Science

The Problem

Why Chronic Wounds?

Wound healing is an extraordinary and complex process, but one that most people take for granted. If a patient has underlying diseases, the healing of wounds might be disturbed and it is found that these wounds no longer close on their own, they become chronic.

Alongside the therapy of the underlying disease, the first step for treatment is wound bed preparation.

checking infected feet
Wound Bed Preparation

Wound bed preparation is the systematic approach clinicians use to identify and remove barriers to the healing process of the wound. The approach aims to create an optimal wound healing environment by focusing on all critical components, including debridement, bacterial balance, and exudate management, as well as taking into account the patient’s overall health status and how this may impinge on the wound healing process. 

The Unmet Need

Access to and delivery of wound care are both significant problems that challenge patients suffering from chronic wounds. Lack of access to specialized wound care can result in amputations.

In the United States, chronic ulcers are conservatively estimated to cost the health care system $28 billion each year as a primary diagnosis and up to $31.7 billion as a secondary diagnosis. According to the American Diabetes Association (ADA), over 9–12 million Americans suffer from chronic ulcers.

There is a profound psychological impact on the patients suffering from chronic wounds, such as loneliness, separation from active social life, and depression. These psychosocial stressors further worsen healing outcomes.1
Our Solution

Aurase Wound Gel

Our first investigational product, Aurase Wound Gel, is a hydrogel containing an enzyme cloned from medical maggots, that aims to facilitate debridement, reduce bacterial biofilm, and promote wound bed preparation and healing.

aiding pus in the skin

When looking into the nature of the proteins that maggots express, it became apparent that one dominated the others when feeding on wound debris and interestingly has similarities with digestive proteins found in a large part of the animal kingdom.

We are, therefore, focusing our research on simpler ways to deliver it in an outpatient or home setting.

Our goal is to find a solution to painful or inadequate debridement procedures such as surgical or autolytic debridement and improve the outcomes of patients with chronic wounds in all settings: hospitals, nursing homes, or home care.

liquid inside the skin

Through biomimicry, Aurase Wound Gel may harness the enormous and still largely untapped potential of biodiversity.The protein was initially named “Aurase” in reference to the German name of the blowfly – Gold-Fly. The provisional international non-proprietary name of the enzyme is now known as “Tarumase”.

Game-Changing Characteristics of Aurase Wound Gel:

Aims to target all elements of TIME wound management paradigm

For all stages of the wound-healing journey

Pain free & not adding to patients’ pain burden

High compatibility with established wound care products

Introductory Video*
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* Aurase Wound Gel is a medical product under investigation. It is not available for sale or commercial distribution anywhere in the world.

Phase IIa Trial Results Demonstrate:

Proof-of-Concept

✓ Tarumase successfully debrides wounds faster
✓ More complete debridement & improved healing at increased enzyme concentrations

Strong Safety Profile

✓ No indications of systemic absorption
✓ No antibody generation
✓ No systemic effects on coagulation

Pain-free

✓ Does not add to patients’ already existing pain burden
✓ No evidence of local tolerability issues

Development Pipeline

Exploring wound bed preparation/wound debridement in chronic ulcers, our first trial targets venous leg ulcers.

References

[1] Chandan K. Sen.Advances in Wound Care.Feb 2019.39-48. http://doi.org/10.1089/wound.2019.0946
[2] Fleischmann W, Grassberger M, Sherman R. Maggot Therapy: A Handbook of Maggot-Assisted Wound Healing. New York: Thieme;2004.
[3] Chernin E. Surgical maggots. South Med J. 1986;79:1143-5.
[4] Whitaker IS, Twine C, Whitaker MJ, Welck M, Brown CS, Shandall A. Larval therapy from antiquity to the present day: mechanisms of action, clinical applications, and future potential. Postgrad Med J. 2007;83(980):409-13.
[5] Fairlamb DM, Szepeshazi K, Goldsmith D, Danos P, Lev-Tov H, Young N, Hanft J, Zelen C. First clinical evaluation of the safety and efficacy of tarumase for the debridement of venous leg ulcers. Int Wound J. 2024  Mar;21(3):e14805. doi: 10.1111/iwj.14805. PMID: 38385795; PMCID: PMC10883251.

The Problem
Wound healing is an extraordinary and complex process, but one that most people take for granted. If a patient has underlying diseases, the healing of wounds might be disturbed and it is found that these wounds no longer close on their own, they become chronic. In the treatment of wounds, in addition to the therapy of the underlying disease, the wound must also be treated, the first step is wound cleansing – debridement. Access and delivery of wound care are both significant problems that challenge patients suffering from chronic wounds. Lack of access to specialised wound care has resulted in amputations and loss of work productivity. In the United States, chronic ulcers are conservatively estimated to cost the health care system $28 billion each year as a primary diagnosis and up to $31.7 billion as a secondary diagnosis. According to the American Diabetes Association (ADA), over 9–12 million Americans suffer from chronic ulcers. The mortality rate for leg ulcers after the first amputation has dramatically doubled from 20% to 50% in the first 3 years to 70% after 5 years. There is a profound psychological impact on the patients suffering from chronic wounds, such as loneliness, separation from active social life, and depression. These psychosocial stressors further worsen healing outcomes.[1]
Venous Leg Ulceration (2021 NICE Guidelines)[2]
  • A leg ulcer is a break in the skin below the knee which has not healed within 2 weeks.

