Canadian Nanotech Wound Dressing Saves Lives
Alberta Scientist Wins Top Innovation Award
Calgary, AB (September 10, 2009) - Dr. Robert Burrell, inventor of Acticoat™ antimicrobial wound dressings, will receive this year's $100,000 Encana Principal Award from the Ernest C. Manning Awards Foundation. The nanocrystalline silver coated dressings are used in clinical practice in over 40 countries around the world to prevent life threatening infections and promote wound healing.
Acticoat™ is the world's first commercial therapeutic application of nanotechnology. Since 1997, the nanotech dressings have become the treatment of choice in settings such as burn units, diabetic foot clinics, chronic wound clinics and nursing homes. Dr. Mayer Tenenhaus, who treats about 300 burn patients a year at the University of California at San Diego Medical Center, says that Acticoat™ is "the biggest breakthrough in wound care in the last 40 years."
The sustained release of silver from Acticoat™ dressings mean that they can be left in place for days, thus saving the patient the pain and trauma of frequent dressing changes. The unique coatings also have potent anti-inflammatory activity. The dressings have saved limbs and lives, allowed paediatric burn patients to safely recover at home, and healed decades-old debilitating wounds in weeks.
Burrell is the lead inventor on over 290 patents and patents pending related to Acticoat™ technology. He began developing the innovation in the 1990s in his role as a research director with Westaim Biomedical Corp. A microbiologist by training, he also grew to become a renowned expert in burn and chronic wound healing. Today Burrell is the Canada Research Chair in Nanostructured Biomaterials and a professor with both the Faculty of Engineering and Faculty of Medicine and Dentistry at the University of Alberta.
Acticoat™ dressings and related products are manufactured by NUCRYST Pharmaceuticals Corp. in Fort Saskatchewan, Alberta and marketed internationally by UK-based Smith and Nephew Plc. NUCRYST, a spinoff of the Westaim Corp., supports the local economy with over 100 high tech manufacturing jobs.
The Ernest C. Manning Awards Foundation
This year the Foundation will award $145,000 to leading Canadian innovators plus $20,000 to Young Canadians chosen at the 2009 Canada-Wide Science Fair.
The Foundation was established in 1980 to promote and support Canadian innovators. This is the 6th year that the Principal Award has been sponsored by Encana Corporation, one of Canada's leading oil and gas companies. Since 1982, the Foundation has presented over $4 million in prize money. The 2009 awards will be presented at an awards gala on Friday, September 18 in Vancouver, BC.
A Media Backgrounder about the innovator and his work is now available on the Foundation's website, with video available after September 18, 2009: www.manningawards.ca
For more information on the Foundation, contact Bruce Fenwick, Executive Director: 403-645-8288 or email@example.com
For more information about Acticoat™, visit http://wound.smith-nephew.com/uk/Home.asp or www.nucryst.com/ or contact Dr. Robert Burrell: 780-492-4972 (office), 780-717-0088 (cell) or firstname.lastname@example.org
$100,000 Encana Principal Award
Sponsored by Encana Corporation
Dr. Robert Burrell
Acticoat™ Silver-Coated Antimicrobial Dressing
Dr. Robert Burrell is the inventor of Acticoat™ silver-coated wound dressings. He is named as lead inventor on over 290 patents and patents pending worldwide relating to nanocrystalline silver coating technology.
Burrell is the Canada Research Chair in Nanostructured Biomaterials at the University of Alberta, a professor with both the Faculty of Engineering and Faculty of Medicine and Dentistry, and Chair of the Department of Biomedical Engineering. Heis also a world-renowned expert in burn and chronic wound healing.
Acticoat™ dressings include an array of antimicrobial dressings that prevent life threatening infections and promote wound healing.
The nanocrystalline silver-coated dressings represent the world's first commercial application of therapeutic nanotechnology. Over 17 million units of Acticoat™ dressings have been sold to date; in 2008 alone, sales of Acticoat™ products were $60 million USD.
Open wounds such as severe burns are vulnerable to infection; should an infection take hold, the wound will not heal properly and the infection may spread.
Dressing changes are painful and may re-injure the wound; the sustained release of silver from Acticoat™ dressings mean that they can be left in place for several days.
Acticoat™ dressings promote wound healing and so speed recovery and reduce scarring.
Acticoat™ dressings are used in burn units around the world. They were used to save the lives of victims of terrorist attacks, including 9-11 and the 2002 Bali nightclub bombings.
Acticoat™ dressings and related products are manufactured in Fort Saskatchewan, Alberta and marketed internationally in 40 countries by UK-based Smith and Nephew Plc. Underlying research is ongoing in the Burrell lab at the University of Alberta in Edmonton, Alberta.
