Developing New Treatments

As well as treating patients with novel treatments, scientists at the Blond McIndoe Research Foundation are constantly trying to improve these treatments and develop entirely new ones through a sustained programme of scientific research. Much of this research is conducted ‘in vitro’ using cells or small pieces of skin (explants) grown in the laboratory. We can use these to test new ideas and gain a better understanding of the fundamental processes which occur during wound repair.

Understanding Fibrinolysis

The mechanisms involved in wound repair are poorly understood and a better understanding of these processes is vital in enhancing the human body’s own repair mechanisms, such that rapid repair occurs. One of the processes of particular importance is fibrinolysis. The clot which forms on the surface of an open wound provides a temporary barrier to water loss and infection. This clot is mainly made up of fibrin. As the wound heals from the edges, skin cells migrate into the fibrin clot which is degraded as tissue is formed. This process is call fibrinolysis. The cues for cell migration and the mechanisms behind the formation of functional skin following fibrinolysis are poorly understood.

This project uses small pieces of skin (explants) isolated from discarded skin, retrieved following surgery. When these skin explants are placed into a culture dish containing clotted blood and incubated at body temperature, skin cells begin to grow out of the piece of skin. These cells form a sheet of new cells around the skin explant. As the cell sheet grows the blood clot is degraded. This is the same process as occurs when a wound heals. We have already found that this process happens more quickly in blood from some individuals than from others and would like to try and establish what is causing this difference. We are also going to look at the effect of factors such as oxygen levels, glucose concentration and fat content to establish whether dressings can be modified to provide a better environment to increase the speed of wound healing in patients suffering from burns or other serious injuries. This could potentially have an impact on how burns patients are treated and is vital in developing revolutionary new treatments in burn care.

New materials for treating burns

The first stage in the treatment of patients who have suffered full thickness burns is the rapid closure of the burn wound. This provides an instant barrier to bacterial invasion of the wound and prevents fluid loss. Surgeons currently use donated cadaver skin which is rejected several weeks after application but provides temporary wound closure. Artificial collagen based skin substitutes are also used which require a second skin graft. These materials are extremely costly however, making their use outside of wealthy developed countries prohibitively expensive. Scientists at the Blond McIndoe Research Foundation are developing a novel wound repair material which can be manufactured at low cost and provide an alternative to these methods of treatment. It is hoped that such a material will find use in developing countries where the incidence of burn injuries is much higher and current treatments are much less effective. This new material has been found to have anti-microbial qualities and is extremely well tolerated by the body showing great potential as a wound repair material.