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Annual Report 2016-2017


Contents 01 Executive Summary Achievements CRC Operational Units Research and Collaboration An empowered workforce Streamlined CRC Management Optimising Outcomes Millions of Australians Becoming Wound Aware Commericlisation and Utilisation Risks & Impediments Impacts

3 3 4 4 5 5 5 6 6

02 Annual Report Performance Against Activities Publications Education and Training Utilisation and Commercialisation Intellectual Property Management SME Engagement Communications Governance Participants Collaboration Financial management Future Plans and Transition Arrangements Other Activities

7 9 10 12 14 14 16 20 24 25 26 26 27

ŠWound Management Innovation Cooperative Research Centre, 2017 Head Office: Oxley House Level 2, 25 Donkin St West End QLD 4101 www.woundcrc.com + 61 07 3088 6666 enquiries@woundcrc.com


WOUND CRC ANNUAL REPORT 16-17

01 Executive Summary The Wound Management Innovation CRC (Wound CRC), now in its seventh year, continues to bring together academia, research and industry to transform wound outcomes in Australia. Research and educational packages developed over the course of the CRC are now delivering optimised patient care pathways for the treatment and prevention of chronic wounds. These packages are reaching thousands of clinicians in multiple care settings across Australia and thus affect thousands of patients. In addition, the research conducted by Wound CRC has been instrumental in defining and validating optimal patient care utilising multidisciplinary teams. This year, the CRC has considerably progressed its final milestones and strategic objectives by establishing operational units that together will form a long-term legacy of the CRC.

Achievements

In March 2017, the CRC launched Wound Innovations, Australia’s first dedicated multidisciplinary evidence-based treatment, education and research centre. Wound Innovations is transforming the wound industry through leveraging the CRC’s previous research and crystallising Participant and end-user collaborations to improve patient outcomes. Ultimately, the service will reduce avoidable hospitalisations and begin to address the multibillion dollar burden of chronic wounds.

The CRC has aligned the majority of activities toward these legacies which are already influencing best-practice care in Australia. These legacies and CRC outputs will continue to drive the use of best practice wound care and research beyond the CRC’s term, reducing the burden of chronic wounds on the Australian health care system into the future. The culmination of many of these legacies is in the entity Wound Innovations. Wound Innovations is establishing Australia as a leader in wound care globally through practicing optimal patient care, measuring the health economics of best practice and providing clinical education and research.

Research Translation – CRC Operational Units

Wound Healing Institute Australia is a CRC spin-out company, delivering certificated and accredited online learning and audit and research assets that are utilised across the CRC’s research activities. The online modules are interactive, using 3D images, simulation techniques and videos including case studies and quizzes to support professional education.

Healthy Ageing Node/Healthy Healing and Prevention: The CRC is partnering with aged care facilities nationally and key Participants to identify the prevalence and cost of wounds in aged care and implement cost-saving strategies to promote healthy ageing. The Node leverages WHIA’s educational, audit and prevention tools, and engages with medical device companies to research cost effective solutions that yield best practice wound care. This strategy has delivered incredible outcomes. For example, two test facilities reported a 43.8% reduction in preventable wounds and a 54.2% reduction in pressure injuries 12 months after implementation of a customised healthy ageing strategy.

Wound Credentialing: the CRC designed and built a wound clinician credentialing platform in collaboration with a steering committee of industry experts and key Participants. This system is currently in a roll-out phase to become operational in 2018.

Diabetic Foot Australia (DFA), launched in 2015, is an Australian peak body charged with raising awareness of and reducing the burden of diabetic foot disease with a long term aim of ending avoidable amputations within a generation. DFA educates and empowers health professionals through the provision of educational materials, arming health professionals with the latest research and patient resources, and enabling industry collaboration through a clinical research network. In September 2017 DFA held the first Diabetic Foot Australia conference, the largest gathering of the world’s diabetic foot thought leaders in the Southern Hemisphere and launched the Australian Diabetes-Related Foot Disease Strategy 2018-2022.

