The Greatest Thing Since The Band-Aid

Burn victims are just a few of the injured who may now see their wounds heal faster with less scarring, thanks to a new technique designed by researchers at Brigham and Women's Hospital.

Dr. Elof Erikkson, a professor of surgery at the Medical School and chief of plastic surgery at Brigham and Women's, is now testing a new technique of treating open wounds on humans.

The experimental treatment can cut healing time by at least one half and may be more effective than surgery, Erikkson said.

"The overall goal is to gain better control of the would healing process," he said.

Erikkson said he hopes to develop sufficient control over the healing process to be able to slow it down or speed it up.

"The technique," he said, "speeds healing and appears to reduce scarring."

Erikkson said scarring can restrict motion in the arms, the legs or even the shoulders, making it as serious a problem as the wound itself.

The treatment is used for chronic wounds which cannot be healed by conventional methods--such as plastic surgery--or wounds with unusually long healing times. It cannot be used to treat surgical wounds.

Erikkson said that at any given time about one to three percent of people have a chronic wound. Chronic wounds, such as a severe burn, cannot heal without treatment.

The new treatment, according to Erikkson, is "not for everybody." Older people and those suffering from disease like diabetes, which slow the healing process, will benefit most from the new technique, Erikkson said.

The treatment works by using a small, sealed transparent chamber, called an incubator, that is glued to the wound.

The incubator contains a nutrient-rich fluid with a ready-made growth factor which Erikkson said acts like "cell-feed." The wound heals faster because the fluid helps the cells fight infection, while the incubator protects the wound from external harm.

The incubator can remain attached to the wound for up to five days, when the fluid must be replaced with fresh media. Patients continue to wear the incubator until the wound has healed completely.

According to Erikkson, experiments show that the incubators could be worn for as little as two or three days or for as long as nine weeks. More severe wounds require that the incubator be attached for longer times.

Incubators are new being tested on a group of about 20 people, Erikkson said.

Patients would be able to leave the hospital wearing their incubators, just as if they were wearing a bandage or cast. The patient would only need to return to the hospital to monitor healing of the wound.

Erikkson said the treatment provides a convenient alternative to surgery.

"It is done with simpler tools and keeps the patient out of the operating room," Erikkson said. "Our goal is to be able to treat patients as outpatients."

Erikkson said that treating a severe leg burn with this method would first require removing the dead skin. An incubator would then be placed on the wound to get rid of infection, and a small piece of skin would be removed from the wound to create a cell suspension.

When the patient returned, the liquid from the incubator would be removed, the piece of skin that had been removed would be placed in a cell medium, and the wound would be allowed to heal.

Erikkson, is conjunction with Dr. Richard Mulligan of the Whitehead Institute of Cambridge, is now trying to incorporate genetic therapy into this novel healing technique.

"The reason we started to collaborate with Richard Mulligan," Erikkson said, "was that we thought it would be useful to use gene transfer techniques."

Erikkson said he was injected genes directly into the wounds of Yorkshire pigs so that they can manufacture their own growth factor, rather than having it supplied by the incubator.

Erikkson said he first started to research new techniques for healing wounds 20 years ago, when he was dissatisfied with the standard treatments for burn wounds.

The results of Erikkson's initial research were published in the September 27 issue of Proceedings of the National Academy of Sciences. Mulligan, Karl Breuing, Paul Liu, Peter Vogt, Chris Andree and Simon Thompson co-authored the paper.

Erikkson said that the results of the gene therapy experiments will be published in about one month.