The 2002 Wound Healing: Science and Industry Meeting

Oscar Alvarez, PhD

Disclosures

Wounds. 2003;15(2) 

Introduction

The third annual Wound Healing: Science and Industry (WHSI) meeting was held December 6-8, 2002, at the Renaissance Grand Beach Resort Hotel in St. Thomas, United States Virgin Islands. The meeting was sponsored by the Hospital for Joint Diseases, Orthopedic Institute, and New York University in New York, New York. The meeting was chaired by Peter Sheehan, MD, and planning committee members included Christopher Attinger, MD; Kelman Cohen, MD, PhD; Aristidis Veves, MD; and myself. Drs. Sheehan, Veves, and I also serve on the WOUNDS Editorial Advisory Board.

This meeting provided a unique interaction between the science and business of wound healing. The topics of presentation were selected by the program committee and were based on research developments and emerging trends that impacted the field of wound care in 2002. Researchers from both industry and academia were invited to present papers describing recent unpublished work. Because this meeting was small (80 attendees), it provided a venue for more intimate interchange of information between the industry leaders and the scientific community.

Those of us who traveled to the meeting from the Northeast in the US (myself included) were lucky if they were able to depart for the meeting before the snow storm arrived, which set in on the morning of December 5 and lasted through the next day. Unfortunately, the inclement weather caused several of the meeting faculty members and guests to be delayed in their arrival to tropical paradise.

St. Thomas, one of the United States Virgin Islands, is nearly 1,000 miles from the southern tip of the US mainland and is truly the combination of the familiar and the exotic in the US. It has been described as, "a paradoxical blend of island serenity and American practicality," and was the ideal backdrop for this intimate meeting. The 2002 WHSImeeting was structured so that its scientific sessions were held during the mornings (7am-12pm), which left the afternoons free for interaction and recreational events. The 2002 meeting included three days of sessions and was held over a weekend.

The first day of the 2002 WHSI meeting featured an introduction and overview by Dr. Sheehan, who in addition to being the meeting chairman is also the director of the Diabetic Foot and Ankle Center at the Hospital for Joint Diseases in New York. The first day also featured talks by Breda Cullen, PhD; William Li, MD; Keith Harding, MBChB, MRCGP; Phil Bowler, PhD; Barry Wright, PhD; and Bruce Gibbins, PhD. The topics selected for that day embraced the concept of wound chronicity (protease imbalance, bacterial burden, angiogenesis, and cellular aging). Dr. Cullen (Principal Scientist, Johnson & Johnson Wound Management, Gargrave, United Kingdom) presented work on the chronic wound proteolytic environment and the importance of maintaining a balance of matrix metalloproteinases (MMPs) to allow cell migration and subsequent healing. Dr. Li (President, Angiogenesis Foundation, Cambridge, Massachusetts) delivered an elegant lecture, which presented collaborative research (with Dr. Judah Folkman) on mechanisms of wound vascularization and factors affecting angiogenesis. Dr. Harding (Head, University Department of Surgery, Wound Healing Research Unit, Cardiff, Wales), also a WOUNDS advisory board member, reviewed accomplishments made throughout 2002 in the field of cell therapy. He discussed clinical research results with bioengineered skin constructs and chronic wound healing. Dr. Bowler (Principal Scientist, ConvaTec GDC, Flintshire, United Kingdom) spoke on emerging concepts of chronic wound bacteria interplay. He presented data showing that microbial numbers should not be used in isolation to predict wound healing or diagnose infection. Instead, he suggested the collective effect of certain bacteria residing together in the wound is a much better predictor of chronicity. Dr. Wright (Program Manager, Tissue Management Division, Healthpoint, Ft. Worth, Texas) spoke about bacterial biofilms and their roles in silent infections and chronic inflammation. Finally, Dr. Gibbins (Chairman, Chief Technical Officer, Acrymed, Inc., Portland, Oregon) detailed findings describing the antibiotic effect of silver and its effect on wound bioburden.