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WOUND CRC ANNUAL REPORT 16-17

Achievements Research and Collaboration

The CRC’s research activities for FY16-17 have been focused on collaborative projects with industry including:

• • • •

• •

5 major randomised controlled trials, designed to address fundamental gaps in the wound care treatment and prevention evidence base Simplification of wound dressing selections through industry-led projects Development of a perineal wound care module to be implemented into the WHIA education suite. The project is developing an evidence base on perineal wound prevention and treatment in addition to epidemiology of female genital mutilation Working with SMEs to embed research into product development, including supporting definitive pre-clinical proof of concept models for the use of the Flightless monoclonal antibody in the treatment of epidermolysis bullosa and developing technology to incorporate bioactive polysaccharides derived from seaweed into wound dressings. Development phase projects, including new materials for negative pressure wound therapy, using bidirectional evolutionary structural optimisation techniques for which Wound CRC researcher Prof. Mike Xie was awarded the 2017 Clunie Ross Innovation Award from Australian Academy of Technology and Engineering (ATSE). Translating research outcomes into clinical practice is underpinned by the CRC’s investment in health economics analysis that demonstrates the cost effectiveness of improving wound care to the health system. Health economics research outcomes this year included: Informing policy and improving practice in aged care – including demonstrating the efficacy of moisturising protocols, Risk Assessment Tools, skin audits and other continuous improvement strategies Making the case for implementation of best practice wound care via the Plenary talk at the 2016 Wounds Australia Conference (Health economics; measurement/the case for wound funding and cost shifting), and opening address at the 2nd World Congress on Health Economic Policy & Outcomes Research.

Ministerial level engagement with a view to furthering reimbursement of compression garments for the treatment of venous leg ulcers on the Medical Benefits Schedule. Establishing clinical studies to provide accurate data on the costs of wound care both in community nursing organisations and in wound clinics. Publishing a cost-effectiveness analysis demonstrating that implementing best practice care for diabetic foot ulcers would provide savings to the Australian health system of AUD 2.7 billion over 5 years.

An Empowered Workforce Through WHIA, the CRC has empowered the wound care workforce with over 2,000 health professionals each month engaging in accredited online education. The uptake of WHIA’s online training continues to grow with several state health and SMEs incorporating the program as a part of their staff professional development. Utilising the WHIA learning platform, The Healthy Ageing Node has transformed Registered and Enrolled nurse wound knowledge in test residential aged care sites with a 121.6% increase in average knowledge scores. Through the Healthy Ageing Node, the CRC also delivered education workshops, webinars and presentations in concert with Industry Participants including Hartmann Pty Ltd, Acelity, Southern Cross Care (SA & NT), Wounds Australia and 3M Pty Ltd, which were attended by over 670 clinicians across 13 events. The CRC is in the final phase of its HDR education program and is proud to have graduated 23 PhDs, 6 Masters, 9 Honours with the remaining cohort completing in 2018/19. These graduates will continue the CRC’s legacy through innovative wound research and education, with 3 graduates with lectureships at Australian universities. The CRC has continued to support its HDR and ECRs with a special workshop and competition for the CRCA Early Career Researchers Competition. Additionally, CPD seminars and workshops were held by Diabetic Foot Australia and Wound Innovations for professionals working at the frontline of wound care and the CRC-funded clinical evidence summaries have been accessed over 80,282 times.

Below: Dr Charlie Day (CEO, Innovation & Science Australia), Mr Stephen Carmody (CRC Director), Dr Ian Griffiths (CEO), Dr Susan Pond (CRC Director), Ms Jenny Flood (CRC Programme), Prof. Rob Sale (CRC Chairman)


WOUND CRC ANNUAL REPORT 16-17

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Above from top left: some of the Wound Innovations clinical team, Dr Michelle Gibb, Nurse Practitioner, with Wound Innovations patient, Studio 10 live TV segment for Wound Awareness Week and Dr Japp van Netten of Diabetic Foot Australia filmed for Channel Nine news.

Streamlined CRC Management Optimising Outcomes With the support of the CRC Programme, the CRC executive have defined a system of streamlined administration that enables research to be industry-focused and outcome-driven. This team will successfully wind up the Wound CRC in 2018 and incorporate the existing operational areas to allow for the succession and legacy of the CRC.

Millions of Australians Becoming Wound Aware The Wound CRC partnered with CRC Participant Wounds Australia to design, develop and implement a landmark wound awareness campaign. The CRC created a visual identity for the campaign that is professional, memorable and provides a face to the campaign for years to come. This nationwide health awareness campaign generated publicity and raised awareness of the wounds issue through a highprofile ambassador, Denise Drysdale. The campaign also garnered substantial media attention including a prime time segment, national print media and a broadcast to over 900 GP clinics.

