Scar Free in Focus
Dr Amber Young is a Consultant Paediatric Anaesthetist at University Hospital Bristol and is the clinical lead for The Scar Free Foundation Centre for Children's Burns Research. We spoke to Amber about a new dressing that detects infection through a simple colour change. This dressing is currently being trialed in collaboration with Professor Toby Jenkins (pictured with Amber) and the University of Bath.
What does the Smart Wound dressing do and why is it important?
At the moment doctors cannot easily diagnose a wound infection at the bedside of burns patients.
If a patient becomes unwell after a burn injury they have to have their dressings removed so that a swab can be taken. This can be painful, may require an anesthetic for younger children, and can delay healing. Blood culture tests can also diagnose an infection but take 48 hours for a result to come back from the lab. This difficulty in diagnosing infection means currently there is an over-use of antibiotics, which can lead to increased bacterial resistance.
The Smart Wound dressing that we are trialing contains very tiny capsules that are sensitive to bacteria toxins that cause wound infection. When, and only when, the capsules come into contact with these toxins they break open and release a dye, which turns the dressing yellow. This dressing will mean that we can diagnose infection at the point of care, so it can be treated early. The dressing also, just as importantly, rules out wound infection when a patient is unwell or has a temperature for another reason. This will save patients' distress and unnecessary treatment and save the NHS money.
When will the bandage be available to patients?
The prototype dressing has been developed by Dr Toby Jenkins and his team from the Department of Chemistry at the University of Bath. I am leading the clinical trial, which started last October. The study is a great, though all too rare an example of scientific and clinical teams working side-by-side. This kind of collaboration means that the patient and their care is considered at all stages of the treatment's development and translation into the clinic.
We will test the dressing on over 300 patient samples from Bristol, East Grinstead and Chelsea & Westminster hospitals. This study will determine the sensitivity and specificity of the dressing, that means how well it detects wound infection that needs treatment and, conversely, how often it changes colour when there is no infection present. Once it completes in autumn 2018 we will need to go through a number of further clinical trials before the dressing can be made available across the NHS. This can take up to a decade, but will mean we can test the dressing on larger patient numbers.
How does your research contribute to our vision of a world without scarring?
One of the complications of burn wound infection is delayed healing. When healing is delayed, there is more likelihood of scarring. Scarring is permanent and irreversible. Scarring affects all aspects of a patient’s life. It can affect their movement due to contractures (when scarring happens around joints) and cause pain and itching. Psychologically scars often have an impact on how patients feel about their appearance. For children it can affect their confidence, friendships, and ability to play normally.
Photograph courtesy of University of Bath