The Need: Infection is a global problem of traumatic, post-surgical or chronic wounds.
10% of surgical wounds exhibit bacterial infection within 30 days. Heavy bacterial colonization is the main reason for non-healing of chronic wounds such as decubitus, ulcus cruris and diabetic foot ulcers. The severity and cost of wound infections increase dramatically the longer they remain untreated and reach >5 billion € per year in Europe. The resulting pain, impairment and social isolation lead to reduced quality of life and, in the worst case, hospitalization, and eventually sepsis and death (1).
Early detection of an incipient wound infection is important for the attending physician(2,3) since it would allow the timely initiation of treatment, thus reducing the severity of the disease.4 Currently, however, wound infection is not diagnosed until becoming pathologically evident. As a consequence, the treatment of the patient is further complicated and more likely to have a negative outcome(4). In addition, wounds are often treated with antibiotics prophylactically, leading to unnecessary selection for bacterial resistance.
Nowadays, a Point of Care Testing (PoCT) device to identify incipient wound infection does not exist. Clinicians rely on a combination of clinical information and long-lasting laboratory tests requiring equipment and experts for diagnosis. However, clinical parameters such as redness, heat, swelling and pain appear only at the lamination of the infection cascade making early clinical judgment so uncertain that 50% of infections are not initially identified(5). Microbiology laboratory tests used to identify wound infection and the type of pathogen take 3–4 days, and in the meantime, antibiotic treatment is often initiated as a precaution. Furthermore, positive swab findings indicate presence of bacteriaonly , even, but do not provide objective evidence of a clinically important infection due to variation in host factors, colonization and virulence.
InFact rationale: Consortium partners have patented the know-how to convert wound dressings into a diagnostic tool capable to inform both patient and therapist about the wound status, thus allowing a proactive diagnostic step. The proposed functional materials allow a real time in situ infection diagnostic reaction and, thus, a timely treatment intervention. A next-generation Protective, Predictive and Proactive (triple-P) material for in situ diagnosis of wound infection to be integrated in conventional dressings will be prototyped andadvanced to commercialization by InFact.
1. Lookingbill etal.,Bacteriology of Chronic Leg Ulcers, Arch.Dermatol. 114 (1978) p 1765-1768.
2. Cutting et al.,Criteria for Identifying Wound Infection - Revisited, Br.J.Community Nurs. 9 (2004) pp. S6-S16
3. Sibbald, Preparing the Wound Bed 2003: Focus on Infection and Inflammation, Ostomy. Wound Man. 49 (2003) pp. 23-51.
4. Dellinger at al., Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock, Int.Care.Med. 36 (2008) p296-327
5. Gardner et al. Clinical signs of infection in diabetic foot ulcers with high microbial load. Biol Res Nurs (2009) 11:119-128