Direct Patient Impact Australia-Wide As a part of the Wound Innovations service model, the CRC has established a national telehealth infrastructure. This allows clinical support to improve health outcomes into even the remotest part of Australia. Initial patient outcomes clearly demonstrate the benefit of research-based, best practice and holistic care.

Commercialisation and Utilisation CRC research into clinical practice, health economics and education continues to be utilised and commercialised via the CRC’s operational units (see page 3). As the CRC’s project portfolio matures, the CRC has entered into Utilisation Agreements on several projects which enables University partners to engage in licensing activities for the new diagnostics, prognostics, treatments and technologies developed by the CRC. The CRC is continuing to support development of an imaging technology and a new material for negative pressure wound therapy. CRC development work has yielded three new patents in FY16-17. CRC risk assessment tools have been embedded in a freely downloadable multi-platform app and bioinformatics software has been integrated into the Mixomics multivariate analysis software suite available globally under an GNU Public Licence. The CRC has developed a series of 25 evidence summaries, providing busy clinicians with a guide to recommended practices supported by evidence in a format that is current, valid, reliable and relatively easy to translate into practice. These summaries are hugely successful, with total downloads of 80,282 since the inception of the CRC project creating the summaries.

• • •

Venous leg ulcer risk tools: www.vlur-risk-tools.org.au Bioinformatics tools: http://mixomics.org/ Evidence summaries: http://www.woundsaustralia.com.au/ journal/index.php


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WOUND CRC ANNUAL REPORT 16-17

Risks & Impediments Risks and impediments are evaluated regularly by the Executive and Management teams and a risk register is maintained and reviewed by the CRC Governing Board. The Wound CRC has continued to pro-actively manage risks relating to delivery of outcomes within the remaining Commonwealth-funded time-frame, and has judiciously reviewed all projects to ensure that they will deliver the contracted outcomes, or terminated projects where substantive outcomes are not achievable. This has included terminating development projects where the probability of impact from a commercial return and achievement of CRC milestones relative to project progress and current competitive landscape was reassessed and found to be unlikely. Termination of these projects will impact some product development related milestones. However, these milestones would not have been met in the time-frame of the CRC’s term if the projects had continued. So the CRC chose to strategically reallocate resources to projects that would achieve milestones. The CRC also reviewed the proposed legacy entities

and prioritised support for near term impacts on patient outcomes, specifically Wound Innovations and Wound Healing Institute Australia. Project Milestones contingent on student completions and graduate employment continue to be impacted by the length of time the examination phase can take, and student leave of absences. The CRC has implemented a completion bonus scheme to reward completion, and encourage the students to remain engaged with the CRC through the examination phase. The Wound CRC takes financial risk seriously, and the revised financial management system introduced in 2015-2016 has significantly improved financial processes. This is evidenced by increased Participant contributions and a significantly reduced audit burden.

Impacts The CRC completed a thorough review of the Impact Tool in September 2015 to align it with the CRC’s transition plan. In preparation for the annual report in 2016, and again for this year the CRC has reviewed the Impact Tool relative to expected benefits. In the first half of the CRC’s final year, the CRC will be determining the strategy for sustainability of each of its major legacy vehicles, which will underpin the overall impact of the CRC. The alternative strategies possible for each of the legacy vehicles and the CRC’s

Below: Wound Innovations launch media event

development assets under consideration provide variability around the impacts and limited formal modelling. Hence the Impact Tool will be updated once key strategic decisions relating to these project outputs have been made.


WOUND CRC ANNUAL REPORT 16-17

02 Annual Report Performance Against Activities Research Program 1: Enabling Technologies

Educational and dissemination outputs to date (Output 1.5, ongoing) include: • 21 PhD, 9 Honours and 6 Masters students commenced • 7 Honours, 4 Masters, 9 PhD students completed (with a further 2 submitted) against a target of a minimum of 15 PhD and 15 Honours student completed by 30th June 2018. • 34 refereed papers, 3 review articles and 1 book chapter published to date exceeding the target of 30 papers to June 2018. • 3 patents (target 1 patent by June 2018) • 68 conference presentations against a target of 16 by June 2018.