The topics of the second day were related to research developments in the treatment of diabetic foot ulcers. Dr. Sheehan gave an excellent overview of the epidemiology, assessment, and management of these difficult wounds. He presented recent work on how early wound improvement is predictive of complete healing. Luigi Uccioli, MD, (Chairman, Study Group on the Diabetic Foot, Italian Diabetes Society, Department of Internal Medicine, University of Roma, Roma, Italy) presented new information about the pathomechanics of neuropathic ulcer development. I reviewed research findings on local skin temperatures/skin perfusion and presented results of a randomized clinical study on the effects of noncontact, normothermic wound therapy on diabetic foot ulcer healing. Thomas Lyons, DPM, (Division of Podiatry, Beth Israel Deaconess Medical Center; Clinical Instructor in Surgery, Harvard Medical School, Boston, Massachusetts) spoke about the latest procedures for surgical reconstruction of the diabetic foot. Dr. Attinger (Department of Plastic Surgery at Georgetown School of Medicine, Washington, DC; Harvard Medical School, Boston, Massachusetts) delivered a magnificent presentation on how to apply the angiosome principle to improve the outcome of vascular reconstruction in this patient population. Dr. Cohen (Professor of Surgery, Medical College of Virginia, Medical College of Virginia Hospital, Richmond, Virginia) gave an overview of wound healing physiology and discussed the importance of several emerging technologies. Dr. Veves (Research Director, Joslin-Beth Israel Deaconess Foot Center; Harvard School of Medicine, Boston, Massachusetts) presented recent progress in his laboratory regarding skin microcirculation in diabetic patients and implications on wound repair. Paul Glat, MD, (Director, Burn Unit, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania) ended the session by discussing recent experience with vacuum-assisted wound closure in both acute and chronic wounds.

Research developments in the basic science of wound healing made up the third and final day. The day started with Fred Grinnell, MD, (Professor of Cell Biology, University Texas Southwestern Medical Center, Dallas, Texas) updating the audience with exciting laboratory findings about the dynamics of extracellular matrix (ECM)-cell interactions and wound healing. He explained that fibroblasts explore the matrix and become metabolically coupled to each other through dendritic extension, which may be the mechanosensors of connective tissues. Jeffrey Davidson, PhD, also a WOUNDS advisory board member from Vanderbilt University School of Medicine (Nashville, Tennessee), spoke about genomic approaches to new therapeutics for tissue repair. Marjana Tomic-Canic, PhD, (Department of Dermatology and Microbiology, NYU School of Medicinem, New York, New York) told us about progress in gene chip technology in relationship to epidermal wound resurfacing. Helen Vlassara, MD, (Professor of Medicine, Geriatrics and Gene Therapy, Director, Division of Experimental Diabetes and Aging, Mt. Sinai School of Medicine, New York, New York) delivered a most interesting lecture about bioreactive advanced glycation endproducts (AGE) and their functions to alter the structure and function of molecules in biological systems, which result in increased oxidative stress. AGEs have been implicated with atherosclerosis, renal, eye, and neurological diseases as well as impaired wound healing in the diabetic patient. Michael Hiles, PhD, (Vice President of Research, Cook Biotech, Bloomington, Indiana) presented work on collagen matrix materials and their roles in wound repair and organ regeneration. Gonzalo (Al) Serafica, PhD, (Vice President, Research and Developement, Xylos Corporation, Newtown, Pennsylvania) spoke about developments in biosynthetic cellulose, a novel and economical technology useful for dressing design in wound healing and implantology. The meeting ended with a presentation from Martin Wendelken, DPM, (Director, Research and Development, Hudson Diagnostic Imaging, LLC, Elmwood, New Jersey) on diagnostic ultrasonography to study wounds quantitatively and noninvasively.

Overall this meeting was a gem. Dr. Sheehan and the program committee intend to keep it small and intimate in the future (80-100 attendees). This year's meeting will also be held in St. Thomas around the first week in December. So, mark it on your calendars and keep alert to meeting updates, which will be included in upcoming issues of WOUNDS.

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