Patrick Bilbo, COO, Organogenesis, explores the factors driving need for wound care – such as the ageing population, increasing rate of obesity and diabetes, sports and military injuries.
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What factors are driving the need for wound care?
Wounds can be categorised into two broad types: acute and chronic. An acute wound follows a standard, timely healing process and is typically caused by trauma, such as a surgical incision, a cut, or a burn, with an incidence rate in the U.S. exceeding 17 million hospital visits annually. Chronic wounds, on the other hand, have essentially stalled and are no longer healing. It is estimated that chronic wounds impact more than 40 million patients worldwide. These wounds are most often linked to other comorbidities, including type 2 diabetes, obesity, and cardiovascular diseases; conditions that compromise circulation, immune function, and the body’s overall healing capability. The prevalence of these conditions increase as the population ages. Without intervention, chronic wounds on the lower limbs can lead to serious complications, with as many as 30% resulting in amputation. 85% of all leg amputations are preceded by a diabetic foot ulcer. The five-year pooled mortality rate for patients with a lower-limb amputation is higher than the mortality rate for all cancers combined.
How is the ageing population influencing demand for wound care solutions?
Older adults are more vulnerable to chronic wounds, including pressure ulcers, diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs). This is often exacerbated by age-related physiological changes that slow healing rates, such as decreased collagen production and impaired immune function.
Additionally, older adults frequently manage multiple conditions, including type 2 diabetes and cardiovascular diseases, which can complicate wound management strategies and increase the risk of complications. As the population ages, there is a growing need for long-term care facilities, which drives the parallel demand for specialised wound care services.
What impact are rising obesity and diabetes rates having on wound management strategies?
Obesity and diabetes are closely linked, with obesity being a major risk factor for developing type 2 diabetes, increasing the risk of these patients developing a DFU. Obesity and diabetes contribute to vascular dysfunction, which impairs circulation. This leads to inadequate oxygen and nutrient delivery to the wound site and delays healing. Additionally, diabetes can weaken the immune system, making patients more susceptible to wound infections, which in turn increases the risk of chronic wounds and delaying wound closure. Diabetic neuropathy, which is common among individuals with type 2 diabetes, can cause a loss of sensation in the feet, raising the risk of unnoticed injuries and ulcers. Without intervention, these wounds can cause serious complications, including amputations and even death.
Are healthcare systems prepared for the growing burden of wounds?
Healthcare systems' preparedness varies significantly depending on the region, resources, and infrastructure. Many healthcare systems face resource constraints, including a shortage of wound care specialists, specialised equipment, and funding for advanced therapies. However, there are also highly regarded specialised wound care centers with multidisciplinary teams. In many cases, wound care is fragmented, with patients receiving treatment from multiple providers in various settings, resulting in a lack of coordination and continuity. Adopting evidence-based guidelines for wound management can help address the fragmentation and lead to improved patient outcomes.
Complications such as infections and amputations significantly increase the cost of wound care with amputations, extended hospital stays and increased emergency department visits. Early and effective intervention with evidence-based therapies is key to reducing the burden chronic wounds can have on healthcare systems.
How do wound care needs differ between sports injuries and military trauma?
Sports injuries requiring surgical management and military wounds involving soft tissue and skeletal damage require significantly different approaches. For sports injuries requiring surgery, incisions are typically made under sterile conditions during planned procedures. These wounds are generally clean, with well-defined edges, and present a lower risk of infection due to the controlled surgical environment. The focus of wound treatment is on closure to promote rapid healing, with minimal scarring and restored function, while preventing infection. Military trauma often involves complex, contaminated wounds with significant tissue damage, bone fractures and potential for infection. In particular, military trauma wound healing is often focused on infection control, wound stabilisation, and limb salvage. Cellular and tissue-based products such as placental allografts can provide a protective barrier to provide an optimal environment for healing.
What emerging treatments are showing promise?
Organogenesis is leveraging regenerative medicine technology as a potential non-surgical solution for pain symptoms associated with knee osteoarthritis (OA). Knee OA is a degenerative joint disease and is ranked among the most common causes of disability and poor quality of life, generally characterised by pain and functional deficits. End stage management of the disease in these patients is typically a total knee replacement when all other treatment options are exhausted.
Organogenesis is currently evaluating ReNu, a cryopreserved, amniotic suspension allograft (ASA) developed for the management of symptomatic knee OA. ReNu consists of amniotic fluid cells and micronised amniotic membrane and contains cellular, growth factor and extracellular matrix components.
Are there any innovative materials or delivery systems revolutionizing wound treatment?
Organogenesis is actively exploring new regenerative medicine treatments for wounds, surgeries, sports medicine and related areas to drive meaningful change and raise expectations for healing and recovery. Our diverse technology platforms now encompass bioengineered cellular products made from living allogeneic cells, amniotic and placental products derived from human placental tissues and cellular fluids, porcine collagen biomaterials and antimicrobial technology.
From these platforms, we have developed solutions for significant unmet patient needs, including chronic, acute and surgical wounds, as well as pain associated with knee osteoarthritis. These include Affinity, launched in 2017, the only fresh, amnion placental allograft designed for both acute and chronic wounds, and NuShield, a complete dehydrated placental allograft used for surgical applications as well as for acute and chronic wounds.
What are the main barriers slowing progress in regenerative medicine for wound healing?
Organogenesis is developing healing solutions based on the foundation that regenerative medicine holds significant promise for improving wound healing and pain management. The wound healing process is very complex, involving various cell types, growth factors and intricate signaling pathways, making it inherently difficult to navigate. In the past four decades, we have developed one of the most comprehensive portfolios of cellular-based advanced wound care and surgical products, designed to assist patients at all stages of healing, from the onset of the wound to its complete closure. We successfully navigate the challenges of scalability and how to scale the production of cell-based therapies, which face numerous obstacles that complicate their wider application in clinical settings. Addressing these barriers, as well as coverage and access challenges, will be crucial for continuing to advance the field of regenerative medicine and enhancing its potential benefits for patients.