Rory Donnelly, clinical research director of Copper Clothing, examines copper’s potential for wound dressings after a randomised study showed they created a significant reduction in postpartum surgical site infection following a caesarean section.
Wound and surgical site infections (SSI) pose a significant problem in healthcare today. In fact, according to NICE, SSIs have been shown to account for up to 16% of all healthcare-associated infections in the UK.
Not only do they threaten the lives of patients, they also increase the threat of antibiotic resistance. This alone is expected to kill more people than cancer by 2050. That equates to over 10 million people a year worldwide. It’s therefore clear we need to find new and innovative ways of reducing infections in hospitals across the globe.
Copper can be the solution. The material has been around for millennia. As early as 2600-2200 BC, the Egyptians used green copper rust for the treatment of chest wounds and to sterilise drinking water. But its use in the modern medical space is yet to be fully realised.
So how exactly can copper be applied in a clinical setting to prevent infection?
Research into copper infused medical devices
In 2012, Copper Clothing made a breakthrough when Professor Bill Keevil, University of Southampton, carried out in-vitro testing on our copper and bamboo fabric, highlighting that the copper ions kill MRSA on contact. The initial kill rate for the first 30-40 minutes of contact on the copper nylon fabric was actually faster than 100% pure copper metal.
This year, a team of experts from NHS Croydon University Hospital conducted a study in partnership with our team at Copper Clothing. The double blind randomised controlled trial involved 324 women. 159 were randomised to the study group and 165 to the control group. The studies aim was to investigate the effect of copper impregnated wound dressings on the surgical site infection (SSI) rate following caesarean section (CS).
The findings were published in the European Journal of Obstetrics & Gynaecology and Reproductive Biology. It found that copper caesarean wound dressings not only demonstrated a significant 38.7% reduction of overall Surgical Site Infection (SSI) rate, but also a significant 80.3% reduction of organ/space SSI.
This is outstanding. It is the first study of its kind that demonstrates a significant reduction in SSI rates following caesarean section with the use of copper impregnated wound dressings.
In another recent test at a world-renowned Dermatology Centre in the UK, the Copper Clothing team was able to independently validate in human trials that its copper plasters resulted in a more than 90% reduction in medial bacteria count when compared to a global leading silver plaster brand.
Copper infused plasters perform better than standard and silver plasters against common skin bacteria which are typically responsible for infections of open wounds. Not to mention at a significantly lower cost than silver, it is estimated that the NHS alone spends over £20 million a year on silver dressings.
Copper infused dressings can therefore reduce infection, reduce the number of complications and save hospital resources. With an increasingly burdened health system, these new infused dressings have the power to bring about significant changes for the better.
How copper works to prevent infection
The reason copper is so effective at preventing infection is because of its oligodynamic effect. This is the ability of small amounts of certain metals to exert a lethal effect on pathogenic cells. Some metals are more effective than others, but copper has been identified to be the most potent and cost-effective, due to its reputation for being one of the best conductors of electricity.
The copper ions cause a schizophrenic reaction which electrostatically rupture and destroy the outer cell membrane of any pathogenic microbe it encounters. By puncturing the outer cell membrane of a bacteria or virus, the copper ions are then able to destroy the RNA or DNA to prevent the cell from replicating. This is important to understand as without the RNA or DNA, the microbe can no longer replicate and therefore become resistant to copper. This is not the case for antibiotic treatments, where increasing resistance is occurring.
A materials revolution?
Dressings are yet to see a fundamental shift in their material construction. While iodine and sterilised strips are effective to an extent, we need new cutting-edge solutions if we are to free up time, resources and prevent further loss of life.
The widespread introduction of copper impregnated materials across obstetrics and gynaecology could have a significant impact. Copper should be used as the first tool in the ‘infection armoury’, as a front line of infection prevention across a range of applications in a clinical setting. As an antimicrobial, abundant and sustainable resource, it can be integrated easily into any material for medical purposes, whether that be on hospital door handles or into catheters.
It is now apparent that our thinking is being shared by healthcare bodies. After the success of Copper Clothing’s first three wound dressing trials showcasing the power of copper technology in a clinical setting, NHS Croydon University Hospital is conducting a new study with us this year. This will continue to explore the impact of copper on other types of wounds and will involve 3,000 participants.
More research needs to be conducted into copper’s application in infection prevention to continue to prove its effectivity across all applications. But our indications look very promising. Not only can it free up resource for healthcare systems globally, but it has the power to help areas hit by natural disaster where antibiotics may be limited, or resistance is high. For both developed and developing countries, we need to start looking at introducing new ways of disease prevention. Infusing copper into our medical devices on a large scale seems the most logical next step.
