Bully Pulpit: Engineering Healing


Tim Gilmer

The current state of wound care is undergoing changes, in part because numerous wound care materials have fallen short. Some even bring about negative results — drying out, scabbing, or maceration (where too much moisture from a draining wound enlarges the wound perimeter). Fortunately, speaking for myself, I have found a systematic approach and two wound treatments that I can rely on.

In my March column, I reported on a shallow yet dangerous wound I discovered on my heel. I followed five critical protocols — eliminating edema, staying free of pressure and infection, having adequate circulation and eating more protein — and the wound healed in one month. I also got help from using two Unna boot wraps (see Para/Medic, Feb. 1, 2014) followed by a flexible silicon mesh dressing impregnated with petroleum jelly (ADAPTIC).

I changed each Unna boot dressing after three to four days. The wound began to heal right away. Next, I applied ADAPTIC as a primary dressing, along with a secondary gauze pad to absorb moisture, and changed this every three days. Three weeks later the wound had completely closed over.

But the most serious wounds, admittedly, are more difficult. Complete wound healing often takes months or even years. Knowing this, a team of UCLA bioengineers and researchers have developed a gel made from microporous annealed particles (MAP) that promises to speed healing and reduce scarring when used to treat burns and chronic wounds.

A common problem with non-healing wounds is fragility. Too often tender new growth is either washed away, pulled off by adherent dressings, or aborted by scabbing. The wound lingers and the danger of infection persists. The MAP gel, bioengineered by UCLA post-doctoral fellows Don Griffin and Westbrook Weaver, along with researchers Dino Di Carlo and Tatiana Segura, can be injected into a wound bed and easily made to conform to its exact dimensions. The porous gel, made of microcellular spherical particles invisible to the naked eye, looks like a cream but lays down a scaffolding that encourages new skin growth and inhibits scabbing.

The soft gel hardens after being injected, then gradually degrades as new growth grows through its porous micro-spaces to knit together. “Over time the hardened gel solubilizes, falls apart and leaves the body through urine,” says Griffin. “The scaffolding is a support system for the body to do its healing work. As a result, healing happens faster because the body does not have to make its own scaffolding.” Because the gel is similar to commonly used materials and contains no biologicals, it can be approved for use by doctors or wound care specialists after large animal trials that are expected to take place in two to three years. Mice trials have already demonstrated rapid healing and less scarring.

Potential applications are many and exciting for this newly engineered product. For instance, the newly injured spinal cord attempts to heal itself, but that process is short-circuited by scarring after two weeks. Ultimately, the injectable MAP gel may be combined with stem cells or other healing agents to spur new growth and inhibit scarring in many soft tissue injuries — including the newly injured spinal cord.


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