Development of an infection detecting wound dressing

The project commenced on 1 June 2015 and will end on 31 May 2018

The overall aim of the proposed work programme is to create a wound dressing that provides an early indication of infection at point of care (PoC) which would significantly enhance clinical decision-making - with the capability to rapidly distinguish the bacterial Clinical Colonisation Threshold (TREAT) from sub-clinical colonisation (DON'T TREAT). The major overarching outcome we wish to deliver is to progress the dressing technology to a point suitable for large scale manufacture and first-in-human studies post DPFS.

This study includes an in vitro study of burn patients with suspected infections, using a non-invasive exudate collection approach that would be subjected to the normal microbiological culture tests as well as quantitative evaluation of virulence factors expression. This work would also aid analysis and understanding of various biological mechanisms of bacterial infection related to population density (quorum sensing). For example, understanding the processes involved in wound healing or identifying early indicators of tissue damage and wound infection related to quorum sensing controlled activity could identify additional targets for intervention, and there is considerable interest in this area. Specific beneficiaries will include:

• Academics and other scientists seeking to understand the pathogenesis of wound infections, and undertaking translational research
• 'Front line' nursing and clinical care staff in secondary care settings involved in infection control and the treatment of burn patients.
• Clinical microbiologists based in secondary care settings with responsibility for infection diagnosis.
• Infection control teams responsible for monitoring and preventing hospital acquired infections.

There is also significant potential to adapt and exploit the novel technology as a platform technology for critical colonisation detection (infection) in other acute and chronic wounds.

Over 140,000 people in England and Wales suffer burn injuries every year, with about 50,000 requiring treatment at specialised burn centres, and approximately 13,000 admitted to hospital. A major problem in the care of these patients is infection, to which patients with burn injuries are particularly vulnerable. An estimated 18 per cent of burn patients acquire infection-related complications – a major cause of morbidity, mortality and increased cost of care. In addition to aggressive antibiotic therapy, treatment typically necessitates the removal of dressings, and sometimes further surgery. This significantly increases the probability of scarring and undermines clinical outcomes, resulting in a subsequent life-long psychological burden to the patient.

Failure to treat patients in a timely manner also increases overall morbidity and mortality rates. Infection also greatly increases treatment costs associated with in-patient stays, dressing changes and surgical time.

The dressing being developed in this research programme indicates critical bacterial infection within a burn wound without the need to remove it. The dressing will signal infection by a simple colour change, that occurs when clinically relevant bacteria in the wound reach a level at which treatment is necessary. This can be used by clinicians directly at the patients’ bedside to provide more accurate and more effective treatment. In doing so our technology would not only improve outcomes for patients, but also reduce NHS costs and unnecessary antibiotic use.

Further details of this research will be available on completion of the project.