Wound care coverings such as adhesive bandages are important for the healing of skin wounds, by protecting the injured area from contaminants and thus helping to prevent infection. Adhesive bandages and wound dressings come in various forms, such as having waterproofing, different backing materials to provide durability during usage, and pad materials that prevent sticking to the wound. Some bandages offer even further defensive properties by incorporating an antibiotic substance in the pad of the bandage.
Adhesive bandages are used ubiquitously in both home and professional care settings and are essential as a first line of defense in the prevention of more serious medical issues in wounds.
In embodiments, a wound care covering includes a pad having a pad material. A lactate-based enzyme is crosslinked with the pad material by a crosslinker. The wound care covering also includes a dye that changes color when hydrogen peroxide is present.
In embodiments, a wound care covering includes an enzyme layer comprising a pad material crosslinked with a sugar-based enzyme by a crosslinker. A sugar-containing layer includes a sugar in a hydrogel. A rupturable barrier is between the enzyme layer and the sugar-containing layer.
In embodiments, a wound care covering includes a first enzyme layer comprising a first pad material, a lactate-based enzyme, and a dye that changes color when hydrogen peroxide is present, wherein the lactate-based enzyme is crosslinked with the first pad material by a first crosslinker. A second enzyme layer comprises a second pad material crosslinked with a sugar-based enzyme by a second crosslinker. A sugar-containing layer comprises a sugar in a hydrogel, wherein the second enzyme layer is between the sugar-containing layer and the first enzyme layer. A rupturable barrier is between the second enzyme layer and the sugar-containing layer.
Wound care coverings are disclosed that provide diagnostic and/or therapeutic capabilities for infections in skin wounds. In some embodiments, wound care coverings have a pad that indicates the presence of an infection by detecting a rise in lactate levels in the wound. Such wound care coverings can provide real-time monitoring for the development of an infection, so that the infection can be treated promptly. In some embodiments, wound care coverings have a pad that helps prevent infection by producing hydrogen peroxide at levels that promote both antiseptic and wound healing activity rather than impairing tissue growth. Such wound care coverings can reduce or eliminate the need for a user to apply other products (e.g., antibiotics, antiseptics, rubbing alcohol) manually, and also enable infection-prevention substances to be applied on an ongoing basis to a wound. Some embodiments include wound care coverings that have both the infection detection and prevention capabilities.
Embodiments of wound care coverings shall be described in the form of adhesive bandages having an adhesive strip and/or a pad mounted to the adhesive strip. However, embodiments shall also encompass standalone pads that can be applied as dressings for wounds in other manners, such as by being placed on an injured area and held in place by a gauze or fabric wrap, or by medical tape. The pads for wound care coverings in this disclosure may also be referred to as a carrier pad, a sheet, or a membrane.
In some embodiments, wound care coverings serve as an infection-alerting bandage, also referred to in this disclosure as an “alert-aid.” Wounds are known to accumulate lactate as a consequence of both anaerobic and aerobic glycolysis following microcirculation disruption, immune activation, and increased cell proliferation associated with wounds. Assessment of this lactate concentration in the fluid of the wound is helpful for confirming the suspicion of soft tissue infection, as higher levels of lactate indicate higher levels of cellular activity that are associated directly with a localized infection response. Embodiments of the present disclosure provide an easy-to-use and cost-effective product utilizing this rise in lactate concentration to provide a visual indicator to alert a user to a possible infection.
In
Various enzymes (e.g., lactate oxidase, lactate dehydrogenase) exist that convert lactate to a measurable quantity by conversion of lactate to hydrogen peroxide (H2O2) through a direct chemical reaction with the lactate. This reaction product concentration of hydrogen peroxide can result in a color change (e.g., from colorless to dark blue or purple) through reaction of hydrogen peroxide with a dye. The pad 120 of bandage 100 contains this type of dye that changes color in the presence of hydrogen peroxide, and also contains a lactate-based enzyme. The enzyme in the pad reacts with lactate in the wound to produce hydrogen peroxide, and the dye then indicates the presence of an infection via elevated lactate levels in the wound by changing color when H2O2 is detected. For example, the amount of enzyme and/or dye in the pad may be configured to trigger a color change when a certain threshold of lactate is detected (i.e., pad undergoes a color change when the threshold is reached or exceeded), where the threshold indicates a level high enough to indicate an infection.
In some embodiments, the dye is a colorimetric dye such as one or more of xylenol orange, titanium oxysulfate, titanium sulfate, 5,6-dimethyl phenanthroline (Fe complex), 2,2′-bipyridine (Fe complex), nitro phenanthroline (Fe complex), 1,10-phenanthroline iron(II) sulfate complex (Ferroin), and viologen. The color change can be detected by measuring a certain wavelength of color, a shift of the color, or alternatively by the intensity of the color. Observation of these changes may be accomplished by imaging the pad 120 with a camera on a smartphone (or other electronic device such as a computer tablet) and displaying results on an app in the phone as part of the wound care covering product (e.g., adhesive bandage 100). For example, existing peroxide assays measure absorbance of samples in the range of 550 nm to 650 nm, which can be used in conjunction with embodiments of the present disclosure.