1991 - Burrell joins Alberta-based Westaim Technologies Inc., a government-industry venture to create advanced materials
1992 - first nanostructured silver coatings are made
1993 - first prototype dressing made
1995 - first clinical trial (University of Alberta Hospital, Firefighters' Burn Treatment Centre)
1996 - US Food and Drug Administration approval granted; Canadian manufacturing plant built and commissioned
1997 - first sales of Acticoat™; receipt of University/Industry Synergy Award for Innovation from NSERC and Conference Board of Canada
2002 - Burrell joins the University of Alberta
2004 - Acticoat™ named one of top 10 nanotechnologies by Forbes magazine
Silver is a potent antimicrobial agent used since the 1870s to treat and prevent infection. For many years, it was applied as a silver nitrate solution, and then later as a silver sulfadiazine cream. To some extent, these applications worked, but they also interfered with wound healing. In contrast, Acticoat™ is a nanocrystalline silver coating that both effectively kills microbes and helps wounds heal.
The nanotechnology behind Acticoat™ takes construction to the atomic level using silver atoms as the main building blocks. As in any crystal, the building blocks are put together in a particular array. However, there is one nanoscale difference - irregularities in the nanocrystalline coating allow it to release just the right amounts and types of silver needed to be effective.
Rewriting the Chemistry Books
"When I told the material scientists I wanted to make a soluble form of metallic silver, they said it wasn't possible, because that's what all the textbooks said," notes Alberta scientist Robert Burrell. He has won top prize from the Ernest C. Manning Awards Foundation for inventing a unique antimicrobial and anti-inflammatory wound dressing that releases soluble forms of silver. "Fortunately for me," adds Burrell, "I'd never read those textbooks."
He first had the idea for an antimicrobial silver coating in the late '80s, when he was working with the Ontario branch of Alcan International. Alcan's R&D team was investigating advanced materials, with an eye to using high tech coatings in medical applications.
A microbiologist by training (PhD 1983), Burrell was quite new to material science. Mentors Larry Morris and Aron Rosenfeld brought him up to speed and opened the doors to a fascinating world of materials. "For me, it was like being a kid in a candy shop," says Burrell.
He envisioned a silver coating that could be used to inhibit bacteria. To show that this could work, Burrell updated a classic microbiology demonstration that used silver coins to inhibit microbial growth in a Petri dish: He used silver-coated slide covers instead. The demo was a flop. The slide covers had no antimicrobial activity whatsoever.
"I'm a little bit stubborn," says Burrell, explaining how he repeated the experiment with different types of bacteria and finally with old dimes, made of an 80/20 silver-copper alloy, which inhibited the bacteria. Eventually he realized that the standard demonstration of silver's antimicrobial properties was really showing copper's antimicrobial properties. This meant that there was no known solid material that could release the charged, soluble silver needed kill microbes.
Trial and error led Burrell to one last experiment before Alcan shut down its biomedical division in 1990. He created a silver-copper laminate with layers just 5 nanometres thick - 10,000 times thinner than a single hair. The coating did what should have been impossible and released both copper and the sought-after silver.
Burrell kept the promising results in the back of his mind when he joined Alberta's Westaim Technologies Inc. in 1991 as the Biomedical Program Principal. Westaim was a collaborative venture between industry and the federal and provincial governments to develop and commercialize advanced materials. In his new position, Burrell jumped on the opportunity to address wound infection, a widespread and pernicious problem.
By 1992, Burrell's team had developed a sputtering machine that would deposit a nanostructured layer of silver. Burrell explains: "What we're doing in that machine is taking a piece of silver, disassembling it into its component atoms, and then reassembling it under a controlled set of conditions to produce the structure we want."
The trick was to create a coating with the right degree of stability - stable enough to have a reasonable shelf life, but also able to gradually release antimicrobial silver particles. Eventually, the research team created a coating that was worth testing in vitro and in vivo. Westaim Biomedical/NUCRYST Pharmaceuticals Corp. became the branch of Westaim to further develop and commercialize the nanotechnology, and in 1995, the first clinical trials of the high-tech dressings began at the University of Alberta Hospital, Firefighters' Burn Treatment Centre.
US FDA approval for the dressings followed in 1996. The same year, NUCRYST built a manufacturing plant in Fort Saskatchewan, Alberta. By 1998, they were selling the first Acticoat™ dressings.
Synergy Begets Innovation Begets Synergy…
Cooperation between the University of Alberta and Westaim had allowed the company to move forward with a proven product. In 1997, in recognition of the successful collaboration, they won a university-industry Synergy Award for Innovation from NSERC and the Conference Board of Canada, which allowed Burrell to further the research on nanocrystalline silver.
By 2001, the work had led to another seven patents, and sales of Acticoat™ had reached $8 million Can a year. Smith and Nephew, a leading UK medical device company, acquired the sales and marketing rights to Acticoat™ and quickly took product distribution worldwide.
Diabetes foot clinics, burn units, and chronic wound clinics were among the centres to adopt the life-saving dressings. Because Acticoat™ dressings could be safely left in place for three or four days, burn units could send patients home to recover on an outpatient basis. Physicians could salvage limbs that would otherwise require amputation. Patients with chronic wounds had less pain and a better quality of life.