Research Program 1 focused on improved understanding of the wound micro-environment and the application of this knowledge to identify new diagnostics, prognostics and therapeutics, including pre-clinical models. All projects in Program 1 have now completed, with the majority of outputs achieved. The program developed new bioinformatics tools available to researchers worldwide through incorporation in the Mixomics analysis suite (Output 1.3, complete). Interrogating the world’s largest wound fluid database (Output 1.1, complete) yielded protein and microbial markers associated with wound healing that are under consideration for development external to the CRC (Output 1.2, complete). In vitro and in vivo pre-clinical models developed under Output 1.4 (ongoing) continue to support evaluation and pre-clinical testing of new wound therapies. This program has contributed substantially to increasing the understanding of wound micro-environment with 34 journal articles providing a comprehensive update of wound biology across research areas such as the biochemical and microbial profiles of healing and non-healing wounds, proteomic analysis of burns and scarring, wound cell biology, and bioinformatics approaches to analysing multivariate wound data sets.

378

Total publications as at FY 16-17, consisting of:

220

Conference presentations

Research Program 2: Tools and Therapies Research Program 2 is focused on the development of new wound management products including bioactives, diagnostics and dressings. The CRC has matured a number of technologies under the program and transferred them to University Participants for Utilisation and licensing and is continuing to support imaging and wound closure technologies. Due to the cost of development and long time lines involved in early stage therapeutic development, as part of the third year review, the Wound CRC de-prioritised development of bioactives discovered under Output 2.1. However, projects funded as part of Output 2.1 did yield 4 journal publications and 2 completed PhDs.

147 Papers

8

Reviews

3

Book chapters

7


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WOUND CRC ANNUAL REPORT 16-17

The CRC has now completed all milestones for Output 2.2 (at least 5 new prototype wound diagnostics and prognostics that will guide clinical decision making) including manufacturing a smart insole minimum viable product prototype and testing in a clinical study. The CRC has transferred pH and temperature sensitive sensors, hyperspectral imaging, wireless sensor dressing and pressure sensing insole technologies developed under Output 2.2 to University Participants for Utilisation and licensing. Prototype advanced wound care products developed under Output 2.3 have yielded 11 patents, with several products under review by medical device companies. The CRC’s Development Advisory Committee (DAC) has continued to provide valuable assessments and recommendations to ensure that the development portfolio aligns with commercial realities. The CRC completed clinical trials of first generation ischemia sensing hyper-spectral imaging technology and pressure sensing insoles, and after review by the DAC returned the technologies to Participant Universities for further research and development. The CRC has continued to align new product development with industry norms via the DAC and using expert consultants on individual projects where external support is required (Output 2.4). Educational and dissemination outputs to date (Output 2.5 ongoing) include:

• • • • •

18 PhD students commenced; 8 completed, 2 submitted against a target of a minimum of 11 PhD students completed 4 Honours students commenced and 2 completed 41 papers and 4 reviews, 2 book chapters to date (against a June 2018 target of 15) 48 conference presentations against a June 2018 target of 15. 11 patents filed (against a target of 7)

Research Program 3: Clinical Application Research Program 3 is focused on delivery of best practice wound care, including conducting clinical studies, developing risk assessment tools and translating evidence-based care into practice, including education of health-care practitioners. This Research Program continues to focus on the delivery of best practice wound care with key activities surrounding clinical research and its translation to adapt to an environment of constrained health-care budgets and growing patient need. The Program also supports the legacy vehicles for the CRC. For example, researching the clinical consensus required to develop a new module for perineal wound care and measuring the real cost of treating wounds, data that underpins the CRC’s health economics activities. The CRC has established 20 proof of concept clinical trials on new wound interventions (dressings, therapies, diagnostic/prognostic tools and devices) or existing interventions with a limited evidence base (Output 3.1, total target of 9 studies). 11 of these significant clinical studies have now completed, including major randomised controlled trials (RCTs) comprehensively demonstrating the efficacy of the use of moisturiser in the prevention of skin tears in hospitals and aged care, smaller proof of concept studies testing new medical devices (smart insoles and hyper-spectral imaging), preventative strategies including exercise and social media gamification to deliver public health messages, and prognostic risk assessment tools. Six studies are ongoing and are expected to complete in the first half of 2018. Two additional studies closed early on the grounds of poor patient recruitment and increased risk to patients from the device combination. As clinical studies complete and report, the

