Whether we fell off a bike as a child, fell while climbing a tree or scraped a knee on some asphalt, we all suffer some kind of injury involving wounds during our lives. But our bodies, with a kind disregard for our carelessness, will usually go about recovering through an autonomous wound healing process.

However, this process is not only complex but fragile, and susceptible to interruption or failure. Often this failure leads to the formation of what is known as chronic non-healing wounds, or simply chronic wounds. There are many factors that contribute to interrupted healing including diabetes, venous or arterial disease and infection; while one of the most common causes is simply old age.

Chronic wounds can take years to heal and sometimes never heal at all, causing patients severe emotional and physical stress as well as creating a significant financial burden on the healthcare system. In chronic wounds the matrix scaffold, known as the extracellular matrix (ECM), is degraded. This scaffold is very important in helping coordinate the process of normal healing. Without a viable ECM, normal wound healing cannot proceed and a cycle of self-amplifying inflammation continues. There may now be a break-through answer to the problem. Researchers at the Queensland University of Technology (QUT) have developed a wound healing treatment called VitroGro® ECM, set to arrive in commercial markets around the world in the next year. VitroGro® ECM is a flow-able scaffold that is applied as a solution to the wound. VitroGro® ECM adsorbs to the degraded ECM of the wound forming a physical matrix that replaces the degraded scaffold with a viable scaffold that is able to restore normal wound healing.

Professor Zee Upton is Co-Leader of the Tissue Repair and Regeneration Program within the QUT Institute of Health and Biomedical Innovation and has been working on the project over the last decade. While undertaking her PhD and studying the evolution of molecules and cells, Professor Upton laid the foundations of the project with analysis of a sticky protein found in blood and other cell tissue called Vitronectin. Initially, study of Vitronectin was based on work with chickens, but later expanded to humans. Vitronectin is involved in the early stages of normal wound healing, promoting cell adhesion and cell spreading into the wound space. Professor Upton came to recognise its potential use as a replacement for the degraded matrix in chronic wounds. She thought that perhaps by giving the cells a new matrix of Vitronectin on which to grow, healing could be kick-started and restore healing to a more normal balance.

It was recognised early that providing a simple Vitronectin scaffold was not enough. To be effective the “replacement ECM” would have to mimic the normal ECM that is present in the early stages of wound healing. Normal early-stage wound healing involves gylcoproteins (sticky proteins) such as Vitronectin and Fibronection but also involves growth factors sequestered to the matrix, both of which provide attachment sites for cells and guide tissue restoration. With this in mind, VitroGro ECM was developed as a synthetic protein that incorporates components of native ECM to better mimic the scaffold that is present during the early stages of normal wound healing. By replacing the degraded ECM with a functional ECM tailored to early stage healing, the cycle of chronicity could be broken and wound healing restored.

The technology has been assessed in humans, with the latest successful clinical trials focused on venous ulcers. Venous ulcers, which affect around one per cent of the Australian population, are painful leg wounds that are a major cause of chronic wounds, occurring in 70% to 90% of chronic wound cases. The most common cause is poor blood circulation, particularly the inability of the veins to return deoxygenated blood from the legs back to the heart. Other causes or exacerbating factors include relentless pressure (often seen as bed sores), badly managed diabetes, high cholesterol, smoking, dietary problems and poor arterial circulation.

Led by the world-renowned Cardiff University Wound Healing Clinic in conjunction with QUT, the trial evaluated VitroGro® ECM in the treatment of venous leg ulcer patients who had not responded to compression therapy, which is the current standard of care.

After 12 weeks, the trial found 92% of the patients taking part in the trial were partially or completely healed. The average reduction in wound size was 65 per cent, with no adverse events related to VitroGro® reported. The huge clinical success was highlighted by the average treatment time that patients' venous ulcers had not responded to expert care before the VitroGro® treatment, which was a huge 37 months.

"We're very excited by these results as it's a new formulation which is going to be extremely cost effective to the consumer," says Professor Upton. "There's nothing else like it in the market in terms of approach, outcome or cost effectiveness.”

"For conditions like venous ulcers where the biology of healing is aberrant, VitroGro® ECM provides critical adhesion for cells by forming a scaffold they can attach to and migrate upon. It creates a favourable environment for healing and this is something that has been missing from conventional wound care."

Planned first sales in Australia and Europe for VitroGro® ECM are scheduled in the second quarter of 2012, with future trials also set to commence in the United States and while the journey is by no means over, Professor Upton is quick to point to the environment where she works as a key contributor to her work’s success. “QUT didn’t put up any barriers”, Professor Upton says. “They did absolutely everything they could to help.”

Tissue Therapies Limited, the start-up company that was formed in 2003 to commercialise Professor Upton’s work (of which she is consulting Chief Scientific Officer) was also a large beneficiary of Australian investors and the Queensland Government, who granted funding through its Smart State Program, a $120 million four year program to invest in people, ideas and partnerships driving creativity and innovation.

Although so much has already been achieved, the future of VitroGro® ECM would seem to be only beginning. While the preliminary work leading to the product’s commercial introduction has focused on venous ulcers, the potential use for VitroGro® ECM is not, by any means, limited. Professor Upton would like to see it used to treat both diabetic ulcers and burns moving forward in a more preventative manner.

“I hope VitroGro® ECM will eventually be used as a tool to maintain skin integrity”, says Professor Upton. “Perhaps one day you’ll get up in the morning and put on your moisturiser which contains VitroGro® ECM, while you’ll be able to find bio-active bandages that actively assist in healing wounds on the shelves in pharmacies.”

VitroGro® ECM certainly poses an exciting future scenario for so many people, whose wound woes may very soon, thanks to Australian innovation, be a thing of the past.