Achieving Homeostasis in Traumatic Injuries with a Nitric Oxide-Driven Antimicrobial Dressing Combined with a Rapid Blood Clotting Agent
Abstract
FY22 DMRDP BWMIR Focus Area for Project: Nytricx, Inc., is responding to the FY22 DMRDP, Battlefield Wound Management and Infection Research (BWMIR), specifically to understanding appropriate wound prophylaxis/empiric treatment strategies throughout continuum of care, regardless of injury status, through preclinical studies to inform clinical practice guidelines. The technology described in this application is designed to manage hemorrhagic shock, super-massive transfusion, traumatic limb ischemia (secondary to vascular disruption or tourniquet use), complex soft tissue injury/blast injury, open fracture, and/or frost bite, including evaluation of antimicrobial dosing and tissue penetration studies. This project encompasses a new, innovative wound dressing that can be applied in the field in the golden hour following injury, and when conventional medical treatment may be delayed for days due to combat circumstances and logistics. Problem: Most dressings developed to-date for treating acute wounds are used as a cover to possibly prevent on- set of infection, and act as a secondary dressing. Combat wounded often experience bleeding and potential exposure to austere environment making wounds vulnerable to infection. There remains an unmet need to provide a therapy that will both prevent infection and rapidly stop bleeding. Solution: The proposed wound dressing combines tranexamic acid (TXA), Propolis (a natural product), and the nitric oxide (NO) donor, S-nitroso-N-acetylpenicillamine (SNAP) termed TPS. Propolis is an antibacterial resin that provides a sticky matrix that is embedded with the antifibrinolytic agent TXA and also acts as the boundary layer between SNAP and TXA. This boundary layer promotes SNAP’s antibacterial effect while limiting putative NO interference with clot formation. TXA is then able to reinforce and enhance blood clot stability. Objective: Our overall goal is to develop a wound dressing with dual capacity of preventing infection and stop hemorrhage post injury by promoting formation of a rapid blood clot. We will achieve this by fabricating and optimizing the TPS wound dressing and evaluate in vivo using porcine wound healing models. Applicability and Impact: Nytricx wound dressing design focuses on rapid application and ease of use in conflict environments, and delivers a shelf-stable product focused on rapid application and will be available in a variety of sizes (Including very large), which potentially can be applied even by untrained personnel. The technology will bring a life-saving field treatment modality to the point of injury by managing threats of bacterial infection and promoting healing for several days until acute medical care is available. These practical attributes, combined with the product’s wound healing abilities and infection control, will increase medical readiness. Benefit to Service Members: Combat-injured Service Members often lack a wound dressing that has addressed both infection and hemorrhage problem in tandem. Lack of an effective intervention immediately after an injury may delay timely treatments to address key issues like infection control, worsening of burn wound and consequently will impact outcomes. We envision deploying the TPS wound dressing as close to geographical location of Service Members and making it available for prolonged field application. In particular, the dressing will benefit Service Members; those who sustain manageable size combat wounds can get appropriate treatment close to area of operation, which ultimately helps to preserve combat power. In addition, the dressing can also be employed outside of war zones such as subterranean and dense urban environments (DUE) and in different chemical, biological, radiological and nuclear events (CBRN) scenarios. Potential Clinical Applications, Benefits, and Risks: The wound dressing described will be appropriate for wounds other than burns and acute injuries, including
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310955
Entities
People
- Ronald Shebuski
Organizations
- United States Army