CRC is focused on dissemination and embedding outcomes into best practice (Utilisation Milestone 3.1). The CRC’s Health Economics Lead Dr Rosana Norman presented the opening Plenary talk at the 2016 Wounds Australia Conference which also featured 20 presentations disseminating outcomes from CRC projects, and to date study results from Program 3 have been published in 72 papers. In addition to building an efficacy base for interventions that enhance wound healing, the CRC has developed wound risk assessment tools for preventing wounds which are now being disseminated and the CRC has catalysed the uptake of preventative strategies in the aged care and hospital sectors (Output 3.2). In two aged care test sites, these approaches reduced pressure injuries by 54% and skin tears by 48% over 12 months. Prospective studies on prevention strategies for pressure injury prevention in the aged care and intensive care settings are ongoing. Research outcomes demonstrating effective wound prevention strategies from our RCTs have been integrated into CRC education packages and internationally recognised evidence summaries and implemented in residential aged care and hospital settings (Output 3.3). As part of the CRC’s legacy planning, the CRC has a suite of educational resources that provide recognised professional education for clinicians, in the form of online modules via WHIA, face to face training at Wound Innovations, and training/education outreach sessions (Output 3.4). Student educational and research dissemination outputs to date (Output 3.4 ongoing) include:

• • • • •

13 PhD students commenced; 6 completed, 1 submitted against a target of a minimum of 6 PhD students completed 5 Masters students commenced and 2 completed against a target of 4 Honours students completed 72 papers and 1 review article 104 conference presentations 1 Patent


WOUND CRC ANNUAL REPORT 16-17

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Publications FY17 (listed by research project) CR02

Q Cheng, P.A. Lazzarini, P Derhy, E Kinnear, E Burn, N Graves, R Norman (2016). A cost-effectiveness analysis of optimal care for diabetic foot ulcers in Australia. International Wound Journal, 14(4), pp 616 -628.

CR04

J. van Netten, M Babe, P Lazzarini, (2017). Epidemiology of Diabetic Foot Disease and diabetes-related lower-extremity amputations in Australia: a systematic review protocol. Systematic Reviews, 6, pp101.

CR14

K. Price, K. Kennedy, T.L. Rando, A. Dyer, J Boylan (2017). Education and process change to improve skin health in a residential aged care facility. International Wound Journal, 10.1111/iwj.12772.

RP1.19

T. Zang, D.A. Broszczak, L. Cuttle, J.A Broadbent, C. Tanzer, TJ Parker, (2016). Mass spectrometry based data of the blister fluid proteome of paediatric burn patients. Data in Brief, 8, pp 1099 – 1100.

RP2.11

J.S. Oh, E.J. Szili, N. Gaur, S.H. Hong, H. Furuta, H. Kurita, A. Mizuno, R.D. Short (2016). How to assess the plasma delivery of RONS into tissue fluid and tissue. Journal of Physics D: Applied Phsyics, 49, pp30.

2.16

A. Ghaedizadeh, J. Shen, X. Ren, Y.M. Xie, (2016). Designing composites with negative linear compressibility. Materials and Design, 131, pp 343-357.

RP3-05

Parker, C., Finlayson, K. J., and Edwards, H (2016 Ulcer area reduction at 2 weeks predicts failure to heal by 24 weeks in the venous leg ulcers of patients living alone. Journal of Wound Care, 25(11) pp626-634.

RP3.14

E.Haesler (2016). Evidence Summary: Lymphoedema: skin care. Wound Practice and Research, 24(4), pp 266-268. E.Haesler (2016). Evidence Summary: Managing Lymphoedema: compression therapy. Wound Practice and Research, 24(4), pp 263-266. E. Haesler (2017). Evidence Summary: Single modality treatment of lymphoedema – Exercise. Journal of Wound Practice and Research, 25(1), pp52-55. R Watts, E Frehner (2016). Evidence Summary: Wound management-low resource communities: citric acid as a topical antiseptic. Journal of Wound Practice and Research, 24(3), 184-186. R Watts, (2016). Evidence Summary: Wound management: larval therapy. Journal of Wound Practice and Research, 24(3), 180 – 182.

RP3.30

K. Sandy-Hodgetts,G.D Leslie, N. Zeps, R Parsons, K. Carville, (2017). Prevention of post-surgical wound dehiscence after abdominal surgery with NPWT: a multicentre randomised controlled trial protocol. Journal of Wound Care, 26(Sup2). S23-S26.

K.Sandy-Hodgetts,K Ousey, L. Howse (2017). Top Ten Tips: surgical wound dehiscence, clinical management. Wounds International, 8, pp11-14. K Sandy-Hodgetts, G.D. Leslie, G. Lewin, D. Hendrie, K. Carville (2016). Surgical wound dihescence in an Australian community nursing service: time and cost to healing. Journal of Wound Care, 27(1), pp 377 – 383.

RP3.36

S. Boxall, K. Carville, G. Leslie, S. Jansen (2017). Treatment of anticoagulated patients with negative pressure wound therapy. International Wound Journal. doi: 10.1111/iwj.12737

RP3-38

Monica Diaz, Mary Steen (2017). Perineal wound care: Education and Training in Australia. Australian Nursing and Midwifery Journal, 24, pp 41.

SP05-2

Cramer A. D., Dong, W., Benbow, N. L. Webber J. L., Krasowska, M., Beattie, D. A., Ferri, J. K., (2017). The influence of polyanion molecular weight on polyelectrolyte multilayers at surfaces: elasticity and susceptibility to saloplasticity of strongly dissociated synthetic polymers at fluid–fluid interfaces. Physical Chemistry Chemical Physics, 19(35), pp 2378123789. Benbow. N. L., Webber J. L., Karpiniec, S. Krasowska, M., Ferri, J. K., Beattie, D. A, (2017). The influence of polyanion molecular weight on polyelectrolyte multilayers at surfaces: protein adsorption and protein–polysaccharide complexation/stripping on natural polysaccharide films on solid supports. Physical Chemistry Chemical Physics, 19(35), pp 23790-23801.

SP08-3

Burgess JD, Kimble RM. Cameron CM, Stockton KA, (2016). Hot Beverage Scalds in Australian Children: Still Simmering 10 Years On. Journal of Burn Care and Research, 37(4), pp 335 -339. Burgess JD, Cameron CM, Watt K, Kimble RM (2016). Cool Runnings - an app-based intervention for reducing hot drink scalds: study protocol for a randomised controlled trial. Trials, 17(1), pp338. J.D. Burgess, C.M. Cameron, L. Cuttle, Z. Tyack, R.M. Kimble (2016). Inaccurate, inadequate and inconsistent: A content analysis of burn first aid information online. Burns: Journal for the International Society of Burns Injuries, 42(8), pp 1671 – 1677. Burgess JD, Kimble RM, Watt K, Cameron CM (2017). Hot tea and tiny tots don’t mix: A crosssectional survey on hot beverage scalds. Burns, S0305-4179(17)30300-5

SP09-2

Jun-Seok Oh, Xanthe Strudwick, Robert D. Short, Kotaro Ogawa, Akimitsu Hatta, Hiroshi Furuta, Nishtha Gaur, Sung-Ha Hong, Allison J. Cowin, Hideo Fukuhara, Keiji Inoue, Masafumi Ito, Christine Charles, Boswell Roderick W., James W. Bradley, David B. Graves, Endre J. Szili, (2016). How plasma induced oxidation, oxygenation and de-oxygenation infludences viability of skin cells. Applied Physics Letters, 109, pp 203701.

Sung-Ha Hong, Endre J. Szili, Michael Fenech, Nishtha Gaur and Robert D. Short, (2017). On the effect of plasma (media) treatment on cell division. CAMT Seminar. http://www.camt.eng.osaka-u. ac.jp/pdf/camtseminar170306.pdf. Endre Szili, Nishtha Gaur, Sung-Ha Hong, Hirofumi Kurita, Jun-Seok Oh, Masafumi Ito, Akira Mizuno, Akimitsu Hatta, Allison Cowin, David Graves, Robert Short (2017). The assessment of cold atmospheric plasma treatment of DNA in synthetic models of tissue fluid, tissue and cells. Journal of Physics D: Applied Physics, 150(27), 274001. Sung-Ha Hong, Endre J Szili, Michael Fenech, Nishtha Gaur, Robert D Short, (2017). Genotoxicity and cytotoxicity of the plasma jet-treated medium on lymphoblastoid WIL2-NS cell line using the cytokinesis block micronucleus cytome assay. Scientific Reports, 7, pp 3854.

