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Engineering a natural solution for chronic diabetic wounds
Paul Gratzer PhD PEng
Associate Professor, School of Biomedical Engineering, Department of Process Engineering and Applied Science, and Department of Surgery, Dalhousie University
An estimated 366 million people worldwide are affected by diabetes.1 Of those, 15–20% experience non–healing (chronic) foot ulcers and of those, 85% will ultimately require amputation.1 In starker terms, someone in the world is losing a limb to diabetes every 20 seconds.
As the number of people afflicted by diabetes is increasing significantly every year, expected to reach 439 million by 2030, equivalent to 7.8% of the world adult population,2 this problem can only be expected to grow. In Canada, nine million people are affected with diabetes today; by 2020, $16.9 billion dollars will be spent directly on diabetes.3 Our lab has developed a new way to heal diabetic foot wounds that could potentially eliminate the need for amputation; we are working to make it available to patients.
An unmet need
The options for treating foot ulcers in people with diabetes are often insufficient. Currently in Canada, the standard of care involves removing dead or infected tissue within the wound site, wrapping the wound with saline–soaked sterile gauze and providing a method to keep the patient from walking on the affected area during healing. The patient will be seen weekly and the standard of care treatment will be repeated until healing is successful, a process that can take up to six months. Often, however, healing does not occur. The risk of the patient experiencing an infection increases dramatically if significant healing (>50%) does not occur within four weeks. Infected wounds can receive another level of treatment involving the application of anti–microbial dressings and topical anti–septic agents. If these measures fail, the infection will persist and spread, until surgical removal of the affected portions of the foot is the only option.
There is a third line of treatment prior to amputation, which involves the use of biologic agents or engineered tissues. This is used in the United States but, due to the very high cost of these treatments, it is used very infrequently and usually as a last–ditch effort to save the affected limb from surgical amputation. Currently, these types of products are not available in Canada for the treatment of diabetic chronic wounds.
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