In other embodiments, the dye is a fluorescing or chemiluminescent dye such as diphenyl oxalate, where the absence of presence of a color in the dye can be assessed visually by the user without a camera or imaging device. With fluorescing dyes, the presence of a color (e.g., changing from colorless to blue) indicates that lactate levels have risen above a certain threshold; a level high enough to represent infection.
The adhesive strip 110 (or other backing material/sheet) is transparent or translucent to allow a user to view the pad 120 through the adhesive sheet. For example, the adhesive strip 110 or backing material may be made of a transparent silicone or spun-lace acrylate.
The lactate-based enzymes are sensitive materials. The wound care covering embodiment of bandage 100 is uniquely constructed to provide encapsulation and stabilization of these materials in a fully biocompatible polymer carrier. This allows for both longevity (e.g., at least 5 days in-vivo use) and stabilization of the enzyme during sterilization of the product and also ensures that the enzymes remain in place in the pad. In embodiments, the pad comprises a pad material, and the lactate-based enzyme is crosslinked with the pad material by a crosslinker to provide this encapsulation and stabilization.
In some embodiments, the carrier pad material in pad 120 may be a hydrophilic polymer (e.g., hydrophilic polyurethane), a polymeric hydrogel or a natural hydrogel. Examples of polymeric hydrogels include poly(hydroxyethyl methacrylate) (i.e., poly-HEMA), polyethylene glycol (PEG), polyethylene glycol monoacrylate (PEGMA), cellulosics (e.g., carboxymethyl cellulose “CMC”), polyvinylpyrrolidone (PVP), and acrylamide. Examples of natural hydrogels include polysaccharides (e.g., alginate, chitosan), collagen, and fibrin. The enzymes can be crosslinked to the pad material by, for example glutaraldehyde, polyfunctional aziridine, bifunctional carbodiimide, dicyclohexyl carbodiimide, 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide, N-hydroxysuccinimide, N-hydroxysulfosuccinimide, ethylene glycol bis(succinimidyl succinate) (EGS), ethylene glycol bis(sulfosuccinimidyl succinate) (SEGS), tris-(succinimidyl) aminotriacetate (TSAT), dimethyl pimelimidate (DMP), dimethyl suberimidate (DMS), 1,5-difluoro-2,4-dinitrobenzene (DFDNB), dimethyl 3,3′-dithiobispropionimidate (DTBP), NHS-Phosphine, NHS-PEG-azide, NHS-azide or combinations thereof.
The pad 120 may also contain initiators, cofactors, and/or mediators as required for the enzyme being used. For example, lactate dehydrogenase requires a mediator, which may be metallic-centered substances such as osmium or iron. Cofactors and/or initiators such as flavin adenin dinucleotide (FAD) may also be included to increase the speed of the enzyme reaction.
The carrier pad 120 can also hold the dye in close proximity to the enzyme such that when H2O2 is produced from the enzyme reaction, a concentration-dependent color signal is produced.
In some embodiments, the color change can be evaluated on a binary basis (i.e., does the dye have a color or not). In other embodiments, the color change can be evaluated on a variable scale, where the specific color and/or intensity of the color can be used to indicate the amount of H2O2 present and thus the degree of infection. In certain embodiments, a smartphone application (or application on another type of mobile electronic device) can be used to scan the color change (e.g., intensity and hue) to determine whether there is an infection, rather than having the end user interpret degree of color change. For example, the optical density (i.e., absorbance) can be determined by scanning the pad with a smartphone camera, where the camera analyzes a specific wavelength or wavelength range associated with the dye reagent.
Embodiments of the bandages 100, 101 and 102 are configured as a wound care covering comprising a pad comprising a pad material; a lactate-based enzyme crosslinked with the pad material by a crosslinker; and a dye that changes color when hydrogen peroxide is present. The dye may be a colorimetric dye selected from xylenol orange, titanium oxysulfate, titanium sulfate, 5,6-dimethyl phenanthroline (Fe complex), 2,2′-bipyridine (Fe complex), nitro phenanthroline (Fe complex), 1,10-phenanthroline iron(II) sulfate complex (Ferroin), and viologen. The dye may be a chemiluminescent dye comprising diphenyl oxalate. The pad material may comprise a hydrophilic polymer, a polymeric hydrogel or a natural hydrogel. In some embodiments, the pad comprises an enzyme layer and a dye layer, wherein the enzyme layer comprises the lactate-based enzyme crosslinked with the pad material by the crosslinker, and the dye layer comprises the dye. In some embodiments, the pad has a layer that comprises both the lactate-based enzyme and the dye. In some embodiments the wound care covering further comprises an adhesive strip, wherein the pad is coupled to the adhesive strip. In further embodiments, the pad comprises an enzyme layer and a dye layer; the enzyme layer comprises the lactate-based enzyme; the dye layer comprises the dye; and the dye layer is between the enzyme layer and the adhesive strip.
