• Danielle Zurovcik SM '07 demonstrates how to use the negative pressure pump to seal an arm wound.

    Photo: Melanie Gonick

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  • The simple pump creates negative pressure — shown here sealing a bandage on a leg wound — which speeds up the healing process.

    Photo: Patrick Gillooly

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In the World: Better wound treatment for all

A streamlined version of 'negative-pressure' wound therapy is put to the test in Haiti — and could have 'enormous potential' across the developing world.


Nobody knows precisely why it works, but doctors have known for decades that the healing process for open wounds can be greatly speeded up by applying negative pressure — that is, suction — under a bandage sealed tightly over the affected area. The speculation is that it helps by drawing bacteria and fluid away from the wound, keeping it cleaner.

For patients, there is a benefit even beyond the speedier healing. Traditional dressings need to be removed and replaced — sometimes painfully — up to three times a day, but with the negative pressure system dressings can be left in place for a few days. But in the developing world, there's a problem: The systems are expensive, and they need to be plugged in or powered by batteries that last only a few hours. In many developing nations, a reliable source of electricity is rarely available.

That's the problem that students in an MIT mechanical engineering class decided to tackle a few years ago. With the help of Dr. Robert Sheridan from Massachusetts General Hospital, the students developed a simple, inexpensive and lightweight version of the system that required no power supply and could be left in place for days. One of those students, Danielle Zurovcik SM '07, continued to work on the project and made it the subject of her master's thesis. She has continued to work on it on the side as she pursues her doctorate.

The project was part of a mechanical design class taught by mechanical engineering professor Alexander Slocum in collaboration with local hospitals through a Boston-based organization called the Center for Integration of Medicine and Innovative Technology.

Earlier this semester, Zurovcik, who had been making plans for field tests of the patent-pending device at a rural clinic in Rwanda this fall, was asked by the nonprofit healthcare organization Partners in Health to take part in earthquake relief efforts in Haiti. She traveled there with a supply of 50 of the current version of the plastic, molded pumps, which cost about $3 each. (The only portable versions on the market today cost $100 a day just to rent, and must have their batteries recharged after about six hours.)

The device, a cylinder with accordion-like folds, is squeezed to create the suction, and then left in place, connected to the underside of the wound dressing by a thin plastic tube. At that point, it requires no further attention: "It holds its pressure for as long as there's not an air leak," Zurovcik explains. For that reason, a suitable dressing that can hold the seal is a crucial element of the system.

The Haitian patients who were treated with the device were pleased with how it worked. While the team didn't have time to conduct long-term evaluations, Zurovcik says, "In the short term, we systematically evaluated the wounds, and were able to verify that negative-pressure therapy was being applied and the healing process was underway."

'Enormous potential'

The trip to Haiti was led by Dr. Robert Riviello of the Division of Trauma, Burn and Surgical Critical Care at Brigham and Women's Hospital in Boston. Riviello estimates that between 50 million and 60 million people in low-income countries suffer from acute and chronic wounds, and a large number of them would benefit from negative-pressure wound therapy. He says the device "has the potential to be a great benefit to patients around the world" once a few technical hurdles are cleared.

"Our biggest challenge at the moment is ensuring a reliably intact seal on human skin [that can be] easily applied," Riviello says. "If we can resolve this, then I think there is enormous potential."

Zurovcik notes that an improved version of the device — one that maintains a more constant pressure and is smaller and so easier to conceal when being worn for days — has been developed and is being manufactured now.

Zurovcik and her team designed the devices to be made in a sustainable way. They can be manufactured locally in many developing nations, using equipment that already exists there, she says. She is already in discussions with a plastic molding company in Rwanda, she says.

She plans to go to Rwanda in the fall to test the new version of the device, which is small enough to carry in a pocket. "Their clinics are filled with wounds," she says, noting that the injuries are often severe because patients avoid going to clinics as long as they can. The clinics themselves "don't have power, don't have a lot of supplies. I'd like to be able to bring something simple, that patients would be able to care for on their own."

