Although humans have turned to nature to cure their illnesses for thousands of years, most people in the 21st century turn to modern medicine. But in some instances, even the current technology is not the answer. Live leeches have been used for over 3,000 years to treat all types of diseases and continually are used in modern medicine to relieve congested tissues of oxygen-depleted blood.
But Patrick Cottler, a biomedical engineering research associate at the University, plans to change all of that.
Cottler has combined technology and nature and invented a mechanical device that works as well as a natural leech - with fewer risks.
This mechanical leech - dubbed "Smart Bandage" by Cottler to avoid the negative connotations of a leech - is a small device that mimics the medicinal function of a leech: to draw blood.
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Perhaps the most significant advantage in using the mechanical leech is that it eliminates the chance for infection.
"One of the problems in using leeches is that they are contaminated living organisms," said Richard Edlich, distinguished professor of plastic surgery and professor of biomedical engineering. "Cottler's device is sterile and does the same job."
In terms of efficiency, Cottler said his creation out-performed a real leech in a laboratory experiment at the University's Center for the Engineering of Wound Prevention and Repair.
The device contains two separate parts: the actuator and the reservoir. The actuator is the most essential piece - it has hypodermic needles and adhesive on its underside that stick to the skin. By means of an off-board power unit, it flexes like an inchworm to create the negative pressure necessary for drawing out blood.
When Cottler receives additional funding he plans to add an on-board battery supply to the mechanism.
The second part of the device is a replaceable reservoir that collects the stagnant blood.
"The use of the mechanical leech is much more controlled and standardized," said Dr. George Rodeheaver, director of plastic surgery research at the University Hospital. "It has none of the negative consequences of leeches, including scarring and infection."
Cottler said he got the idea for the project as a first-year graduate student in biomedical engineering at the University after he found the use of real leeches in modern medicine surprising.
"I thought, surely we can invent, develop or design something that mimics this," he said.
The modern use of leeches, a practice called hirudotherapy, is limited to plastic or reconstructive surgery, specifically the area of microvascular surgery.
During these types of procedures, the vascular network of veins and arterioles in the skin are severed.
After a surgery, however, complications can arise while reattaching the arteries to reestablish blood flow.
If the oxygen-rich blood in the arterioles is unable to get into the skin, only stagnant, oxygen-depleted blood will remain in the tissues. This can traumatize and even kill the tissue.
"Leeches are not used often; they are a last resort, when we have tissue compromised by stagnant blood flow," Rodeheaver said.
Leeches become critical in those situations. The withdrawal of oxygen-depleted blood makes room in the skin for fresh blood to flow into the vascular network, which nourishes the tissue.
"Leeches buy the body time to do what it would normally do, which is to create new blood vessels to allow stagnant blood to get out," Cottler said.
The new mechanical leech could expedite this process. Unlike live leeches, which can take anywhere between 10-24 hours to arrive, these would be available immediately for use.
In addition, Cottler's creation might alleviate patients' concerns about using a live organism.
"The idea of eliminating or replacing a leech has to do with the fear and disgust of using a real leech," he said. "People are more averse to using a leech than a device."
A unique characteristic of Cottler's device is its usefulness as a preventive measure in damaged tissue.
"Congestion typically occurs within 24 to 48 hours after surgery. Since this device is sterile and off the shelf, it can be used prior to when a [live] leech could be used," he added.
Cottler now is awaiting a grant to begin clinical trials. He expects to start testing in about a year, after he undergoes the approval process from the Food and Drug Administration.
In the meantime, he has designed a computer simulation program so that he can finalize the mechanism.
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