Post-operative cancer treatment and chronic wound care
Chronic wound care, especially in elderly patients, is currently a serious problem – costing the UK NHS around £3bn a year and approximately $25bn in the US.
Many people are unaware that wounds, particularly for the elderly and those with diabetes, can sometimes take weeks or even months to heal. Currently, diagnostics are rarely used in routine wound management because they don’t fit into normal clinical workflow and they’re expensive.
This technology, ‘Spatial Reach’, was designed to be very low-cost and to fit seamlessly into normal clinical practice.
We identified potential applications in wound management and surgery that would help to combat the problem faced by healthcare systems.
Our idea was designed to improve the standard of care without incurring excessive costs or disrupting normal clinical workflow, by giving clinicians understanding about what happens in wounds and surgical sites, and using that knowledge to guide and deliver therapy.
The proof-of-principle concept was then developed to address two significant unmet clinical needs; early detection of cancer regrowth following surgery and detection of infection within chronic wounds.
How the technology works
Utilising low-cost hollow fibre tubing currently used for haemodialysis, alongside specially engineered hardware and software, our Spatial Reach technique fuses diagnostics and therapy and has the potential to create a whole new category of advanced wound care.
A continuous spiral or zig-zag pattern of the porous hollow fibre tubing is placed into or onto the target area. The tubing is filled with saline and the surgical site can be closed, or a dressing can be applied as normal.
With the tubing in place, any biomarkers of cancer or infection can diffuse into the tube. The presence of cancer regrowth or infection can then be monitored by pumping out and analysing the column of fluid.
When the sample is passed through a handheld reader, healthcare professionals can see not only whether cancer or infection is present, but exactly where it is in three dimensions.
Critically, having analysed the sample, the Spatial Reach platform can then be run ‘in reverse’, so that chemotherapy or an antibiotic can be delivered back to just those areas within the wound where it’s required.
Slugs of chemotherapy or antibiotic are pumped back by the device into the tubing – interspersed with saline – so that the therapy ends up adjacent to the infection or cancer. The drug can then diffuse out of the porous tubing and only treats the targeted region. This allows toxic chemotherapy to be used without causing damage to healthy tissue.
It will also allow ‘last ditch’ antibiotics to be delivered which can treat superbugs such as MRSA, yet which are too toxic to be given to vulnerable patients systemically.
Reducing collateral damage for post-operative cancer patients
In the case of post-operative cancer treatment, Team believes that Spatial Reach could be particularly significant for diagnosis and therapy for cancers such as brain tumours. In 2010 there were 9,156 new brain, other CNS and intracranial tumour cases registered in the UK alone.
In any neurosurgical procedure a key requirement is minimising collateral damage to the patient. However, monitoring tumour regrowth currently involves multiple invasive surgeries to collect samples for testing. The use of powerful medication during traditional treatment can also cause unwanted harm to healthy tissues.
By providing the ability to deliver highly targeted therapy and monitor post-operative regrowth without the need for further surgery, Spatial Reach can reduce the potential for physical and mental distress for patients.
Our new technology aims to give clinicians the ability to non-invasively monitor the site of an internal tumour excision or a chronic wound.
Once a site has been analysed then the same platform can then be used to deliver highly targeted therapy to the precise areas where treatment is required, either to kill remaining cancer cells or to treat wound infections – all without exposing nearby tissue directly to either chemotherapy agents or to unnecessary antibiotics.
This patented technique has the potential to dramatically reduce patient recovery time and increase the survival rate of critically ill patients.
Dr. Ben Wicks, Head of MedTech, commented:
“Using Spatial Reach to directly treat tumours and severe wounds could transform treatment for millions of people. Currently there are very few tools available for healthcare professionals to adequately monitor tumour excision sites and wounds, and most techniques employed today involve significant distress for patients.”
“By contrast, our new system enables samples to be taken and medication to be delivered, without disturbing patients at all, which could have a dramatic impact on the efficacy of therapy.”
“Spatial Reach is an early-stage concept but it offers significant benefits to surgeons, healthcare professionals and patients.”
From an expert
“If proven, this technology could offer for the first time the ability to simply, safely and continuously target delivery of both chemotherapeutic and biological therapies to locoregional areas of the brain. Significantly, this would avoid problems of access such as the blood-brain barrier, and problems of systemic toxicity as in the treatment of bone marrow.”
Prof. Garth Cruickshank, Professor of Neurosurgery
University of Birmingham