Any quick search of the internet will reveal hundreds of academic papers around the subject of smart bandages and wound care and at ZP we are delighted that many of these academic papers do you use electrochemistry technology at the heart of them. The reason that electrochemistry is particularly suitable for smart bandages and wound care is because it is a science which offers a low cost of test; if in doubt of the economic merits of electrochemistry then please consider why most home glucose test strips are electrochemical.
At ZP we have reviewed the literature and a common theme within the academic literature for wound care ideas are sensors for pH and uric acid. The pH of healthy skin is 4 to 5 and so as a wound heals it tends to move from a pH of maybe 7 towards pH 4 to 5. In a similar way if a wound is infected it tends to have a high concentration of uric acid due to the bacteria. At ZP we have a low-cost disposable pH and uric acid platform including both the sensors and the electronics, and hence why we are very interested in supporting companies in the development of their smart wound care technologies. At the same time ZP’s technology can be used to generate hypochlorous acid in-situ which can be used to reduce the bacteria load dramatically; effectively generating a bleach/oxidizing agent within the confines of the wound without having to change the dressing. With the promise of smart detection and smart treatment of wounds, we have travelled the world speaking to people regarding smart bandages and wound care and asked if the technology is so ‘doable’ why are there no smart bandages on the market. As with many things the reason why smart bandages and plasters have not moved forward is not a technical barrier, rather is linked to commercial reasons and the incumbent business models.
Currently wound care manufacturers produce products, these products are sold, and care professionals use these upon the patients. In order to fight infection and to keep wounds clean these are regularly replaced, and this workflow creates a good business model for bandage and wound care companies. At Medica 2019 we spoke to a German Wound Care Professional whose role was to drive out to patients and replace wound dressings. We asked him ‘…what was the cost around the materials…’ and he reported that it cost about 25 Euros/Dollars for a 10 cm2 of wound dressing material. So the material alone for dressing a wound is in the 10s to 100s of Euros/Dollars, whilst his time on site plus travel time made this a 100s of Euros/Dollars cost per visit. Therefore the cost of wound care in chronic diseases like diabetes runs into the 1000s of Euros/Dollars per year, yet the remote monitoring of wounds and the generation of antimicrobials within the wound area has not taken off, and the reason is that it is not in the interests of the incumbent companies within the wound care market to disrupt the status quo. The current wound care market is established and gives a regular payment. It is a classic situation where the person who would gain the most from smart bandages and wound care is the patient, but in Europe and the USA they are often not the direct payer, rather they are the indirect payer through their health insurance and so they have less direct influence on the health technologies they receive.
What it will take to bring smart bandages and wound care to marketer is an innovative start-up who is not an incumbent and so doesn’t have an interest in maintaining the current wound care workflow. The analogy would be that of Blockbusters versus Netflix, whereas Blockbusters had very little to gain in disrupting the way movies were viewed at home, whilst Netflix had everything to gain, as they were trying to win market from the incumbent. So at ZP, in our opinion, it is not the technology that prevents smart bandages and wound care, rather a start-up has not yet successfully brought the idea to market, though we do look forward to the Netflix of wound care.