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The work of Cardiff University's Wound Healing Research Unit revealed a need for, and led the development of, a disease-specific Health-related Quality of Life (QoL) instrument; the Cardiff Wound Impact Schedule (CWIS). CWIS is able to quantify in a psychometrically sound manner the impact of chronic non-healing wounds upon a patient's QoL. The tool, a first of its type, is accurate and sensitive to changes in the healing status of chronic wounds, particularly those of the lower limb. CWIS has been adopted internationally advantaging QoL assessments in both commercial and practice settings to yield economic and practice impacts as well as direct patient benefits.
As a result of research on moisture sensing, Professor Patricia Connolly developed and successfully clinically trialled a disposable, sterile, moisture sensor which enabled real-time measurement of the moisture level in a wound without disturbing the dressing. Ohmedics Ltd was spun out in 2009 to market the disposable sensor and associated hand-held meter. The system, known as WoundSense™, gained the CE mark in 2010. The device is available commercially and is in use in hospitals in Saudi Arabia and Qatar, is starting to penetrate international markets, and had first sales to the NHS in the UK in 2012. The system is being piloted for use with remote monitoring `telehealth' technology. The British military currently (July 2013) have the system in clinical trial for monitoring of complex trauma wounds. The creation of Ohmedics has given specialist employment to 6 people in the company and helps support another 4 skilled jobs at UK contract manufacturers.
Adults with epidermolysis bullosa have extensive chronic wounds that seriously compromise their quality of life. Research at King's College London (KCL) has led to the development and commercialization of an innovative range of dressing retention garments, Skinnies WEB™, which radically improve patient experience and significantly reduce costs. KCL work has also generated a range of novel methodologies for research including a validated n-of-1 design for proof of concept tests, a validated model for engaging users in the design and development of medical devices and the TELER clinical notemaking system for wound care, which has been adopted internationally. This work has generated new business opportunities (product lines and roll-outs) for four UK companies.
Half of all burn injuries occur in children and around 10% of children who are burnt become infected by disease-causing bacteria that can increase the likelihood of scarring and in some cases cause death. Novel wound dressing prototypes have been developed using responsive smart sensing chemistry. These provide clinical solutions and commercial opportunities, have led to the founding of the charity Healing Foundation Children's Burns Research Centre with £1.5M of funding, have influenced the work of other charities and altered attitudes and practice in clinical paediatric burn treatment. The impact has been achieved by development of the novel chemistry in partnership with clinicians and practitioners, and through extensive engagement with health professionals, well beyond normal academic reach, parents and the wider public.
Professor David Becker and colleagues at UCL's Department of Anatomy (now Cell & Developmental Biology) identified the gap junction protein Connexin43 (Cx43) to be a new therapeutic target for wound healing. Becker then developed NexagonTM, a topically applied antisense gel that knocks down Cx43 production, and both accelerates the healing of acute wounds as well as stimulating healing in chronic wounds. He co-founded a company, CoDa Therapeutics, to develop this technology. The company has raised $42m in finance and has completed good manufacturing practice (GMP) manufacture, toxicity testing and Phase 1 safety trials for both skin and eye indications. It has recently completed both Phase 2a and 2b clinical trials for venous leg ulcers. Nexagon has been given approval for compassionate use on a number of occasions and, in 2009, Nexagon gel was granted Orphan Drug Designation by the Food and Drug Administration in the US for treatment of persistent epithelial defects of the eye.
It is estimated that there are over a quarter of a million patients with chronic wounds in the UK, and the cost to the NHS is approximately £2-3 billion per year (approximately 3% of NHS budget), with an additional £85-100 million costs as a consequence of psychological disorders associated with chronic wounds. Wounds can place a substantial clinical, social and economic burden on individuals and society. Research examining the relationship between pain and stress and wound healing has had significant benefits for patients with chronic and acute wounds; it has improved clinical practice in wound care; it has led to the development of new wound dressing materials which reduce the pain and stress associated with dressing change; and has brought economic benefits to the business that initially commissioned the research.
Prof Tanner's research on surgical site infections (SSIs) has had a direct impact on both patient care and policy at local, national and international levels. It has resulted in a reduction in the number of SSIs, thus improving patients' quality of life, shortening lengths of stay in hospital and making substantial cost savings for the NHS. The research has led directly to the development of policy and guidelines for various bodies including the World Health Organisation, the Department of Health, NICE and the Joint Commission Accreditation Healthcare Organisations (USA), as well as locally in a number of NHS trusts. The post discharge SSI surveillance programme pioneered by Prof Tanner has led to an increase in the number of trusts in the UK undertaking post discharge surveillance.
Many hand surgical units worldwide have routinely used night-time splints in all patients after Dupuytren's contracture fasciectomy and dermo-fasciectomy, despite the lack of robust evidence to support its use.
Jerosch-Herold's programme of research identified that routine night-time splinting for all patients after fasciectomy or dermo-fasciectomy surgical treatments for Dupuytren's contracture is not beneficial. This finding is changing clinical practice, and informing guidelines and policies in the UK, New Zealand and the USA. As a result, health care organisations are ceasing to prescribe routine night-time splinting. This reduces inconvenience and discomfort for patients, relieves pressure on services and generates financial savings, all whilst maintaining equally good clinical outcomes.
The reach of the research findings impact is high, as Dupuytren's contracture is a common disorder of people of Northern European ancestry which results in surgical interventions for thousands of people annually (13,000 pa in the UK alone).
Research from the Department of Materials Science and Engineering led to healthcare impact through treatment of burns patients and those with chronic non-healing wounds using the culture and expansion of the patient's own skin cells. This impact was achieved by establishing a product, MySkin®, as the UK's first and only commercially available complete service for the culture and delivery of patient's skin cells. It is now used in 11 out of the UK's 12 major burns units for patients in danger of death from extensive burns. MySkin® benefits patients, clinicians and nurses and was Biomedical Product of the Year in 2008 (see Sky News video (2008) on www.Ilika.com).
Research into healthcare associated infections (HAI) at Aston University is led by Professor Lambert, Dr Worthington and Professor Hilton. New strategies to prevent and reduce HAI through a cleaner healthcare environment (antimicrobial surfaces and disinfection) and improved pre-surgical skin antisepsis have been founded on Aston's research in this field since 2007. This work has delivered significant impact on commerce, health and welfare and policy by: