STAR Trek medicine: coming soon to a doctor near you?

Star Trek is full of cool science-fictiony gadgets, most of which are far beyond the understanding of todays science.    Today, I wanted to write about a new development that now seems related to one of these devices - Star Trek's dermal regenerator.  Dermal regenerators are hand held devices that can be held over cuts, wounds, burns etc. to repair the damage.   Now, a paper in Science magazine has reported on a technique that is at least a small step in that direction.  The paper is Z. Ma et al., Science 377, 751 (2022); unfortunately, Science has a new system for subscribers that defeats my ability to provide a URL.

Today, surgeons seal incisions (either surgical or wounds) using sewing (stitches) or staples.  It works, but is inelegant, and since it involves additional piercing of the skin around the wound, it causes some additional damage.   A worthwhile tradeoff, but not optimal, so doctors have been searching for an alternative.

Adhesives are one obvious alternative, but they have unfortunate limitations which have prevented their use.  In short, living tissue is wet, slippery and pliable - three factors that are difficult for glues.  Pliability is a special problem, since it requires an adhesive that is equally pliable - even after setting.  Otherwise, when the recipient moves, the wound will tear open again. So far, no workable option has been found.  

Now, the Science paper presents a method of using ultrasound to get adhesives to set quickly and strongly.  It starts by adding a solution containing polymers to the wound.  Polymers are long-chain hdyrocarbons that have a tendency to cross-bond with each other.  Think plastics.  This is followed by a hydrogel.  Then, ultrasound is applied - this is where a dermal regenerator  like device comes in - this could be a hand held unit waved over the wound.  The ultrasound performs a couple of functions.  It drives the polymers deeper into the wound.  And, it causes them to spread out and cross-link, forming a strong but flexible network to hold the wound together.  Voila - Star Trek in the 21st century.

It turns out that I am not the only one to make the connection between recent medical developments and a dermal regenerator.  Julia Simpson wrote about some different possible approaches toward a dermal regenerator about a year ago.   She proposed three possibilities, all of which involve adding something to the wound: a matrix of silkworm and spider silk, a specially made biomaterial, and a hydrogel scaffold that would alter the immune system to improve healing.  However, none of these seem to require a handheld device - the need for ultrasound makes this new development closer to a true dermal regenerator.  Another approach, which seems closer to that depicted in Star Trek, would be to use a bioprinter to essentially print replacement tissue to fill in the wound.  

Of course, all of these ideas are quite some distance from routine use in a doctors office or hospital.   And, I should note that I am not a medical doctor, so take this with a grain of salt (or, this being Star Trek, a grain of quadrotriticale).   But, it seems like a really cool idea, and hopefully it will pan out.