barrier to bacterial invasion, allows direct entry of bacteria into a wound. Untreated wound infection is the leading cause of death in patients with burns and can also prevent healing, increase pain and permanent scarring, and lead to sepsis.

Children are at particular risk. Half of all burn injuries occur in children and in around 10% of cases their wounds become infected by disease-causing bacteria. This can increase the likelihood of scarring and in some cases cause death.

Despite the high prevalence of infections, clinicians are unable to reliably diagnose whether a wound is infected and requires treatment at point of care. As such, there is a huge over prescription of antibiotics for patients worldwide with clinicians taking a ‘just in case’ approach to burn wound management.

"SmartwoundTM excites me because this simple, low-cost device has the potential to make a real difference to patient care. It provides a measure of bacterial infection in wounds which is quite different from what has been proposed before. I very much hope it will bring precision, accuracy, and speed to infection diagnosis." Professor Toby Jenkins

Advancing science to safeguard health

Once in clinical use, the SmartwoundTM dressing will help to reduce the unnecessary prescription of antibiotics, shorten hospital lengths of stay, and improve patient outcomes – proving beneficial to both patients and the NHS.

"Little has changed since Roman times when wound infection was diagnosed primarily by wound heat, wound pain, wound redness, and presence of pus. The approach works in some cases but not all as non-infected burn wounds, for example, are often red and painful and even when infected have little visible pus. Our SmartwoundTM sensor measures the presence of the small molecules secreted by bacteria in the wound which indicate that it is becoming critically infected." Professor Toby Jenkins

How IAA funding made a difference

Taking the SmartwoundTM technology forward involved working with burns clinicians at the Bristol Royal Hospital for Children; Southmead Hospital, Bristol; the Queen Victoria Hospital, East Grinstead; and the Chelsea & Westminster Hospital, London to further test the working swab sensor device.

According to Toby, the IAA played an essential role in the development, manufacture, and clinical testing of the SmartwoundTM sensor, including hydrogel development and sterilisation testing.

"IAA funding allowed us to work closely with clinical collaborators at the Bristol Royal Hospital for Children and Queen Victoria Hospital in East Grinstead to conduct a clinical study to demonstrate the accuracy of the diagnostic swab technology, thereby providing vital evidence to speed up adoption of the technology and support the next stage in our commercialisation process.

Crucially, the IAA enabled us to fund Research Nurses which permitted us access to burns patients’ wound material including exudate and dressings. This was essential, as a sensor which doesn’t work in the intended matrix i.e., wound exudate, is useless. Obtaining such material is complicated as any study involving adult and child patients requires full ethical review and health research authority authorisation. The IAA funding made this possible." Professor Toby Jenkins

Next steps

In the short term, Professor Jenkins and his team are working with a Dutch company, Liposoma to upscale production of the smart dressing sensor and manufacture to the required Quality Management regulations. With this, the team hope to obtain CE certification marking and perform a full clinical study in the next two years.

In the long-term, the SmartwoundTM technology has the potential to be used in primary care settings and in low-resource locations, such as sub-Saharan Africa. It could also be adapted to help detect and treat a wide range of diseases.

"We are also looking at a modification of the approach to detect Group B streptococcus bacteria: a major cause of neonatal death and disability via a quick swab test which can be conducted even after pregnancy is underway – or directly on the new-born baby." Professor Toby Jenkins

Professor Jenkins is a Professor in the University of Bath’s Department of Chemistry.