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Trends of Evolution in Wound Healing

| On 01, Oct 2007

By KRD Pravin, Shweta Phadke and Amita Vijay Rumde

Introduction

The Theory of Inventive Problem Solving (TRIZ) is based primarily on three ideas:

  1. Significant inventive ideas do not necessarily tend to be field specific, theses ideas follow some general principles that eliminates contradictions (or trade-offs) between parameters of the system,
  2. All developments follow a trend of evolution towards ideality and
  3. Applying a directed approach to solve a problem and applying knowledge from all the fields can guide us to a faster improvement cycle or new direction for product development.

In this paper, a trend of evolution in the field of medical science is examined – a method of faster external wound treatment is studied. Healthcare in general is an area in which there is much room for innovation, particularly the systematic innovation that is created through the use of TRIZ.

Types of Wounds

A wound is an injury that causes either an internal or an external break in body tissue, causing a disruption of the normal continuity of the body structures. Wounds are classified in two broad categories:

  1. Open – A break in the continuity of tissues due to external trauma. It can be classified into a number of different categories, according to the object that caused the wound
    • Incisions, lacerations, abrasions (e.g., grazes), penetration wounds and puncture (e.g., gunshot wounds)
  2. Closed – A wound in which there is no external or visible injury on the skin, but which damage internal anatomy
    • Contusions, concussion and hematoma

Wound Healing

This discussion is related to open wounds and wound contraction during healing process. Wound healing is a process involving synthesis of new tissue for repair of skin and soft tissue defects. It is a systematic, predictable, complex and dynamic process divided into three basic phases – inflammation, proliferation and maturation.

In all phases, different cells either regenerate and/or repair to reduce the size of a wounded area. In regeneration, replacement of dead or damaged cells takes place by functioning cells of same structure and function as was originally there. In repair, injured tissue is replaced with granulation tissue, which later forms scar tissue. In most cases, the healing process involves both regeneration and repair mechanisms simultaneously. Healing is a slow and time-consuming process, as shown in Figure 1.

Figure 1: Phases and Cell Involvement in Wound Healing

Source: emedicine.com

The above graph depicts approximate number of days taken by each activity for completion. All of these activities overlap with each other and overall wound healing takes about 4 to 6 weeks to complete. Wound contraction occurs throughout the phases and the process. Each cell level activity starts at a particular time and progresses in a defined way.

Progress in Wound Treatment Methods

As medical science evolved, the inhabitants of different places started using, and are still using, different methods of medicine that can be classified into broad categories. The focus of this article is on one of these methods – allopathic – often referred to as “conventional” medicine, as opposed to homeopathic. In prehistoric time, illness or sufferings were considered an act of god and cures were prayers. In those days, healing used to be a long process and at times resulted in deaths. Slowly, ideas of human intervention took place and medicine, as a science, started to be pursued. Negligence toward the wound and infection used to be a common cause of death.

Using some herb paste, extract or powder to treat open wounds improved with the help of experiments. In the 20th century, sprays also came into use for wound healing and pain killing.
Primarily, all these methods focused on keeping the wound clean, preventing infection and improving healing speed. With the advent of systematic approach in studies, research in medicine started focusing on proactive and fast healing of wound. The challenge for science now lies in reducing the wound healing time from the average of 4-6 weeks, and in reducing wound size quickly.

Researchers have studied various methods for fast healing and reducing wound size quickly, including the use of electrical stimulation (ES) and laser treatment. Not only do these studies show promising results in hastening and improving the treatment of wounds, but those results may also help in the reduction of scars and chronic non-healing injuries (such as skin ulcers).

Trends Followed by Advancements in Wound Healing

Recent studies and analysis of the trends in wound healing suggest a path in treatment methods that is moving from solid to fields, as described in Table 1 and displayed in Figure 2.

Table 1: Wound Healing Trends Compared to Similar Trends
TrendWound HealingSimilar Trend
SolidBanana or other leaf/thin potato layerSoap
Granules/powder/pasteTurmeric/turmeric paste/lint/animal grease/honeyGranules
LiquidAlcohol (in Arabic medicine beginning 10th century)/boiling water (during 15th century)/chemicals (recent)Liquid soap
Aerosol/sprayDisinfectant spray (open wound healing), analgesic spray (closed wound healing)Cleaning sprays
FieldsElectrical stimulation/electromagnetic field (e.g., short wave diathermy (closed wound healing)/electric field stimulating catalystsUltrasound or ionization

Figure 2: Trends of Evolution

Source: Creax Inc.

Conclusion

In medical science, we can find ways to improve wound treatment methods based on trends of evolution and TRIZ principles. We can look forward to the use of lasers used to suture in addition to cutting, rather than using a biodegradable (or other type of) thread. And we can anticipate that if the wounded parts of skin do not respond to initial electrical simulation, some intermediate catalysts will be used to stimulate the healing process. These methods, which can be extrapolated from the inventive principles, evince the potential from using TRIZ in medicine; with the help of the trends of evolution, even better wound treatment methods can be developed.

Trends of evolution for improvements are followed in fields other than engineering and technology. Thus, it can be concluded that macro-level merging and learning across different fields can reduce breakthrough development lead-time and allow for research to progress using systematic research methods and trends of evolutions.

Acknowledgements

Dr. Shrikant Agashe was instrumental in helping and supporting the authors with writing this article – sharing his knowledge of wound healing fundamentals and healing techniques. The authors are especially thankful to Naresh N Shahani, M.D., and Mr. Anish Kunhambu, of BMG India for their support and help in writing this paper. The authors also thank Mr. Satish Phadke, assistant manager, Infotech, Rallies India Ltd. for his suggestions and time in checking and updating the article.

References

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