Team:SMS Shenzhen/HP/Gold
Project into the world: In-depth investigation in hospital
A project without basis in the reality is just a useless clothes displayed in window. To make our project contribute to the society better, we considered it necessary to thoroughly understand the nowadays situation. On 7th October 2016, four of our team members visited Shenzhen No.2 People’s Hospital. Welcomed by doctor Song Ting in Department of Orthopedics, we learned about current chronic wound treatments, investigated how chronic wound affect patients’ lives and got inspired by materials used in hospital as well. Then based on the investigation, we evaluate on and improve our project based.
Research
We conducted three researches on: trend of iGEM project, on policies regarding synthetic biology in China, and specific researches on costs regarding chronic wound treatments.
Research Result
Research on Cost of Chronic Wound
To understand the current cost and what we may improve through our project, we conducted a research on costs of current methods and the methods that may be used to improve.
Medicine, Materials & Surgeries curing chronic wound nowadays:
Current hydrocolloid application:
Chinese brand (Shelekang):
(10cm * 10cm)
Cost(in RMB): Around ￥4-5 per slice.
Global brand (Comfeel):
It has several function. Except for wound that has granulation in it, common wounds use bubble plaster or ulcer plaster. Some horrible wounds have to use ulcer plaster. Cost(in RMB):
3533 Transparent plaster (10cm * 10cm): ￥22 per slice.
3146 Ulcer plaster (4cm * 6cm): ￥22 per slice.
3110 Ulcer plaster (10cm * 10cm): ￥42 per slice.
3420 Bubble plaster (12cm * 12cm): ￥42 per slice.
From the research, we can know that our project can benefit among pharmaceutical factory, patients, and hospitals.
First of all, since our project is easy and simple to make in lab, and bacteria can reproduce massively, proteins can be fast generated by it. Thus, it is cheap and not difficult for pharmaceutical factory to produce this medicine.
Our project may benefit patients by saving a large amount of money. As we all know, the cheaper the treatment cost, the lighter the financial burden. SDF enables wounds to recover faster and better, which will decrease the chances of having further operations, which occupy a large part in costs of treating chronic wounds. In addition, we combined LL-37 and SDF together, so that patients would just pay for one medicine to have both treatments.
In the contemporary world, hospitals use an expensive plaster. However, we find another material—hydrocolloid dressing (For more detail, see our Design Page) may replace the plasters in small wounds, which can save much money for patients. Unfortunately, we didn’t find a specific way to save money for large wounds. Thus, the only way to save money for large wounds is to boost recovering quality and speed and combining two functions through our project.
Last but not least, it is also beneficial to hospitals. Since nowadays the relationship between patients and doctors is terrifying in China, our project can help improve this problem. By saving money and gaining a better treatment, patients will be more positive and cheerful.
Project into the world: In-depth investigation in hospital
A project without basis in the reality is just a useless clothes displayed in window. In order to investigate how our project can contribute to the society better, we considered it necessary to thoroughly understand the nowadays situation. On 7thOctover 2016, four of our team members visited Shenzhen No.2 People’s Hospital. Welcomed by doctor Song Ting in Department of Orthopedics, we learned about current chronic wound treatments, investigated how chronic wound affect patients’ lives and were inspired by materials used in hospital as well. Then based on the investigation, we evaluate and improved our project.
What cause chronic wounds?
Chronic wounds usually are not caused solely by external factors, such as burns and bruises, but have the basis of certain latent diseases, so they cannot be cured radically. Most patients with chronic wounds suffer from other chronic diseases, such as hypertension and diabetes. These diseases and other factors impede the healing of the wounds, making the wounds chronic.
Hence, patients with chronic diseases should prevent being wounded.
What aspects do medicines focus on to cure chronic skin wounds?
The medical treatment of chronic wounds should be focused on these two aspects:
1. Promote wound healing
2. Prevent bacterial infection
---which confirm us our project's focus on these two aspects
The doctor then showed the two common medicines to us:
1. Recombinant Bovine Basic Fibroblast Growth Factor Gel:
Medicine containing growth factor contributes to the growth of human flesh. For example, Recombinant Bovine Basic Fibroblast Growth Factor, which contains rbb-FGF, is a type of growth factors that prompts the healing of wounds.
2. Medicine on Prevent bacterial infection
This medicine can form positive charged membranes to kill and isolate pathogenic microorganisms when it sprays to patients’ skin.