In The World is a column that explores the ways members of the MIT community are developing technology — from the appropriately simple to the cutting edge — to help meet the needs of communities around the planet, especially those in the developing world. If you have suggestions for future columns, please e-mail newsoffice@mit.edu.


Topics: Haiti, Health care, In the world, Mechanical engineering, Students, Technology and society

Comments

As a massage therapist..and dealing with client's cronic neck, back, and low back pain. How can your product assist in they're healing? Also, how do I get a hold of your product. I think its a great idea..we need more inexpensive choices to the process of healing our bodies. Thank you for all your efforts..Please reply to me on how I can purchase your product. Thank you ..Florence Blackburn
I use wound vacs on many of my patients and there are numerous types of drainage tubing and dressings available. The one that I like the most is the one with a flat end and multiple drain holes and a white microfiber material for packing. It comes in many different sizes and therefore makes it versatile for different sizes of wounds, tunneling, and etc. The key to a sealed drsg is the plastic sheeting that goes over the drsg and proper skin prep for the drsg. Also if you apply a product called SkinPrep to the edges and then apply to the drsg edges after the drsg is complete it will give you a better seal and tends to remain intact longer. This product also protects the healthy tissue from drsg damage during use and removal. The blue tab that is remaining on the drsg shown in your picture should not be left on after dressing is complete.
WOW I am a practicing wound care doc in NC and have been utilizing the wound vac for over 15 years and I am totally impressed!!!! Please if I can be of any help dont hesitate to contact me. GOOD work the world has improved by your efforts. Rick
I am a wound nurse at our VA facility. WOW...I am really impressed with your device and I think it is great that you have develop such an inexpensive device such as this. I have used wound vacs for 8 yrs but this one is so much simpler. Great job. I hope some day it will be available for our vets who cannot afford this treatment.
Denture paste type of product.
So pleased to see something of such tremendous value at such a low price in today's world, especially the world of medicine. I hope the young lady, Danielle Zurovcik, reaps the rewards, both monetarily and spiritually. You go girl!!
I have chronic stasis ulcers and rely on a wound care clinic now for treatment. This is not only expensive but requires a long treatment period. The common treatment that I receive is usually an unaboot or a 4-layer(?). The last time I needed treatment, it seemed that the recovery time was extended. I also have a problem with the bandages slipping and causing other wounds to open. Can you tell me where I can purchase your suction device or if perhaps you are needing any trial patients. Richard in Louisiana
as an acute care physical therapist with a bit of time doing wound care, we found that in areas which we had difficulty sealing for a wound vac (even with no-sting skin prep) ostomy past works well to assist with the seal. also, would this be available for low income clinic areas here in the states (rural or urban), will there be additional tests run, and how would one become more involved with the tests? thanks
You might be able to retrofit a "certi-suction pump" to your device. It is a pump used to suck out poison from snake and insect bites. If this worked, you would definitely have a more compact design. The pump is sold for around $6. The link I found for the pump is: http://www.scs-mall.com/prodinfo.asp?number=PMP783&variation= Good Luck!
Rick, I have a 91 years old great mom and about a month ago she developed a small wound on her left hill. The nurse who comes 3 times a week did try herself to take care of it for about 2 weeks and it got worst. Finally we went to wound center a couple of times since then and it is getting worst. They keep cutting dead skin of and they said that they cannot go any dipper. I am so upset about it they said that her blood circulation will get bad eventually. Do you think that I can ask them if they have the pump and use it for her. A desperate daughter.
My Othopaedic Surgeon used a pressue-suction dressing on a 14 inch surgical cut in my knee this summer. It was the last of 4 surgeries in 4 months. The standard bandages filled with blood quickly and had to be changed by the hospital staff often. The suction dressing was a black closed cell-type foam that was one inch thick initially; when the air was sucked out, it compressed to about 1/8th inch and helped pull the skin together. It worked well and I believe it helped heal the wound faster without further infection. During PT, I walked with the pump on using the battery pack.
Hi there, I am a medical device engineer and think what you are doing is really cool. My brother had cancer and used the wound vac. Because of it, the infection in his leg was able to heal. After radiation and chemo, he was so low on white blood cells that he needed all the assistance possible to heal. Please contact me if I can help out.