Another use of hydrogen peroxide, besides being a reaction product that serves as an indicator of the presence of lactate, is a topical antiseptic used in wound cleaning that kills pathogens through oxidation burst and local oxygen production. H2O2 has been reported to be a reactive biochemical molecule synthesized by various cells like macrophages that influences biological behavior through multiple mechanisms—alterations of membrane potential, generation of new molecules, and changing intracellular redox balance—which results in activation or inactivation of different signaling transduction pathways. Contrary to the traditional viewpoint that H2O2 probably impairs tissue through its high oxidative property, scientific studies in the field have shown that a proper level of H2O2 is considered an important requirement for normal wound healing. (e.g., Loo et al., “Effects of Hydrogen Peroxide on Wound Healing in Mice in Relation to Oxidative Damage,” PLoS ONE 7(11): e49215, doi: 10.1371/journal.pone.0049215; and Zhu et al., “Hydrogen Peroxide: A Potential Wound Therapeutic Target?” Medical Principles and Practice 2017; 26: 301-308, doi: 10.1159/000475501.) Although conventional clinical use of H2O2 is still limited to the elimination of microbial contamination and sometimes hemostasis, low level production of H2O2 within wounds enhances the potential to exogenously augment and manipulate healing. Wound care coverings of the present disclosure utilize this finding to deliver hydrogen peroxide to an injury site at levels that promote healing.
Some embodiments of the present disclosure include wound care coverings with therapeutic capabilities, which may also be referred to in this disclosure as a “prevent-aid.”
Various enzymes exist that enable sugars to be assessed in a measurable quantity by conversion of sugar to hydrogen peroxide through a direct chemical reaction with the sugar. In the bandage 200, the concentration of the reaction product H2O2 is controlled to create very low continuous production of H2O2 over several days. The sugar in the sugar-containing layer 222 may be, for example, glucose, fructose, or galactose. For glucose as the sugar, the sugar-based enzyme may be glucose oxidase or glucose dehydrogenase. For fructose as the sugar, the sugar-based enzyme may be fructose dehydrogenase. For galactose as the sugar, the sugar-based enzyme may be galactose dehydrogenase. The sugar in the sugar-containing layer 222 may be contained in a hydrogel such as a silicone hydrogel.
In the bandage 200, the pad 220 uniquely provides encapsulation and stabilization of the sensitive sugar-based enzymes in a fully biocompatible polymer carrier. The enzyme layer 224 comprises a pad material and a sugar-based enzyme, where the sugar-based enzyme is crosslinked with the pad material by a crosslinker. The enzymes may be crosslinked to the pad material by, for example glutaraldehyde, polyfunctional aziridine, bifunctional carbodiimide, dicyclohexyl carbodiimide, 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide, N-hydroxysuccinimide, N-hydroxysulfosuccinimide, EGS, SEGS, TSAT, DMP, DMS, DFDNB, DTBP, NHS-Phosphine, NHS-PEG-azide, NHS-azide or combinations thereof. This crosslinking allows for both longevity (e.g., at least 5 days in-vivo use) and stabilization of the enzyme during sterilization of the product and also ensures that the enzymes remain in place in the pad. In some embodiments, the carrier pad material may be a hydrophilic polymer (e.g., hydrophilic polyurethane), a polymeric hydrogel or a natural hydrogel. Examples of polymeric hydrogels include poly-HEMA, PEG, PEGMA, cellulosics (e.g., CMC), PVP, and acrylamide. Examples of natural hydrogels include polysaccharides (e.g., alginate, chitosan), collagen, and fibrin. Cofactors and initiators may be included in the enzyme layer as needed for the specific type of enzyme, and mediators may also be included (e.g., for dehydrogenase-type enzymes).
The polymeric carrier pad of the sugar-containing layer 222 releases the sugar into the enzyme layer 224 (e.g., glucose oxidase carrying membrane) in a controlled manner. This allows for slow production of hydrogen peroxide for several days and thus provides continuous production of H2O2 for wound cleaning and oxygen generation, thereby helping to prevent infection. The bandage 200 can be tuned to produce different levels of hydrogen peroxide based on controlling the flux of the sugars via a secondary enzyme encapsulation layer.