The application of both the two aforementioned types of medicine is through the use of cotton gauze, which helps the wound absorb the medicine.
What is the curing process to patients?
First, changing medical dressing is the basic operation to every patient:
The process of changing dressing:
1. Clean the wounds with iodine.
2. Use scissors to scratch and cut off the necrotic tissue, or tweezers to rip the wound to the point where fresh blood can be seen.
The patients must endure the whole process without anesthetic.
How often do patients need to be changed dressing?
At first, patients change the fresh medical dressing every day since the wounds secrete a large amount of exudates. After a few days, if the wounds improve better than before, it is acceptable to reduce the frequency of changing dressing of the wound to once in three days or a week.
How long could chronic usually be healed?
The time length can reaches years. A patient might not be cured all life. The picture shown below is a chronic wound that has not been cured for 6 years.
What are other common treatments for chronic skin wound?
There are three types of surgical treatment methods: debridement, skin grafting, and surgical flap
Debridement:
Debridement refers to the use of tweezers to rip the wound to the point where fresh blood can be seen. Surgical debridement is required when the patient still has necrotic tissues under the skin.
Skin grafting:
This procedure refers to the cutting of one piece of skin from other intact section of the body and sticking the normal skin on the wound.
Surgical flap:
The therapy surgical flap is applied when the patient is not suited for skin grafting, such as when the area of the wound is too large. The surgical flap is also known as pedicle graft, which means that the donating site is connected to the wound or the vessels are consistent.
Other insight:
Negative Pressure therapy
Doctors also use medical materials named the negative pressure to absorb the exudates which is also important in curing chronic skin wound. Another carefully designed membrane is also used to ensure that bacteria cannot enter the wound while air can easily flow through the material. In the material below, not only the exudates can be absorbed, the medicine to clean the wound can also be continuously delivered.
How do chronic wounds affect patients lives?
1. A typical patient’s wound on head(shown below) was caused by the hemangioma. He has been sought for an effective therapy for 5~6 years, since the necrotic area of his wound was too large and the tumor kept negatively influenced the wound. He stayed in this hospital for several months and was told to go to another hospital since doctors here were incapable of curing his illness.
2. We also interviewed a patient who is around 70 years old. He suffered from diabetic foot ulcer. His wound resulted from merely a small cut on this foot. However, he paid little attention to it, so the wound expanded and became chronic. Then he had no choice but to be hospitalized.
3. Another patient mentioned by the doctor had spent 15,000RMB in three months, mainly due to operations.
From the investigation, we could see that patients suffer from long healing process of chronic wound, which multiples the pain and also the cost.
This investigation confirms us on our project’s focus on promote wound healing and prevent bacterial infection. It also confirms us on our aim to improve the efficiency and shorten the healing time on chronic wounds to relieve patients from immense pain and high cost as quick as possible, since longer healing time means more painful processes of changing dressing, more risks to become worse and heavier financial burdens due to cost of materials and surgery.
We will continue researching on the ELP, which can automatically form nanoparticles that protect SDF from going through proteolysis. With SDF-ELP, a wound on a patient with chronic disease might be healed in 4 weeks, much more efficient than the characterizing standard of chronic wounds.
Unlike the drugs the hospital used to prevent bacterial infection right now, the Human cathelicidin LL-37 we are working on not only prevent bacterial infection by its broad spectrum of antimicrobial activity and kill bacteria within 4 minutes, but also act as a putative growth factor for epithelial cells.As we know re-epithelialization is one of the most important problems in chronic wound treatment. Furthermore, angiogenesis is also a function of LL-37.
This investigation also lent us insight into develop our prototype to apply our products to the reality. From the investigation, we knew that absorbing the exudates in time is also important. Therefore, after we have already combined the two aspects, which are promoting wound healing and preventing bacterial infection, into one, we want to integrate the third important aspect, absorbing the exudates, to provide more convenience for patients, compared to using several different drugs in conventional hospital care. (For more detail, please see our Design pages)
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---which confirm us our project's focus on these two aspects
The doctor then showed the two common medicines to us:
1. Recombinant Bovine Basic Fibroblast Growth Factor Gel: Medicine containing growth factor contributes to the growth of human flesh. For example, Recombinant Bovine Basic Fibroblast Growth Factor, which contains rbb-FGF, is a type of growth factors that prompts the healing of wounds.
2. Medicine on Prevent bacterial infection This medicine can form positive charged membranes to kill and isolate pathogenic microorganisms when it sprays to patients’ skin.
