Re-engineering Stump Skin

Colin and Sharad both joined the lab in November 2017 to work on the 'Re-engineering Stump Skin' project. The goal of this EPSRC funded research project is to engineer stump skin to increase its' load bearing capacity.

Pressure ulcers develop in skin and muscle subjected to high or prolonged external loads. They affect 18% of all hospital patients, and their treatment cost the NHS £2 billion annually. Lower-limb amputees are a high-risk population for pressure ulcers due to the interaction between the prosthesis and the skin and muscle of the residual limb. Pressure ulcers rarely form at healthy palmoplantar sites (the palms and soles of the feet), and we know the skin on these sites have distinct differences compared to other sites.

These observations lead us to propose an alternative preventative therapy for pressure ulcers. Instead of focusing on prosthesis design we decided to focus on redesign of the interface between the prosthesis and the body-i.e. the skin. We proposed to re-engineer skin on the residual limb to better withstand pressure, and thus reduce the incidence of pressure ulcers. In this EPSRC-funded project, we aim to further understand the differences between palmoplantar skin versus skin found on other body sites. We aim to show that non-plantar epidermis can be directed towards a more plantar-like phenotype, and that this could protect against pressure ulcers.

Colin uses mathematical modelling to investigate the effect of skin structure and properties on stresses and strains in the residual limb. He uses mechanical testing at the macro and micro scale to investigate the unique properties of plantar skin.

Sharad is using a combination of transcriptomics and cell culture techniques to determine biological differences between reprogrammed skin cells versus non-reprogrammed skin cells. He develops 3D skin constructs designed to mimic native skin.