Chronic wounds are a significant societal problem, expected to increase as the population ages and co-morbidities such as obesity and diabetes become increasingly common. Currently 4% of the total NHS budget is used in treating chronic wounds and their infections. Most of the burden is within general practise, consuming 25-50% of community nurse time. More than 80% of wounds show colonisation with bacteria, thought to be a major contributor to wound chronicity. Biofilm formation is a strategy used by bacteria to persist in wounds. Four of the top five wound-associated bacteria are classified as high/ critical priority antibiotic resistant pathogens by the WHO. Treatment failure is thus common. Microwave-based therapeutics, already routinely used in tumour ablation and minor skin conditions (e.g. verrucae) have proven efficacy and safety records clinically. Our preliminary work shows that low-level microwave energy is effective in inhibiting the growth of Staphylococcus aureus, commonly associated with chronic wound infections. Microwaves have not only been shown to modify microbial populations but are also able to stimulate proliferation and migration of healthy fibroblasts, promoting wound healing.
1. Can microwaves disrupt bacterial biofilms associated with chronic wounds, leading to enhanced antibiotic efficacy?
2. Can microwaves augment the wound healing process through stimulation of healthy or chronic wound fibroblasts?
3. How can we deliver microwaves safely and effectively to heal chronic wounds in a clinical setting?
1. Early-phase patient and public engagement to assess acceptability of microwave-based therapeutics and capture insight to inform technology design. The ultimate long-term ambitions of this project are to implement microwave technology in a clinical wound healing setting. To achieve this, we plan to involve the end-users of the proposed technology (i.e. chronic wound patients and members of the public) from an early stage in order to scope their opinions on wearable technologies. This will be achieved through initial Patient and Public Involvement (PPI) sessions to scope these areas and help co-develop an informative multi-modal survey.
2. Microwave treatment regime (in vitro). Determine the optimal microwave parameters for: (i) biofilm disruption and synergy with antibiotics, focussing on the top 2 woundassociated pathogens: Staphylococcus aureus and Pseudomonas aeruginosa comparing clinical and non-clinical isolates, as well as broadspectrum antibiotics commonly prescribed to treat wound infections. (ii) Wound healing using healthy and chronic fibroblast cells.
3. Mode of action studies (in vitro). (i) Detailed growth, microscopic (via scanning electron microscopy, confocal microscopy and atomic force microscopy), membrane integrity and biochemical (reactive oxygen species) studies to determine the mechanism of microwave-induced effects. (ii) Challenge studies to determine whether microwaves affect the ability of bacteria to infiltrate fibroblast cells and enhance the ability of fibroblasts to eliminate bacteria.
4. Technological design: Microwave applicators have already been developed and validated by our team for the in vitro investigations described above. However, these applicators will need further refinement for future clinical use. The student will scrutinise the current literature and market for current clinical microwave applicators, seek the opinions of medical experts (e.g. Welsh Wound Innovation Centre) and industry experts in this field (e.g. Emblation) and use this information to design a bespoke microwave applicator specifically for wound healing applications. This interdisciplinary project will allow the student to expand their skillset into new areas of interest. The student will be encouraged to develop their own project-related ideas and interests and participate in local and national research networks
Applications open on 2nd September 2022 and close at 5.00pm on 2nd November 2022.
About the GW4 BioMed2 Doctoral Training Partnership
The partnership brings together the Universities of Bath, Bristol, Cardiff (lead) and Exeter to develop the next generation of biomedical researchers. Students will have access to the combined research strengths, training expertise and resources of the four research-intensive universities, with opportunities to participate in interdisciplinary and 'team science'. The DTP already has over 90 studentships over 6 cohorts in its first phase., along with 20 students in its second phase.
Residency: The GW4 BioMed2 MRC DTP studentships are available to UK and International applicants. Following Brexit, the UKRI now classifies EU students as international unless they have rights under the EU Settlement Scheme. The GW4 partners have all agreed to cover the difference in costs between home and international tuition fees. This means that international candidates will not be expected to cover this cost and will be fully funded but need to be aware that they will be required to cover the cost of their student visa, healthcare surcharge and other costs of moving to the UK to do a PhD. All studentships will be competitively awarded and there is a limit to the number of International students that we can accept into our programme (up to 30% cap across our partners per annum).
Academic criteria: Applicants for a studentship must have obtained, or be about to obtain, a UK degree, or the equivalent qualification gained outside the UK, in an appropriate area of medical sciences, computing, mathematics or the physical sciences. Please check the entry requirements of the home institution for each project of interest before completing an application. Academic qualifications are considered alongside significant relevant non-academic experience.
English requirements: If English is not your first language you will need to meet the English language requirements of the university that will host your PhD by the start of the programme. Please refer to the relevant university for further information.
How to Apply
A list of all the projects and how to apply is available on our website at gw4biomed.ac.uk. You may apply for up to 2 projects.
Please complete an application to the GW4 BioMed2 MRC DTP for an ‘offer of funding’. You may also need to make an application for an 'offer to study' to your chosen institution(s) – further details are on the website.
Please complete the online application form by 5.00pm on Wednesday, 2nd November 2022. If you are shortlisted for interview, you will be notified by Friday 16th December 2022. Interviews will be held virtually on 25th and 26th January 2023.