BACKGROUND ON BACTERIAL WOUND INFECTIONS 

With a prevalence of between 2-5% of its respective population chronic wounds have become one of the most pressing problems of western societies.

 

In the United States, chronic wounds affect 6.5 million patients. An estimated excess of US$25 billion is spent annually on treatment of chronic wounds and the burden is rapidly growing due to increasing health care costs, an aging population and a sharp rise in the incidence of diabetes and obesity worldwide. (NCBI report)

 

The cost of diabetic foot ulcers is greater than that of the five most costly forms of cancer

(Barshes, et al, 2013)

 

In Germany chronic wounds affect depending on the source of information 2-4 million patients with an estimated  cost of c. 4-6 billion annually (f.e. Medical Data Institute) and in Switzerland chronic wounds affect c. 150.000 -300.000 patients with annual treatment cost of around 500million to 1 billion.

 

The most common chronic wound diseases are diabetic foot ulcer, pressure ulcer (Dekubitus) and venous ulcers.

 

Additional to above mentioned reasons for rapidly growing treatment costs of chronic wounds, the increasing antibiotic resistance is causing complications in the treatment of any wound, which will further boost treatment costs significantly and increase yearly incidence rates (today c. 0,8% of total population in Germany).

 

Due to the huge numbers of affected people medical health care systems try to keep cost under a strict cost regime which sometimes prevents hospitals or ambulant treatments to even cover their own cost. According to German DRG from av. additional costs of c. EUR 10.000,- per hospitalized MRSA patient only EUR 2.000,- will be refunded by the social insurances leaving a hospital with an average loss of EUR 8.000,- per MRSA patient. This often results in a non-adequate service or even a reluctance to accept MRSA or ESBL affected patients.

 

Modern wound treatment is not a very innovative science, since no or little monetary incentive is given to develop new cures or drugs. Only few efforts to develop new antibiotics are being heard of, due to huge associated cost of such a development (500 mio. EUR up to more than 1 billion EUR) and a high risk of not being able to recoup the investment because of the possibility of a quick bacterial resistance against the new drug and the risk of this drug being used only as a reserve antibiotic by the health care system with resulting lower sales numbers.

 

Apart from this, new antibiotics might not even help or be the solution for hard-to-heal wounds. As statistics already show, systemic use of antibiotics comes to its limits if a “biofilm” is covering the wound. A  biofilm is a thin layer of mucus embedding and thus protecting wound bacteria. Such protected bacteria are extremely resistant to antibiotics and any patients own immunity system. To eliminate “biofilm-protected-bacteria”, a 1,500-fold dose of antibiotics would be required. according to an article from FH Ärztewoche 18/2013 from Springer-Verlag GmbH.

 

Against this background, PAWT was developed, using a different strategy to wound healing. We believe that PAWT will become the first choice therapy for hard-to-heal wounds, since PAWT is able to cope with Biofilms and antibiotic resistant bacterias.