Continuous streaming therapy gets under your skin

‘Chronic hard-to-heal wonds are a huge medical problem. Over the last few years, the health care community has been moving towards advanced wound management treatment and wound care products,’ says Dr. Allon Leibovitz, CEO of Enzysurge.If you’ve ever had an …

‘Chronic hard-to-heal wonds are a huge medical problem. Over the last few years, the health care community has been moving towards advanced wound management treatment and wound care products,’ says Dr. Allon Leibovitz, CEO of Enzysurge.If you’ve ever had an open wound, you know how long it takes to heal. Whether a result of burns, bedsores, or ulcers in the skin, these are types of serious damage that usually don’t heal spontaneously and require constant medical intervention and conventional bandaging is often useless in promoting the healing process.

An innovative concept called ‘continuous irrigation’ which is being developed by Israeli startup EnzySurge offers relief for the 18 million people around the world who suffer every year from these painful ailments.

A treatment concept based on ongoing moisturizing of the wound with active biological solutions to significantly accelerate the healing process, continuous streaming has never been attempted before, according to EnzySurge’s dynamic CEO Dr. Allon Leibovitz.

“Chronic hard-to-heal wounds are a huge medical problem. Over the last few years, the health care community has been moving towards advanced wound management treatment and wound care products,” he told ISRAEL21c.

“These kinds of wounds have traditionally been treated by gauzes, or by surgery, which is very tedious and has to be repeated sometimes, because it doesn’t bring the wound to closure.”

According to Leibovitz, the advanced wound management sector has grown at a tremendous pace in the last 10-15 years, with sales expected to reach $4.5 billion in the US and Europe within two or three years.

“With all those products being marketed, you’d imagine that there’d be something like what we’re trying to do, but there isn’t. There are a lot of advanced products – most are dressings containing some kind of biologically active material. But continuous streaming hasn’t existed in medicine as a concept,” said Leibovitz.

What does continuous streaming actually do?

“It lets the therapeutic fluid – whatever it may be, a saline solution, an antibiotic solution – stream continuously over the wound bed. This augments its efficacy and its therapeutic effect on the wound. It lets the therapeutic fluid stream over the wound cleansing the debris – the wound remains moist, which is crucial for this type of injury,” said Leibovitz.

The science behind EnzySurge comes from the lab of its founder – Prof. Amihai Friman, a veteran researcher in the Tel Aviv University Bio-Technology Department.

“Prof. Friman developed the concept of continuous streaming of therapeutic fluids over wounds. He actually brought in his experience in bio-catalytic processes – working with enzymes for industrial purposes – he’s an authority on this subject,” said Leibovitz

“He just adapted the experience to the medical arena and brought in the concept of continuous streaming that forms the basis of EnzySurge’s technology.”

There are basically three large groups of wounds which EnzySurge’s technology is designed to heal – diabetic foot ulcers, pressure ulcers and venous ulcers.

- A pressure ulcer is an area of skin that breaks down when you stay in one position for too long without shifting your weight, commonly known as bedsores. This often happens if you use a wheelchair or you are bedridden, even for a short period of time (for example, after surgery or an injury). The constant pressure against the skin reduces the blood supply to that area, and the affected tissue dies.

- A pressure ulcer starts as reddened skin but gets progressively worse, forming a blister, then an open sore, and finally a crater. The most common places for pressure ulcers are over bony prominences (bones close to the skin) like the elbow, heels, hips, ankles, shoulders, back, and the back of the head.

- Venous ulcers are sores that develop after veins in the legs have been damaged. These ulcers penetrate deep into the skin. Venous ulcers are relatively common among older people, and they can become infected easily.

- Diabetic foot ulcers are non-healing sores that extend to the subcutaneous tissue or beyond and are the leading cause of amputation among people with diabetes.

“All three kinds of these wounds are hard to heal – they won’t heal spontaneously, they’re labor-intensive to health care providers, and take up valuable hospital beds,” said Leibovitz.

Instead of simply bandaging the wound and having to frequently change the dressing, EnzySurge’s first product – DermaStream – does just what it sounds like: it streams solutions onto the chronic wounds, thereby removing necrosis and infective agents from the wound effectively and quickly.

Leibovitz explained that the therapeutic fluids could be of several types – from simple saline solutions which are very important for treating the wound – to other fluids like antibiotics added to the solution based on a physician’s instructions.

“We also provide an occlusive dressing, a protective cover. And lastly, and very important, we provide the wound with ‘negative pressure,’” – a vacuum-assisted therapy which Leibovitz calls a “rising star” over the last few years in the area of wound management.

Leibovitz, a Haifa native, who attended one of Israel’s most prestigious high schools – the Reali school – studied medicine and later received his MBA at Tel Aviv University. He practiced medicine for several years, but over the last decade, switched his focus to working on product development for startups “in one stage or another,” including clinical software and medical device companies.

Personable with impeccable unaccented English – “I learned my English from watching Starsky and Hutch as a kid” – he is evangelical when talking about the potential that EnzySurge holds in the field of wound management.

EnzySurge was established in 2001 as part of the Misgav Technology Center incubator program, in partnership with Ramot, the technological arm of Tel Aviv University, and the venture capital fund Israel Technology Partners.

“The company was part of Misgav for two years – that’s the usual course of events, and then they raised money from private investors, and towards the middle of 2004 hired me to turn it into an independent company. Misgav is still affiliated as a shareholder, but we’re no longer officially an incubator company,” said Leibovitz.

In October 2004, the company raised $1 million in its first round of financing, and recently completed another round, raising an additional $750,000 in capital.

“We’ve started multi-center studies in Israel testing Derma-Stream for continuous treatment of saline. And we’ll expand the trials to the US and Europe soon. We expect to begin marketing at the end of the year, or early in 2007,” said Leibovitz.

But it doesn’t end there. While working on the delivery system, EnzySurge is also developing its own solutions to be streamed. Currently, the company is completing the preclinical development of its second such product, EnzyStream, a biologically active solution for debriding (removing all of the dead tissue) chronic wounds.

According to Leibovitz, the solution has already been shown to be feasible and safe for use, and will be marketed in a kit along with DermaStream.