I think I have an answer for sealing the would. I am retired, with nothing but time to spend, and I consider myself a creative, mechanical problem solver. If someone at MIT would like to get in touch with me at roygoss@yahoo.com, I am most willing to discuss my potential solutions.
The joy is in creating, not maintaining (Vince Lombardi) How can I purchase this product please?
Forgive me if I am way off base here, (I wasn't there at the development :)) but have you considered a separation of the pump and reservoir mechanisms vs a combined unit as you have now? Perhaps a simple vaccuum reserviour of rubber over a plastic frame to maintain the vaccuum, a detachable hand pump that could create more (or less) vaccuum for bigger wounds and a clip would possibly make a more compact and flexible system. The reserviors could also be of different sizes. Apart from the wound sealing, I suppose maintaining a vaccuum is the tough part. Cheers.
Please contact me wrt the availability of this product for inclusion in a basic healthcare project in Angola.
Very Interesting..... As a podiatrist, exposed to lots of wounds. Perform mission work in Honduras; patients would definitely benefit. Interested in potential use....
I think this is an exelent option for the people that don´t have the economic possiblity to pay for another equipment; How is the way to get this product, I´m from Mexico. It´s possible to produce this product in my country? Thank you Omar Cisneros
Hello, I'm a newbie in a medical devices trading company all the way from Malaysia. I have been Googling around on NPWT cause it's one of the products we have and I thought it was really cool. At a recent conference I went to, people were impressed but all had the same complaint, "Budget doesn't allow", "It's expensive", and etc. If this idea becomes a real deal reality, it would be awesome. Kudos to the inventor!
I work in a small community hospital as wound nurse and have used the negative pressure therapy applications for the past three years with great results. The only issue I have regularly are self-pay patients (no insurance) who have to go through strident review by the company supplying the machines to qualify for their indigent program. This could really be a boon to these patients who need the therapy and can't afford it, or don't qualify for the current machine used in our facility. Also, benzoin is a great sealant for use with the occlusive dressing. It is used frequently in surgery to maintain dressings, and is low cost. A double application should be of great benefit. What do you think of applying the gauze and occlusive dressing and then perforating the occlusive dressing and inserting the tubing, sealing it with a second occlusive dressing? Might maintain a better seal longer, especially if the tubing is "anchored" to prevent a lot of movement with the patient's mobility. Thanks for doing such a great job. The thought has crossed my mind that something like this could be developed and you have done it!!!
This inexpensive device is badly needed all over the world. Do you need financial assistance for further developement of negative pressure product?
I'm biomedical engineering student working with a team right now to create a device to help close uterine hemorrhages caused from pregnancy. I was wondering if a negative pressure pump could be placed directly on a fresh wound to help it clot and seal? I was also wondering if anyone could recommend any sites that could be helpful? All advice and information is welcome! Thanks... Ashley
How do I purchase the pump and associated items? I would like to have a few of those on hand in case of an emergency.
Can the pump be adjusted for pressure? It looks like you could measure the neg pressure fully depressed and mark the outside with a benchmark showing the pressure. Not so fully depressed would be less pressure and could be marked accordingly. It can be detrimental to have to much pressure on a wound, it would be helpful to know how much pressure you are applying. Your vac could be adjusted in relation to the amount of fluid being drained for the most effective healing.
I am an orthopaedic surgeon in India and we have been using this "negative pressure" wound therapy system in our hospitals for more than 15 years for pressure sores as well as chronic wound management. Of course, nobody thought of patenting this idea. It is fairly common practice in many hospitals in India and everyone thought it was too obvious (Just like the medicinal value of certain Indian spices)! We have been using surgical suction drain units for applying wound suction. Wet gauge over wounds followed by sealing the wound with an adhesive surgical incise drape and the suction drain goes under the incise drape. Then the drain is connected to the bellows which applies the suction. Not very difficult to maintain and the patient can walk around with it. The whole construct costs less than 10 dollars.
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