Thinking allowed: Walking Wounded

I will not fear though tens of thousands assail me on every side

Psalm 3:6

Being assailed on every side is something everyone who gets old has to face – and thank goodness there’s the NHS, ready to pick up the pieces when another bit drops off or fails. It’s not the big things that are the worst. It’s the little ones, the things that accumulate and chip away at the overall peace that should come towards the end of a strenuous life.

When you are 20 it’s impossible to imagine 50 years ahead. Yet more and more of us are likely to reach not just 70, but much older. Medicine can keep the body alive; but struggles to combat the array of misery-making problems that come with age – such as the failure of wounds to heal properly, or at all. More than 200,000 people in the UK have chronic wounds and coping with them is a massive financial cost to the NHS. According to the Journal of Community Nursing, the annual cost of wound care services in 2014 to the NHS was around £2.2 billion, which is likely to rise to £2.4 billion by 2019 as a result of the ageing population. Revealingly, it also said that “the sheer choice of wound dressings makes procurement decisions difficult.”

What makes a wound chronic? Insufficient angiogenesis, a natural process by which the body develops new blood vessels, resulting in impaired wound healing and various long-term problems – pain, cross-infection, the need for constant re-dressing of the wound, among associated others. Chronic wounds can particularly affect older people in the form of venous leg ulcers (VLUs): blood vessels in the legs break down as one ages and can lead to a very troublesome and chronic wound. Around 70,000 people in the UK have VLUs that don’t start to get better after a month of good standard treatment; the average time for healing a VLU is 6-9 months. The standard treatment is sterile compression bandaging, but there is good evidence that sometimes this can be counter-productive to good healing. All in all, having a VLU can be not only a painful but depressing experience.

Peculiarly, electrical stimulation (ES) has been shown to enhance angiogenesis and thus stave off chronic wounds; since the late 1960s we have known that externally applied low-level electric currents can improve wound perfusion and reduce pain. One of the leading practical exponents of using electric currents to treat chronic wounds is Synapse Electroceutical, whose Accel-Heal technology is making a positive clinical, financial and social impact in UK healthcare. It addresses a malfunctioning gene protein pathway that result in wounds not following a normal healing trajectory and, as a result become complex, chronic and commonly non-healing.

Accel-Heal is a neat little device – just 70 mm by 40 mm by 2 mm, and weighs 38 grams. It’s powered by an internal 3-Volt non-chargeable battery and delivers a small electrical charge over 48 hours, and comes in a six-pack to provide treatment for 12 days. There’s clinical evidence showing that within 12 months of starting treatment with Accel-Heal 77% of all wounds healed and the other 23% improved. Nor is it just patients who benefitted – there was also an 11% reduction in NHS costs of VLU management over those 12 months. So everyone’s a winner – patients get much better for less cost. A clear example of investing for beneficial social impact.

 

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