Therapeutic Use of Micro-Sponge Embedded Nutritional Liquid Scaffold for Treatment of Non-Healing Wounds

问题和解决方案：慢性压迫性溃疡(PU)是脊髓损伤(SCI)患者再次住院的前五大原因之一，SCI经常导致感染、低生活质量、抑郁，甚至有死亡的风险。仅在加拿大和不列颠哥伦比亚省，治疗脊髓损伤患者的PU费用估计分别为365.7美元和4970万美元/年。脓液的治疗具有挑战性，主要有3个问题：1)空洞和空隙的存在，这使得传统的治疗方案难以治疗；2)位于身体的骨隆起和承重部位上方，复发的风险很高；3)治疗前和治疗中感染的可能性很高。为了解决这些困难，我们最近通过在我们正在进行的试点临床试验中开发和使用名为MeshFill的液体营养支架来解决第一个问题。然而，还需要更多的研究来解决其他问题。因此，在这项研究中，一种名为MeshFill-Plus的新产品包括：1)液体营养支架(MeshFill)，2)海绵和弹性纳米纤维骨架，3)抗菌纳米银颗粒，并将首先在实验室感染和对照伤口中测试其功能，然后在临床前猪伤口模型中进行测试，该伤口具有与人类相似的皮肤。最后，与测试和优化的MeshFill-Plus的安全性和性能相关的证据将提交不列颠哥伦比亚大学/温哥华综合医院伦理委员会，以批准用于治疗12名脓肿患者的小型临床可行性研究。使用MeshFill-Plus不仅自下而上填充所有的洞/洞，还可以增加愈合伤口的体力，防止任何潜在细菌在脓液上生长。结论：这项研究的结果使得将MeshFill-Plus的组件组装成医用包不仅可以治疗脓液，还可以治疗其他不可愈合的伤口

Problems and Solution: Chronic pressure ulcer (PU) is among the top five leading causes of re-hospitalization in patients with spinal cord injury (SCI) which frequently leads to infections, low quality of life, depression, and even a risk of death. The cost of treating PU in patients with SCI in Canada and BC alone is estimated to be $365.7 and $49.7 million / year, respectively. Treatment of PUs is challenging due to 3 major problems:1) The presence of cavities and void spaces which makes them difficult to to treat by conventional regiments, 2) Locating over bony prominence and weight-bearing parts of the body with a high risk of recurrence, 3) A high chance of infection before and during treatment. To solve these difficulties, we have recently addressed the 1st problem by developing and using liquid nutritional scaffold called MeshFill in our ongoing pilot clinical trial. However, more studies are needed to address the other problems. Thus, in this study, a new product, referred as to MeshFill-Plus consists of: 1) liquid nutritional scaffold (MeshFill), 2) Spongy and flexible nanofiberous skeleton and 3) Antibacterial nano-silver particles will be generated and tested for its functionally in infected and control wounds initially in the lab and then in a pre-clinical pig wound model which has a similar skin to human. Finally, evidence related to the safety and capability of the tested and optimized MeshFill-Plus will be submitted to University of British Columbia / Vancouver General Hospital Ethic Board for approval of small clinical feasibility study for treating 12 patients with PUs. The use MeshFill-Plus not only fills up all cavities/ tunnels from bottom up, it increases the physical strength of healed wounds and prevents the growth of any potential germs when applied on PUs. Conclusion: The result of this study makes it possible to assemble the components of MeshFill-Plus in a medical package for treating not only PUs, but also other non-healingwounds