Sustainability
The FDA concluded in 2022 that wounds constitute an area of unmet medical need (Verma et al. 2022). Due to the lack of effective treatments, the burden of wounds on the healthcare systems continues to increase by 11% annually (Guest et al. 2020) and calculations indicate that in 2022 wounds in community care alone demand 20% of the entire NHS budget in the UK.
Existing wound care products use antibiotics, antiseptics, surfactants and different types of dressings containing plastics (polymers), silicones, and chemicals. In comparison, Amicapsil only contains natural, non-toxic ingredients that can be directly reabsorbed into the biological cycle; the packaging is recyclable HDPE and paper/cardboard; and, when using MPPT, the wound is only cleaned with regular tap-water and covered with natural cotton. All shipping materials are recyclable or rapidly compostable. Furthermore, data show that the use of Amicapsil will be associated with considerably fewer dressing changes as the wounds heal and this will mean an overall reduction in consumables, staff resources, transport etc. Finally, it is possible to deliver Amicapsil treatment by telemedicine, which can further reduce CO2-emissions due to reduced transport.
The use of Amicapsil will therefore improve sustainability:
Economic sustainability
Healthcare costs: Reduced costs of wound care and freeing up staff for other tasks will improve the sustainability of the healthcare system
Social care costs: Improved wound healing will enable patients to remain longer in own home, reducing the burden on the social care system, i.e. improving its sustainability.
Individual’s cost of living: A non-healing or slow-healing wound may interfere with a person’s ability to hold a job, run a business, complete an education etc. Quicker healing will reduce the impact of the wound on the person’s life and livelihood.
Social sustainability
AMR: Antibiotics and antiseptics both contribute to AMR. The use of Amicapsil will essentially eliminate the use of antibiotics and antiseptics in wound care, thereby reducing the creation of new resistance. It will also avoid the detrimental effects of antimicrobials on wound healing.
Personal health and social integration: Increased rate and speed of wound healing will reduce the impact of wounds on patient mental health and reduce the probability of long-term follow-on physical complications. It will enable the person to remain longer in own home and postpone any dependence on care support. For individuals who are able to perform the wound dressing procedures themselves or with the help of family or carers, it is possible to deliver treatment by telemedicine. This allows the individuals to perform dressing changes when it suits their schedule, thereby allowing them to continue in a job, take an education etc.
Environmental sustainability
Antibiotic and antiseptic: Both contribute to the creation of AMR in the environment and, as these bacteria tend to be more aggressive, this leads to disruption of microbial systems, which again leads to changes in soil structure, deforestation, desert-formation, increased greenhouse gasses and loss of biodiversity. Eliminating the use of antibiotics and antiseptics in wound care will therefore contribute strongly to environmental sustainability.
Surfactants: These are compounds that reduce the surface tension, e.g. detergents. They contribute to heavy rain, which causes erosion and flooding, and they reduce the transfer of CO2 from the atmosphere into the oceans, thereby causing a build-up of greenhouse gasses, leading to climate change.
Plastic, silicone and chemical waste: In 2022, at least 53,000 tonnes of non-recyclable waste from wound dressing changes are created in UK community care alone. Substantial resources will be required to safely dispose of this waste, making current wound care approaches unsustainable. Amicapsil is non-toxic, non-polluting and only involve ingredients that can return directly into the biological cycle. Packaging and shipping material are recyclable/rapidly compostable materials and only tap water and natural cotton are used in the treatment procedure. These factors will reduce the creation of waste considerably, making this approach much more sustainable.
CO2-emission and net-zero: Quicker wound healing means fewer wound dressing changes and this will result in a reduced need for transport, thereby reducing CO2-emission. Additionally, MPPT is suitable for telemedicine, which will provide further reductions in transport need. The shift to Amicapsil will therefore improve sustainability.
About: Antibiotics, antiseptics and AMR
The role of antibiotics in creating antimicrobial resistance is well documented, but it is less well known that antiseptics, e.g. chlorhexidine, PHMB and silver, also cause resistance, including cross resistance to antibiotics. The use of antimicrobials therefore needs to be limited to infections where efficacy has been demonstrated. The efficacy of antibiotics or antiseptics to remove infections in wounds has never been demonstrated and this lack of efficacy has been highlighted by both NICE (2016) and the FDA (2016 & 2022). The unwarranted use of antimicrobials and its contribution to the ongoing creation of new AMR, makes the use of antimicrobials in wounds unsustainable. Furthermore, the use of antibiotics and antiseptics will exacerbate the infection. Such deterioration of the wound necessarily leads to an increased treatment period, which will unavoidably increase the consumption of all the associated resources as well as the generation of the corresponding waste. MPPT is effective in removing infections in wounds, including antimicrobial resistant strains. It contains no antimicrobials, has no antimicrobial action, and does not require the use of antimicrobials in its care procedures. Its use does therefore not contribute to the creation of AMR and is sustainable.
About: Antibiotics, antiseptics, environment and climate change
Microbes in soil, water and air are essential for life on Earth (https://www.nature.com/articles/s41579-019-0222-5) and an increasing amount of data indicate that they play a critical role in the control of greenhouse gasses (https://www.nature.com/articles/s41579-019-0265-7). These systems are affected by both antibiotics and antiseptics. For example, the antiseptic nano-silver is increasingly being used in wound dressings, but its release into the environment has been found to affect microbial systems essential for food production (https://www.sciencedirect.com/science/article/pii/S0269749121020881) and its accumulation in the environment and in the body is giving rise to toxicity concerns (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177798/). Therefore, from an environmental viewpoint, the continuous release of antibiotics and antiseptics into the environment is unsustainable and is likely to be a major contributor to climate change.