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Healing: what progress!

Today, surgical scars are more and more discreet, thanks to minimally invasive operating techniques. So it is on the front of chronic wounds and burns that research is hyperactive. A public health issue when two million people in France suffer from pressure sores, venous or foot ulcers (120,000 diabetic patients admitted to the emergency room each year), who do not finish despite the care provided.

Connected dressings that monitor wounds
The Grenoble-based start-up team of engineers, Grapheal, has developed a patch containing a layer of graphene (a very thin and flexible carbon) that fits into any dressing. The body perfectly supports this material and the cells regenerate even faster on contact. A big advantage when you want to speed up healing! But that’s not all: by capturing the electrical fluctuations, this patch continuously measures the nature of the liquid on the surface of the wound, its temperature, its acidity rate … So many precious clues to know if the process is going well or if an infection is in progress (the pH changes). By passing a smartphone near the dressing, the caregiver reads this information on an electronic chip and knows whether to change the device or adapt the antibiotics. “This tool could improve the monitoring of chronic wounds that last for months or even years, encourage patients to return home and make it possible to change the dressing less often while reducing the risk of infection and amputation,” says Vincent. Bouchiat, former CNRS researcher, co-founder of Grapheal. The clinical trials have just started. “We are trying to demonstrate that this solution is not a gadget and that its limited cost (less than 10 euros per unit) could help achieve health savings,” he adds. former CNRS researcher, co-founder of Grapheal. The clinical trials have just started. “We are trying to demonstrate that this solution is not a gadget and that its limited cost (less than 10 euros per unit) could help achieve health savings,” he adds. former CNRS researcher and co-founder of Grapheal. The clinical trials have just started. “We are trying to demonstrate that this solution is not a gadget and that its limited cost (less than 10 euros per unit) could help achieve health savings,” he adds.

Electric patches to attack bacteria
What prevents healing , most often, is the presence of a biofilm, a thin layer of microorganisms – including bacteria – which live on the surface of certain burns or postoperative wounds. It is said to cause a good part of infections and is often resistant to antibiotics. Several American universities are working on an electric field dressing. Ohio researchers have found (in vitro) that the electric current disrupts the biofilm enough to start destroying its bacteria. What perhaps strengthen, or even replace in some cases, the action of antibiotics.

A second skin spray
Other labs are working on a spray bandage. Nanomedic, for example, developed SpinCare, a kind of large plastic gun that sprays a transparent polymer. This adapts to the morphology of the injury. The big advantage? You don’t “touch” the wound, so it’s less painful. And above all, no need to redo the dressing: once installed, the polymer remains in place and forms a protective barrier for the time of healing, then “falls” naturally after two to three weeks. As it is transparent, it also makes it possible to monitor progress. SpinCare is already tested in hospitals in Israel (out of 120 patients, no case of infection has been reported) and in Germany.

Tailor-made skin after a burn
Thanks to bio-printing, a new fabric can be obtained on demand. It is “enough” to take a few healthy skin cells from a patient and dilute them in gel ink. A 3D printer then delivers, in about fifteen minutes, different layers of gel which form a skin composed of the hypodermis, the dermis and the epidermis. Once applied to a burn, the cells multiply day by day to start the healing process. A revolution compared to current skin grafts. “These leave scars because they only consist of epidermis, not very flexible and which gives a crumpled and brittle appearance. With the use of total skin, from what we observe on the animal model, we could hope to have almost no scars ”, enthuses Christophe Marquette, research director at CNRS and founder of the 3D.Fab platform at Lyon 1 university, which is developing this project with the company LabSkin Creations. Above all, this would drastically limit the risk of infection: today we must leave the burn uncovered for forty days, very exposed to bacteria, the time to cultivate the skin in vitro for a transplant. Tests on animals (mice and pigs) are continuing before, perhaps within two to three years, the first tests on patients. hui leave the burn exposed for forty days, very exposed to bacteria, the time to cultivate the skin in vitro for a transplant. Tests on animals (mice and pigs) are continuing before, perhaps within two to three years, the first tests on patients. hui leave the burn exposed for forty days, very exposed to bacteria, the time to cultivate the skin in vitro for a transplant. Tests on animals (mice and pigs) are continuing before, perhaps within two to three years, the first tests on patients.

Cold plasma to boost healing
Still with a view to better treating burn victims, we can surely count on cold plasma. This partially ionized gas (it loses electrons after application of an electric discharge) is omnipresent in our daily life, from TV screens to low-energy light bulbs. “In medicine, you have to imagine a kind of flame (at room temperature) that is applied at a distance from a wound. We are looking to see if it can accelerate, through its biological activity, healingskin grafts. Our in vitro and in vivo studies in mice show that it promotes in particular the production of new blood vessels for better vascularization, “explains Constance Duchesne, involved in the PlasmaSkin and Placib projects, carried out in partnership with the Biomedical Research Institute. of the armed forces, the Pasteur Institute and the Plasma physics laboratory at Polytechnique *. By the way, plasma also has the advantage of being antibacterial, which minimizes the risk of infection. Objective: develop within five years a tool that can be used in hospitals to treat extensive burns. In Germany, several processes using plasma have obtained CE certification for the treatment of venous and diabetic ulcers. The Coldplasmatech company even inserted into a large silicone patch that can be applied directly to the wound. Suffice to say that the content of our first aid kit risks getting a makeover in the years to come!

Long live brand testing  !
The keloid scars (raised) are nightmare surgeons and dermatologists. Sometimes the skin produces too much collagen which creates a thick, blistered area. If we know that black skin, in particular, is more prone to it, difficult to predict this complication. This is the objective of the “Bilhi Skin Keloid” test, designed by Professor Alain Dessein, biologist at the Institut Pasteur. He assesses our genetic predisposition to develop a keloid scar through a small sample of saliva. If the results are positive (within seven days), the practitioner can adapt the postoperative care to limit the risks. But it takes 200 euros per test, not supported by Social Security.

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