  • Risk factors include obesity, immobility, increasing age, varicose veins, and a history of deep vein thrombosis (DVT).
  • The estimated prevalence of venous leg ulcers in the UK is between 0.1–0.3%, and this increases with age.
  • Complications include chronic pain, infection, contact dermatitis (caused by allergens in creams and dressings), and negative impacts on quality of life and daily functioning.

  • There is a wide variation in published healing and recurrence rates of venous leg ulcers:
    • Six-month healing rates have been reported as 45% for people treated in the community, and 70% for people treated in specialist clinics.

    • Twelve-month recurrence rates range between 26–69%. 

    • Repeat cycles of ulceration, healing, and recurrence are common.

scientist working
Nature's Solution

A number of technical approaches to debride wounds are used today but all have their shortcomings. Surprisingly, nature has its own debridement technology on offer – maggots of the green bottle fly feeding on dead and dying tissue in the wound, leaving behind a clean wound for healing.

In order to feed on the wound debris, maggots apply a wealth of biochemical tools to digest the wound debris. The first use of maggots was likely many centuries ago, with the details now lost. Better records exist for more recent observations, e.g., during an expedition to Egypt (1799), Napoleon’s surgeon, Baron Dominique-Jean Larrey, observed that only “blue fly” maggots removed dead tissue on the soldiers. Larrey and his medical officers also tried to convince the other soldiers of this natural phenomenon.[3]

The first therapeutic use of maggots is believed to have taken place during the American Civil War. John Forney Zacharias, a Confederate medical officer during the war, is arguably the first physician to intentionally expose his patients’ festering wounds to maggots. Fleischmann et al. note that when comparing the Confederate wounded to the Union wounded, most Confederate soldiers’ wounds were left unkempt and maggot-borne.[3] Reportedly, the maggot-infested wounds of the Confederate soldiers healed more quickly than those of the Union army.[4] Fleischmann et al. also wrote that Confederate soldiers were more likely to survive their wounds than their counterparts.[3] Further experience was gained in the ghastly conditions in the trenches of Flanders fields in World War I.

Today maggots have become accepted as a highly-effective way to treat wound suppuration, but, an intervention of last resort because of revulsion evinced by their presence in both wound care team members and patients alike.[5]

Using maggots to clean chronic wounds in a hospital, however, is a challenge in itself since sterile rearing, shipment, and application require highly trained personnel and complex infrastructure. As a result, this approach is not accessible to most patients who may benefit from it.

We used a biomimicry approach to tap into the great advantages of this therapy without its limitations.

aurase t1 gel kit
shutterstock_1182257017
Our Solution

SolasCure’s first product, Aurase®, is a hydrogel containing an enzyme, isolated and cloned from medical maggots.

When looking into the nature of the proteins that maggots express, it became apparent that one dominated the others when feeding on wound debris and interestingly has similarities with digestive proteins found in a large part of the animal kingdom.

We, therefore, focused our research on a way to deliver it in a simple way to patients in an outpatient or home setting.

The medical use of Aurase® is being developed to accelerate wound cleaning. Our goal is to find a solution to painful or inadequate debridement procedures such as surgical or autolytic debridement and improve the outcomes of patients with chronic wounds in all settings: hospitals, nursing homes, or home care.

Through biomimicry, Aurase® illustrates the enormous and still largely untapped potential of biodiversity. We named the protein Aurase® in reference to the German name of the blowfly – Gold-Fly.

Play Video
References

[1] Chandan K. Sen.Advances in Wound Care.Feb 2019.39-48. http://doi.org/10.1089/wound.2019.0946
[2] Venous Leg Ulceration, 2021 NICE Guidelines. https://cks.nice.org.uk/topics/leg-ulcer-venous/
[3] Fleischmann W, Grassberger M, Sherman R. Maggot Therapy: A Handbook of Maggot-Assisted Wound Healing. New York: Thieme;2004.
[4] Chernin E. Surgical maggots. South Med J. 1986;79:1143-5.
[5] Whitaker IS, Twine C, Whitaker MJ, Welck M, Brown CS, Shandall A. Larval therapy from antiquity to the present day: mechanisms of action, clinical applications and future potential. Postgrad Med J. 2007;83(980):409-13.