Electrical stitches make wounds heal faster

A new study has found that surgical stitches that can pick up an electrical charge can help speed up the healing of skin wounds. Electrical potentials delivered to the skin by the conductive sutures made new skin cells grow to heal injuries far faster. The findings, published in Nature Communications, are the work of a team of scientists based in China. We asked Steve Jeffery, consultant plastic surgeon and specialist in skin repair at Birmingham City University, to take a look at the results for us…

Steve - This paper from China, they've designed a suture, which is absorbable, but it's got a metal core of magnesium. They put wounds in rats and they sutured up muscle with this suture. Then, they've closed the skin and then they've discovered that when the rat moves, it moves the suture and that generates an electric potential and that acted to improve the healing of the actual wound.

Chris - What's the rationale for thinking that, if one looks at a wound, some local electricity might make a difference?

Steve - We know that there is an electrical potential across the wound. If you put a volt meter from one edge of the skin, the intact skin, down into the depths of the wound, there is a potential. A long time ago, there was a German scientist called Emil du-Bois Reymond who described the nerve action potential, and he actually cut his finger and did that experiment. He measured the current flowing. So we know current does flow from the edge of the wound to the depth of the wound, and we also know that current becomes less as you become older and also if you've got certain comorbidities such as diabetes, etc.

Chris-  What effect does that current have on the tissue, if any? Can the local skin cells detect that and do they use it in some way? Presumably, if it's accelerating wound healing, perhaps they can?

Steve - We think so. We know that when you have an acute wound, the cells at the margin of the wounds start to proliferate and migrate, and they lay down an extracellular matrix and new blood vessels, and the cells migrate through the wound until they meet each other in the middle. It is thought that the electrical potential helps guide the healing cells in order to achieve healing

Chris - In this present study, then, is the electrical conductor of the suture picking up its electricity from the deeper muscle and conveying that into the superficial layer, the skin, and therefore helping it to heal?Is that the sort of mechanism here?

Steve - It is, yes. It's the physical movement of the muscle creating the electrical charge and then that is being delivered to the wound itself.

Chris - How much better was this? When you apply this electrical stimulation, admittedly picked up from the underlying muscle to the wound, how much quicker did they get better? Do you think this is a realistic prospect: using electrical stimulation to heal wounds in this way?

Steve - Yeah, definitely. There's some issues with the paper. So, for example, it's talking about wounds in muscle. We don't normally talk about wounds in muscle. We talk about wounds in the skin. But they had significantly better healing. One side experiment they did was in an infected wound model and they were able to show quite remarkable improvements in fighting the infection. So definitely something to look out for for the future.

Chris - The ultimate aspiration then must be a sort of smart dressing, one day, where we have something that doesn't just cover a wound but is almost actively interrogating the wound, electrically and chemically, to adjust its behaviour. So you basically optimise the wound dressing, which is evolving as the wound changes or heals?

Steve - Exactly. So this has to be something that doesn't have a great big battery pack attached to it. Everything is contained within the dressing. And, as you say, that dressing could detect things that are going on in the wound. So what kind of things could it detect? Is there infection? Is it too wet? Is it too dry? What's the pH, oxygen saturation, the temperature, the pressure? A lot of people are under compression garments, glucose, uric acid, you name it, there's a whole lot of things it could detect. And then to be truly smart, this means the dressing can then act and say, okay, we've got too much of this, we need to change what we're delivering, whether that be delivering electrical stimulation or electromagnetic stimulation or antibiotics or an antimicrobial or growth factors, a light, whatever, so that it detects as a problem and then it treats the problem.