The application of both the two aforementioned types of medicine is through the use of cotton gauze, which helps the wound absorb the medicine.
What is the curing process to patients?
First, changing medical dressing is the basic operation to every patient:
The process of changing dressing:
1. Clean the wounds with iodine.
2. Use scissors to scratch and cut off the necrotic tissue, or tweezers to rip the wound to the point where fresh blood can be seen.
The patients must endure the whole process without anesthetic.
How often do patients need to be changed dressing?
At first, patients change the fresh medical dressing every day since the wounds secrete a large amount of exudates. After a few days, if the wounds improve better than before, it is acceptable to reduce the frequency of changing dressing of the wound to once in three days or a week.
How long could chronic usually be healed?
The time length can reaches years. A patient might not be cured all life. The picture shown below is a chronic wound that has not been cured for 6 years.
What are other common treatments for chronic skin wound?
There are three types of surgical treatment methods: debridement, skin grafting, and surgical flap
Debridement:
Debridement refers to the use of tweezers to rip the wound to the point where fresh blood can be seen. Surgical debridement is required when the patient still has necrotic tissues under the skin.
Skin grafting:
This procedure refers to the cutting of one piece of skin from other intact section of the body and sticking the normal skin on the wound.
Surgical flap:
The therapy surgical flap is applied when the patient is not suited for skin grafting, such as when the area of the wound is too large. The surgical flap is also known as pedicle graft, which means that the donating site is connected to the wound or the vessels are consistent.
Other insight:
Negative Pressure therapy
Doctors also use medical materials named the negative pressure to absorb the exudates which is also important in curing chronic skin wound. Another carefully designed membrane is also used to ensure that bacteria cannot enter the wound while air can easily flow through the material. In the material below, not only the exudates can be absorbed, the medicine to clean the wound can also be continuously delivered.
How do chronic wounds affect patients lives?
1. A typical patient’s wound on head(shown below) was caused by the hemangioma. He has been sought for an effective therapy for 5~6 years, since the necrotic area of his wound was too large and the tumor kept negatively influenced the wound. He stayed in this hospital for several months and was told to go to another hospital since doctors here were incapable of curing his illness.
2. We also interviewed a patient who is around 70 years old. He suffered from diabetic foot ulcer. His wound resulted from merely a small cut on this foot. However, he paid little attention to it, so the wound expanded and became chronic. Then he had no choice but to be hospitalized.
3. Another patient mentioned by the doctor had spent 15,000RMB in three months, mainly due to operations.
From the investigation, we could see that patients suffer from long healing process of chronic wound, which multiples the pain and also the cost.
This investigation confirms us on our project’s focus on promote wound healing and prevent bacterial infection. It also confirms us on our aim to improve the efficiency and shorten the healing time on chronic wounds to relieve patients from immense pain and high cost as quick as possible, since longer healing time means more painful processes of changing dressing, more risks to become worse and heavier financial burdens due to cost of materials and surgery.
We will continue researching on the ELP, which can automatically form nanoparticles that protect SDF from going through proteolysis. With SDF-ELP, a wound on a patient with chronic disease might be healed in 4 weeks, much more efficient than the characterizing standard of chronic wounds.
Unlike the drugs the hospital used to prevent bacterial infection right now, the Human cathelicidin LL-37 we are working on not only prevent bacterial infection by its broad spectrum of antimicrobial activity and kill bacteria within 4 minutes, but also act as a putative growth factor for epithelial cells.As we know re-epithelialization is one of the most important problems in chronic wound treatment. Furthermore, angiogenesis is also a function of LL-37.
This investigation also lent us insight into develop our prototype to apply our products to the reality. From the investigation, we knew that absorbing the exudates in time is also important. Therefore, after we have already combined the two aspects, which are promoting wound healing and preventing bacterial infection, into one, we want to integrate the third important aspect, absorbing the exudates, to provide more convenience for patients, compared to using several different drugs in conventional hospital care. (For more detail, please see our Design pages)
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Furthermore, angiogenesis is also a function of LL-37.
This investigation also lent us insight into develop our prototype to apply our products to the reality. From the investigation, we knew that absorbing the exudates in time is also important. Therefore, after we have already combined the two aspects, which are promoting wound healing and preventing bacterial infection, into one, we want to integrate the third important aspect, absorbing the exudates, to provide more convenience for patients, compared to using several different drugs in conventional hospital care. (For more detail, please see our Design pages)
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