Laying the groundwork: Researchers prepare for $1.6 million study to improve wound healing

Norfolk, Va.

- Researchers at Old Dominion University (ODU) in Norfolk, Va., are gearing up to begin work on a $1.6 million study to learn how tiny pulses of electricity can reduce wound-related infections and accelerate the healing process.

Monies for the study will come from the Department of Defense, whose interest in the project is finding new ways for the U.S. military to deal more successfully with casualties of war.

In the clinic, the results could help dermatologists decrease infections or someday eliminate them altogether.The multidisciplinary effort combines the research and development expertise of ODU staff of the Frank Reidy Research Center for Bioelectrics and its Computational Intelligence and Machine Vision Laboratory. The study will be a three-pronged approach - all using electricity - to accelerate the healing process.

"We have a lot of synergy between the different areas of our center," says Richard Heller, Ph.D., professor and director, Frank Reidy Research Center for Bioelectrics, Old Dominion University, Norfolk, Va.

"Now, we will be able to look at how we might combine different technologies to facilitate healing, and add a disinfection component as well," he says.

About a dozen researchers will be involved in the work involving three areas of wound management. All three approaches have undergone preliminary research and have shown to be promising.

First area of study

The first area of study employs the use of nanosecond pulsed electric fields to activate platelets in the blood, which have been demonstrated to have antibacterial and analgesic properties that speed up wound healing.

In this approach, nanosecond electric pulses are used to activate platelets and form a platelet gel, as opposed to using thrombin, which can have adverse effects. In this arm of the research, investigators will test the effect of nanosecond pulses on human platelet aggregation, intracellular free Ca2+ ion concentration and platelet-derived growth factor release.

In earlier studies, researchers found that when platelet-rich plasma was pulsed with one 300 ns electric field, platelets accumulated and a platelet gel was produced. The direct activity of the platelets appeared to facilitate and accelerate healing, Dr. Heller tells Dermatology Times.

Second area of study

The second part of the study includes the use of a device that emits cold plasma to disinfect wounds and reduce wound-related infections.

This plasma ‘jet stream’ is "essentially a discharge in the form of a plasma stream that puts out a plume from the plasma device that has some antimicrobial effects," Dr. Heller says.

Electricity at a high voltage is utilized within the device to cause a discharge, which generates the plasma.

"The discharge is cool to the touch," he says. "While the process has an effect on microorganisms, it doesn’t appear to burn or damage the skin." This cold plasma jet provides an effective method of treatment for yeast and bacterial infections of the skin, according to Dr. Heller.

Third area of study

The third aspect of the study involves the delivery of genetic material to cells. Here, researchers will look at plasmid DNA encoding angiogenic factors using in vivo electroporation - a process that can greatly enhance wound healing and improve the viability of a large flap or skin graft.

"This is a gene transfer approach for stimulating angiogenesis in a wound to also facilitate healing," Dr. Heller says. "And skin is an excellent target for gene transfer protocols."

In this part of the research, scientists will attempt to demonstrate that in vivo electroporation enhances intradermal delivery of plasmid DNA. The electrode design offers the potential for easier and more rapid application of electrically mediated cutaneous plasmid delivery than the electrodes that are currently available commercially.

Study objectives

The three approaches will be tested as single agents or as combinations to find the best treatment approach, according to Dr. Heller.

"It is important to have the capability to provide fast and efficient care for our troops in case of casualties," he says. "Full development of these approaches will fill this need."

Closer to home, physicians may someday benefit from this work when treating large wounds or defects in patients with diabetes or those with ischemic areas that aren’t healing well to get faster tissue and skin repair.

"We’re pretty excited about beginning this multidisciplinary study," Dr. Heller says. "This funding will help us to build the instrumentation that we will need to eventually move these applications to humans.

"What we’re looking at is to be able to add to the physician’s arsenal so they can help patients heal," he adds.

"We hope we can decrease the failure rate of grafts and flaps, and reduce the potential for infection in wounds. These would be very nice medical weapons to have, and that’s what we’re hoping will be our end result," Dr. Heller says. DT