Roy Sashwati, Prakash Shaurya, Mathew-Steiner Shomita S, Das Ghatak Piya, Lochab Varun, Jones Travis H, Mohana Sundaram Prashanth, Gordillo Gayle M, Subramaniam Vish V, Sen Chandan K
Department of Surgery, Indiana Center for Regenerative Medicine and Engineering (ICRME), Indiana University School of Medicine, Indianapolis, Indiana.
Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, Ohio.
Adv Wound Care (New Rochelle). 2019 Apr 1;8(4):149-159. doi: 10.1089/wound.2018.0915. Epub 2019 Apr 3.
To evaluate if patterned electroceutical dressing (PED) is safe for human chronic wounds treatment as reported by wound care providers. This work reports a pilot feasibility study with the primary objective to determine physically observable effects of PED application on host tissue response from a safety evaluation point of view. For this pilot study, patients receiving a lower extremity amputation with at least one open wound on the part to be amputated were enrolled. Patients were identified through the Ohio State University Wexner Medical Center (OSUWMC) based on inclusion and exclusion criteria through prescreening through the Comprehensive Wound Center's (CWC) Limb Preservation Program and wound physicians and/or providers at OSUWMC. Wounds were treated with the PED before amputation surgery. The intent of the study was to identify if PED was safe for clinical application based on visual observations of adverse or lack of adverse events on skin and wound tissue. The pilot testing performed on a small cohort ( = 8) of patients showed that with engineered voltage regulation of current flow to the open wound, the PED can be used with little to no visually observable adverse effects on chronic human skin wounds. The PED was developed as a second-generation tunable electroceutical wound care dressing, which could potentially be used to treat wounds with deeper infections compared with current state of the art that treats wounds with treatment zone limited to the surface near topical application. Technology advances in design and fabrication of electroceutical dressings were leveraged to develop a tunable laboratory prototype that could be used as a disposable low-cost electroceutical wound care dressing on chronic wounds. Design revisions of PED-1 (1 kΩ ballast resistor) circumvented previously observed adverse effects on the skin in the vicinity of an open wound. PED-10 (including a 10 kΩ ballast resistor) was well tolerated in the small cohort of patients ( = 8) on whom it was tested, and the observations reported here warrant a larger study to determine the clinical impact on human wound healing and infection control.
为评估伤口护理提供者所报告的图案化电疗敷料(PED)用于人类慢性伤口治疗是否安全。这项工作报告了一项初步可行性研究,其主要目的是从安全性评估的角度确定PED应用对宿主组织反应的物理可观察到的影响。对于这项初步研究,纳入了在将要截肢的部位至少有一处开放性伤口的下肢截肢患者。通过俄亥俄州立大学韦克斯纳医学中心(OSUWMC),根据纳入和排除标准,通过综合伤口中心(CWC)的肢体保全计划以及OSUWMC的伤口内科医生和/或提供者进行预筛选来确定患者。在截肢手术前用PED治疗伤口。该研究的目的是基于对皮肤和伤口组织上不良事件或无不良事件的视觉观察,确定PED用于临床是否安全。在一小群(n = 8)患者身上进行的初步测试表明,通过对开放伤口的电流进行工程化电压调节,PED可用于慢性人类皮肤伤口,几乎没有视觉上可观察到的不良影响。PED被开发为第二代可调电疗伤口护理敷料,与当前将治疗区域限制在局部应用附近表面的现有技术相比,它可能用于治疗感染更深的伤口。利用电疗敷料设计和制造方面的技术进步,开发了一种可调实验室原型,可作为慢性伤口的一次性低成本电疗伤口护理敷料。PED - 1(1 kΩ镇流电阻)的设计修订避免了先前在开放伤口附近皮肤观察到的不良影响。PED - 10(包括一个10 kΩ镇流电阻)在测试的一小群(n = 8)患者中耐受性良好,此处报告的观察结果值得进行更大规模的研究,以确定其对人类伤口愈合和感染控制的临床影响。