"(Acticoat™) is, in my opinion, the biggest breakthrough in wound care in the last 40 years," says Dr. Mayer Tenenhaus, an Associate Professor of Plastic and Reconstructive Surgery at the University of California at San Diego Medical Center. Tenenhaus lists improved care and reduced costs as two benefits to the dressings. "Then there are the intangibles of giving people hope," adds Tenenhaus. "In the past many chronic wounds would last years if not decades. These wounds robbed the patients of dignity but this technology has given them that back."
Acticoat™ is also an important tool in the fight against antibiotic resistant bacteria, such as methicillin resistant Staphylococcus aureus, or MRSA. Dr. Gordon Dow is the Chief of Infectious Diseases and Director of the Chronic Wound Clinic at The Moncton Hospital in Moncton, New Brunswick, the largest multidisciplinary wound clinic in Atlantic Canada. Dow says that, in combination with systemic antimicrobial therapy, Acticoat™ has made it possible to completely eradicate MRSA from their patients.
Since joining the Department of Chemical and Materials Engineering at the University of Alberta in 2002, Burrell's research has uncovered some of the whys and hows of Acticoat™'s antimicrobial and healing properties.
Part of innovation is in recognizing problems, says Burrell, and then looking for ways to solve them. "There's tremendous satisfaction in actually having had the opportunity to change the outcome of people's lives," he says. "There's a huge reward in that."
Inflammation, the Body's Frenemy
Inflammation is the body's response to trauma or infection; it is familiar as the redness, pain, warmth and swelling in and around a wound.
Some inflammation helps fight infection, but if the inflammatory response is too strong, it can be the body's worst enemy. Wounds are slow to heal and so continually vulnerable to infection, and excess scar tissue builds up. The scarring that results may not only affect the way someone looks, but may cause discomfort or impede mobility.
Silver is known for making inflammation worse, not better, says Burrell. This "fact" made early reports from clinicians using Acticoat™ very surprising. In the case of one burn patient, scalded from shoulder to wrist by a pot of boiling water that had slipped off the stove, Acticoat™ dressings were applied on the upper arm and silver sulfadiazine cream to the lower arm. The upper arm healed nicely, but the lower arm required a skin graft. There was something different about the new wound dressing.
A similar story was told by Dr. Bob Demling of Brigham and Women's Hospital, Harvard University. Demling was treating a pilot who had escaped a private plane crash with a broken pelvis and severe burns to 60 percent of his body. The plan was to wrap the patient's back with Acticoat™, allow his pelvis to heal and then apply a skin graft to his back. To Demling's amazement, by the time the man's pelvis had healed, so had his back, making a skin graft unnecessary.
It seemed clear that Acticoat™ had an anti-inflammatory effect. To find out what was happening at the cellular level, Burrell's research team measured the amounts of inflammation-related proteins in chronic wounds treated with or without Acticoat™. Says Burrell, "you could show that this is probably one of the most potent anti-inflammatories of the last 30 or 40 years." Ongoing studies support this conclusion.
Burrell, a self-taught expert in burn and chronic wound healing, won the 2008 World Union of Wound Healing Societies Lifetime Achievement Award.
Silver - A Precious Element
"A whole gamut of microorganisms are killed by silver at different levels," says Burrell, listing various bacteria, fungi, algae, and viruses. Because burn wound infections typically involve multiple types of microbes, burn doctors of the 1960s turned to the old remedy of aqueous silver nitrate.
Silver is a very active antimicrobial at low concentrations that are not toxic to humans. This is why it is safe to add a small amount to the skin or eye to kill disease-causing microbes. Silver stops microbial cells from respiring, making them unable to obtain energy to live. Silver also attacks cell membranes, poisons various enzymes, and interrupts DNA function. Because silver acts against features common to most microbes, it has a very broad spectrum of activity.
Whether in a solution, cream or coated dressing, it is the individual silver atoms that attack microbes. In a piece of jewellery, for example, the individual silver atoms are neutral, but in an antimicrobial product, the silver particles are charged and reactive. The reactive silver ions diffuse passively into microbes and kill them.
Like other silver-coated dressings, Acticoat™ releases the silver ion, Ag+. However, Acticoat™ dressings are not to be confused with silver-coated bandages from the drug store or sweat socks impregnated with silver to reduce foot odour - these products have relatively low levels of silver and the coatings are not built like Burrell's.
His team believes that Acticoat™ releases a highly unstable and reactive silver ion, Ag3+, which would explain the coating's advanced antimicrobial activity. In addition, it appears that microbes actively pump in Ag3+. We're working to prove this, says Burrell.
Another feature of Acticoat™ is that it releases neutral silver atoms. Burrell believes that this could account for the coating's unique, potent anti-inflammatory activity. His research team at the University of Alberta continues to investigate this exciting possibility.
The Ernest C. Manning Awards Foundation
This year the Foundation will award $165,000 in prize money. Four awards, totalling $145,000, will go to leading Canadian innovators. Another $20,000 will go to Young Canadians chosen at the 2009 Canada-Wide Science Fair. The Foundation was established in 1980 in the name of prominent Alberta statesman, Ernest C. Manning, to promote and support Canadian innovators. Since 1982, the Foundation has presented over $4 million in prize money through its annual awards program (www.manningawards.ca).