Bio-instructive' materials for chronic wound healing

In this project we hypothesise that novel 'bio-instructive' materials with the ability to prompt fast re-epithelisation, hamper inflammation and enhance vascularisation could provide an alternative to the existing state-of-the-art in chronic wound care (e.g. polyurethane films or Hydrocolloids)). These novel bio-instructive materials will be used for developing next generation dressings and scaffolds for cell based therapies for wound care in diabetic wounds and other types of chronic wound and extensive burns.
There are a large number of patients who suffer from chronic non-healing wounds in our ageing population. Chronic wounds represent a significant burden to patients and to the National Health Service, with an estimated cost of £3.1billion per year in the UK alone accounting for >3% of the total health budget. The problem is exacerbated by the increasing incidence of other conditions such as diabetes, vascular disease and long-term immobility.
In the skin, the wound healing process involves close collaboration between different cell types including epithelial cell, stromal cells (e.g. fibroblast), endothelial cells and immune cells particularity macrophages. Under normal conditions skin epithelium has a high renewal capacity due to the presence of resident stem cells, good perfusion and efficient removal of damaged cells by phagocytic cells, providing an optimal environment for re-epithelization. Fast re-epithelisation and wound closure reinstate skin barrier function which is crucial for stopping infection.
However, in the case of deep injuries (e.g. extensive burns), or chronic non-healing wounds, due to compromised vascularisation or chronic inflammation (e.g. in diabetes), a limit is reached where the epithelium self-healing cannot occur. This leads to creation of a non-healing wound that is prone to chronic infection creating a cycle of chronic inflammation and further tissue damage.
A prime example of chronic non-healing wounds are diabetic ulcers where high glucose levels, compromised function of macrophages, poor circulation and chronic inflammation render conventional treatments non-efficient and make wound care a clinical challenge.