In some embodiments illustrated by bandage 201 in the cross-sectional view of
The enzyme layer 224 contains a sugar-based enzyme crosslinked with a pad material as described above and may be encapsulated with a polymer or hydrogel. For example, the enzyme layer 224 may be covered with a hydrogel to ensure that the sugar gel (of the sugar-containing layer) remains in close contact with the enzyme layer 224. Additionally, the enzyme-containing pad 220 may be covered with a sugar limiting material 227 (e.g., glucose limiting material) as shown in
Embodiments of the bandages 200, 201 and 202 include a wound care covering configured as an enzyme layer 224 comprising a pad material crosslinked with a sugar-based enzyme by a crosslinker; a sugar-containing layer 222 comprising a sugar in a hydrogel; and a rupturable barrier (e.g., barrier 223, barrier 225 and/or sugar limiting material 227) between the enzyme layer 224 and the sugar-containing layer 222.
As shown in
The second enzyme layer 324 is a sugar-based enzyme layer containing one or more sugar-based enzymes (glucose oxidase “GOx”; fructose dehydrogenase “FDh”; glucose dehydrogenase “GDh” are shown in the figure as examples). Second enzyme layer 324 is similar to enzyme layer 224 of
The sugar-containing layer 322 includes a sugar in a hydrogel, where the second enzyme layer 324 is between the sugar-containing layer 322 and the first enzyme layer 326. The sugars (e.g., one or more of glucose, fructose, galactose) react with sugar-based enzymes delivered from the second enzyme layer 324 to produce hydrogen peroxide. The sugar-containing layer 322 provides titrated hydrogen peroxide delivery to the injury site for prevention of infection. A rupturable barrier 325 (as described for barrier 225 in relation to bandage 202) is between the second enzyme layer 324 and the sugar-containing layer 322 to help with titrating the production of H2O2 in the sugar/enzyme reaction. The rupturable barrier 325 may also help reduce inadvertent effects of H2O2 production from the sugar-containing layer 322 on the dye color change in the dye layer (first enzyme layer 326).
In
In some embodiments, the first enzyme layer 326, the second enzyme layer, 324 the sugar-containing layer 322, and the rupturable barrier 325 form a pad 320 that is coupled to the adhesive strip 310. In some embodiments, the first enzyme layer 326 is adjacent to the adhesive strip 310, the second enzyme layer 324 is on the first enzyme layer 326, and the sugar-containing layer 322 is on the second enzyme layer 324.
In an embodiment of making an infection-detecting wound care covering, block 422 of depositing the enzyme layer may be performed prior to block 424 of depositing the dye layer onto the enzyme layer, or vice versa, and block 426 is omitted. In another embodiment of making an infection-detecting wound care covering, block 422 and block 424 are combined, such that the lactate-based enzyme and dye are in the same layer of the pad. In an embodiment of making infection-preventing wound care covering, block 422 of depositing the enzyme layer may be performed prior to block 426 of depositing the sugar-containing layer onto the enzyme layer, or vice versa, and block 424 is omitted. In an embodiment of making a combination infection-detecting and infection-preventing wound care covering, block 424 (dye layer, which in this embodiment will also include the lactate-based enzyme) may be performed first, then block 422 to deposit the enzyme layer (sugar-based enzyme in this embodiment) on the dye layer, then block 426 to deposit the sugar-containing layer. Alternatively, the order may be reversed to start with block 426, then block 422 then block 424.
Prototype wound care pads were fabricated and tested in accordance with embodiments.
As described herein, the wound care coverings of the present disclosure provide beneficial capabilities for detecting and preventing infections in wounds, in an easy-to-use and cost-effective manner.
Reference has been made in detail to embodiments of the disclosed invention, one or more examples of which have been illustrated in the accompanying figures. Each example has been provided by way of explanation of the present technology, not as a limitation of the present technology. In fact, while the specification has been described in detail with respect to specific embodiments of the invention, it will be appreciated that those skilled in the art, upon attaining an understanding of the foregoing, may readily conceive of alterations to, variations of, and equivalents to these embodiments. For instance, features illustrated or described as part of one embodiment may be used with another embodiment to yield a still further embodiment. Thus, it is intended that the present subject matter covers all such modifications and variations within the scope of the appended claims and their equivalents. These and other modifications and variations to the present invention may be practiced by those of ordinary skill in the art, without departing from the scope of the present invention, which is more particularly set forth in the appended claims. Furthermore, those of ordinary skill in the art will appreciate that the foregoing description is by way of example only and is not intended to limit the invention.
This application claims priority to U.S. Provisional Patent Application No. 63/266,847, filed on Jan. 17, 2022, and entitled “Wound Care Covering,” which is hereby incorporated by reference for all purposes.
Number | Date | Country | |
---|---|---|---|
63266847 | Jan 2022 | US |