In the UK alone there are 2 million unresolved chronic wounds which are physically and socially debilitating and which come with a huge economic burden. Failure to heal these wounds can often lead to amputation and further disability with, in the UK, some 25 lower limb amputations every day for unresolved diabetic ulcers.
There remain several key challenges in preventing and treating acute and chronic infections globally. Conventional approaches and antibiotics have achieved much, but with overuse and inappropriate usage they are are now being challenged by resistance. In addition, and particularly in chronic infections, clinicians are faced with biofilm production which unfortunately renders common antibiotics useless.
With MHL’s Reactive Oxygen® topical surface active technology, we have the ability to tackle these challenges. Reactive Oxygen® will be able to prevent infections in most surgical settings, treat post surgical infections whilst also aiding wound healing. It will change the standard of care in chronic infections including wounds, chronic sinusitis and urinary tract infections, which together constitute a major global health burden. Reactive Oxygen®’s inherent properties of biofilm penetration, tissue regeneration added to the antimicrobial impact, independent of the organism and its resistance profile, will contribute to a major advance in standard of care and offers the hope of reducing antibiotic usage thus reducing the potential for resistance development.
Reactive Oxygen® technology brings the promise of being the next major breakthrough in acute, surgical and chronic wound management with an elegant manifestation of a naturally occurring mechanism.
Reactive Oxygen® Technology Platform
The first generation of Reactive Oxygen® has been commercialised in the UK as a CE marked medical device called SurgihoneyRO™, this is in gel format and has proven extremely effective in real world settings, particularly against potent antibiotic resistant infections.
For more information about SurgihoneyRO™ and information on how to buy, please follow this link to H&R Healthcare.
Reactive Oxygen® is now being developed in a number of pathways, based on a refined and improved formula which is entirely synthetic and has proven to be more potent and stable than the first generation SurgihoneyRO™. The lead synthetic formulation, RO® 101, can potentially be taken into wider therapeutic areas and applications as a device or pharmaceutical.
Development pathways being worked on with leading academics include (but are not limited to):
gel (SurgihoneyRO™ in market – RO-101® version being developed)
dry powder
liquid spray
dry powder which converts to gel on contact with wound, sealing wound site and slowly breaking down over time so it does not need to be debrided in the future
nano-spun web to be combined with stem cells, promoting stem cell proliferation and preventing infection
systemic nanoparticle and antigen technology
Matoke is actively exploring a range of development pathways for both medical devices and medicinal products.
Development pathway 1 : SurgihoneyRO™
Development pathway 2 : RO® gel
Development pathway 3 : RO® emulsion formulations
Development pathway 4 : RO-101® combination platform
Significant historical advances in wound management
1. The introduction of the halogen, iodine, to control wound infection during the American Civil War (1861-1865).
2. The recognition of the need to create an aseptic wound environment, led by Johnson and Johnson. Inspired by a speech by antiseptic advocate Joseph Lister, Robert Wood Johnson and his brothers created a line of ready-to-use surgical dressings in 1885.
3. The introduction of the heavy metal, silver, to control battlefield wound infections in the First World War. Subsequently, other heavy metals, like mercury have been used but are now seen as just too toxic.
4. The development of antibiotics, accelerated by the Second World War dramatically improved the life expectancy of injured personnel, particularly those with systemic infections. However, they had limited ability to deal with topical wound infections since they don’t reach the site of the infection, the wound bed, and the sub-optimal doses reaching the wound actively stimulate bacterial resistance. The widespread use of broad spectrum antibiotics as a front line treatment for military personnel suffering traumatic injuries has selected multiply resistant strains, resulting in a formerly harmless bacterial species such as Acinetobacter being placed on the WHO crisis list.
5. In the 1960’s research conducted by Dr George Winter, led to the realisation that keeping a wound base moist was key to effective healing, as opposed to the conventional wisdom of drying a wound. Virtually all modern dressings, no matter what technology they use and how they are marketed, essentially control wound moisture.
The evolution of Acinetobacter baumanii from harmless soil borne bacterium to WHO critical pathogen
Acinetobacter baumanii is a Gram-negative bacterium found in soil, where it plays an important role in the breakdown of organic chemical compounds to release nutrients in soluble inorganic forms that can be absorbed by plants. Acinetobacter species are found widely in nature and thrive in a broad range of temperatures and hence environments.
Acinetobacter is a key source of infection in immune compromised patients in hospital where it is associated with bacteremia, urinary tract infections, meningitis, infective endocarditis, and wound and burn infections. It is often associated with hospital-acquired pneumonia and has also been reported to infect skin and soft tissue in traumatic injuries and postsurgical wounds.
It is known colloquially as ‘Iraqibacter’ because of its presence in soft tissue infections experienced by soldiers returning from Iraq and Afghanistan. Furthermore, the use of broad spectrum antibiotics on the battleground has led to a rapid growth in resistance, leading the World Health Organisation in 2017 to name multidrug-resistant A. baumannii as one of its top three threats.
This has the potential to become a serious problem in military and veterans hospitals, where soldiers returning from active duty worldwide are treated in the same environment as other patients, however, the development of resistance is a global issue not just a problem for the military.
1. The introduction of the halogen, iodine, to control wound infection during the American Civil War (1861-1865).
2. The recognition of the need to create an aseptic wound environment, led by Johnson and Johnson. Inspired by a speech by antiseptic advocate Joseph Lister, Robert Wood Johnson and his brothers created a line of ready-to-use surgical dressings in 1885.
3. The introduction of the heavy metal, silver, to control battlefield wound infections in the First World War. Subsequently, other heavy metals, like mercury have been used but are now seen as just too toxic.