Another perspective: For chronic wound sufferers, the forecast is perhaps not so grim

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Carol Emanuele of Philadelphia shows a photograph of a wound VAC (vacuum-assisted closure) procedure on her left foot after the amputation of her big toe.

As health care providers who treat chronic wounds, we are acutely aware of the toll this growing problem places on the American health care system, its patients, and the economy.

A recent Kaiser Health News article published in the Philadelphia Inquirer comprehensively describes the scope of the issue: 6.5 million patients are currently suffering from chronic wounds. Many are dying. And most treatments, while costing Medicare at least $25 billion a year, “prove little more effective than the proverbial snake oil.” The story goes on to explain, “independent academic research is scant for a growing problem.”

It is true these conditions may be “unsexy,” as one researcher notes. (Although our patients are not all “old, sick and paralyzed,” but in fact range widely in gender, age, and physical health.) And indeed, there are few, if any, chronic wound awareness campaigns, 5K walks, or fundraisers.

However, we disagree with the premise that this is a problem that is not being addressed by health researchers.

For more than a decade, an interdisciplinary team of Drexel University researchers — including biomedical engineers, physicians, and nurses — has been developing a new, non-invasive method for healing chronic wounds. Perhaps outside the norm in wound healing research, our studies are randomized, include rigorous testing, and are sponsored by NIH grants, rather than industry funders.

What is our solution? Low-frequency ultrasound — just a few pitches above an average person’s hearing — applied directly to a wound via a small applicator that can be worn like a Band-Aid.

Our team proved the technology’s effectiveness in a successful, albeit small, NIH-sponsored clinical study in 2013. The device significantly accelerated healing in five patients with venous leg ulcers at the end of a four-week period. Our initial results with diabetic wounds were equally encouraging.

Following that pilot trial, the NIH awarded our team a $3 million grant in 2017 to test the therapy on 120 patients over the next five years. Our studies will be randomized and double-blinded, meaning neither the investigators nor the patients will know which treatment they’ll receive, which will provide us with the highest quality, clinically-relevant data. The research seeks to verify not only whether the ultrasound offers an effective and safe treatment, but also how the treatment works on a cellular level. Our studies will also explore the impact of diet and inflammation on wound healing and will employ near-infrared technology to measure blood vessel growth and tissue oxygenation.

Our ultimate goal is to provide patients with a device that is inexpensive, wearable, and easy enough to use at home, significantly reducing doctor’s visits and health care costs.

We still have a long way to go before our sickest patients receive the cures they need. As physicians and nurses at Drexel University, and across the country, pursue the best options for patients with stubborn wounds, one particular ill that we all must safeguard against is the spread of public cynicism about these efforts. It is critical to utilize the most proven means of wound healing. But perpetuating any claim that most wound treatments are a waste of time and money — especially during a policymaking climate in which health care and scientific research are under attack — not only does a disservice to the doctors and nurses working tirelessly to improve patients’ quality of life. It also hampers the vital work of scientists who are finding solutions to this vexing issue.

And for patients in the Philadelphia area, many whom may feel as if they are out of options, we firmly believe that our evidence-based research should offer some newfound hope.

Drexel University College of Medicine is currently recruiting patients with diabetic foot or venous leg ulcers for a study of non-invasive therapeutic ultrasound. For more information, please contact Dr. Michael S. Weingarten at 215-762-7008. 

Rose Ann DiMaria-Ghalili, PhD, is an associate professor in the College of Nursing and Health Professions at Drexel University: rad83@drexel.eduPeter A. Lewin, PhD, is the Richard B. Beard Distinguished University Professor in the School of Biomedical Engineering, Science and Health Systems at Drexel: lewinpa@drexel.edu. Michael S. Weingarten, MD, is a professor at the Drexel College of Medicine and director of the Drexel Comprehensive Wound Healing Program: msw@drexel.edu.