ABM CDT The mechanisms of portable negative pressure wound therapy on wounds

Wounds are a major unmet healthcare burden that impact on millions of patients per year. From those undergoing simple surgeries to complex ulcers of the lower limbs, a common form of therapy is the use of negative pressure wound therapy. The precise mechanisms of its action have yet to be evaluated on the new PICO device, which has a different use to conventional negative pressure wound therapy and is far more portable. This project aims to identify how it works on wounds in the clinical setting in acute and chronic wound conditions and use advanced bioprinting models to investigate whether the precise mode of action can be demonstrated and improved upon.

Background:

Negative pressure therapy has long been established as valuable tool in wound therapy to control exudate, provide barrier function, support wounds through the healing process and help with nursing care of patients. New negative pressure devices such as the PICO provides portable negative pressure therapy enabling the patient and clinical teams far greater flexibility in use. It has a unique mode of action through its proprietary technology enabling delivery of therapy beyond the wound to wider regions including the peri wound. The biological mechanisms by which the device works remains unclear and may help decipher which patients best respond to the device, stratify indications, and importantly identify novel mechanisms that could be further advanced to improve on wound healing.

Main questions:

How does negative pressure work on incisional and excisional wounds?

This will be done by two main methodologies.

1. Evaluation of wounds on patients pre and post application of PICO dressings. This study will investigate the spatial biology of clinical acute wounds and chronic wounds using spatial transcriptomics to provide real patient data on the effect of 7 days PICO dressing therapy.  The study will reveal the wound healing biological mechanisms that are influenced by PICO therapy and aims to identify any novel pathways PICO activates.
2. Development of an in vitro negative pressure model (adapted to PICO) that utilises wound surrogates based on spatial transcriptomics data of human acute and chronic clinical wounds.

The transcriptomic data from acute and chronic wounds is currently being resolved to produce a informatic understanding of the biology within wounds and also providing the data of which cell phenotypes should be where on the wound providing spatial data on where cells should be printed. Hydrogel multicellular surrogates of wound developed will assess therapies such as PICO to decipher mechanism.