SP10-1

Malik A. Hussain, Irani Rathnayake, Flavia Huygens (2016). The importance of anaerobic bacteria in non-healing wounds. Wound Practice and Research, 24(4), pp 248 – 253. Malik A. Hussain, Irani Rathnayake, Flavia Huygens (2017). Prevalence of biofilm controlling ica genes of Staphylococcus epidermidis detected in healthy skin, blood samples from septicaemia patients and chronic wounds. International Journal of Basic and Clinical Pharmacology, 6(4), pp 726 – 733.

SP20-1

Stuart T. Johnston, Joshua V. Ross, Benjamin J .Binder, D.L. Sean McElwain, Parvathi Haridas, Matthew J. Simpson (2016). Quantifying the effect of experimental design choices for in vitro scratch assays. Journal of Theoretical Biology, 400(2016), pp 19-31. Stuart T. Johnston, Ruth E. Baker, D. L. Sean McElwain, & Matthew J. Simpson (2017). Cooperation, competition and crowding: a discrete framework linking allee kinetics, nonlinear diffusion, shocks and sharp-fronted travelling waves. Scientific Reports, 7, pp 42134. Stuart T. Johnston, Ruth E Baker & Matthew J Simpson (2017). A new and accurate continuum description of moving fronts. New Journal of Physics, 19(2017).

SP22-1

Uyen Thi Trang Than, Dominic Guanzon, David Leavesley, Tony Parker (2017). Association of Extracellular Membrance Vesicles with Cutaneous Wound Healing. International Journal of Molecular Science, 18(5), pp 956 -959.

SP47-1

Dr Daniel Broszczak, Elizabeth Sydes, Dr Daniel Wallace, Dr Tony Parker (2017). Molecular aspects of wound healing and the rise of venous leg ulcerations: omics approaches to enhance knowledge and aid diagnostic discovery. The clinical biochemist reviews, 38, pp 35 – 55.


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WOUND CRC ANNUAL REPORT 16-17

Education and Training Higher Degree Research Students The Wound CRC has supported a total of 52 PhD students, 10 Masters and 13 Honours students, including 2 Honours students initiating in FY16-17, exceeding the student targets of 32 PhD and 19 Honours students. To date 23 PhDs, 6 Masters and 9 Honours students have graduated from CRC funded degrees, going on to form the next generation of wound care researchers and academics. The extended period of time required for thesis preparation and examination continues to delay achievement of milestones related to student completions. The CRC’s student completion bonus scheme ensures that students remain engaged with the CRC through the extended examination phase.

The CRC’s cohort of students has made substantial contributions to fundamental wound research, new product development and clinical practice, authoring more than 145 publications and 200 presentations to date, and CRC PhD alumni are primarily engaged in research institutes or as lecturers. Several initiatives have been implemented by the CRC to provide the students with a supportive framework in which to network and liaise with other students and wound researchers within the CRC, including a student dinner following the Wounds Australia Conference 2016 for those in attendance, and a student workshop held in Brisbane in January 2017.

Above from top left: Wound Innovations workshops, WHIA modules, Wound Product User Guide and CRC video competition entrant Ut Bui


WOUND CRC ANNUAL REPORT 16-17

Professional Education

Professional Credentialing

The CRC’s online education platform WHIA was significantly redeveloped as an activity of Wound Management Pty Ltd. The new modules have a target launch date of August 2017 with 8 revised modules including: • Introduction to Wound Management • Aboriginal Health Worker • Burns • Foot Ulcer • Leg Ulcer • Malignant Wound • Pressure Injury • Skin Tears

The Wound CRC developed and implemented a national framework for wound clinicians, providing a nationally consistent, standardised process for credentialing of health professionals from a range of disciplines including nursing, medicine, pharmacy and allied health. The concept was launched at the Wounds Australia Conference in October 2016, and opened for applications in April 2017.

In recognition of the quality of the revised educational content in the Australian College of Nursing has increased the Continuing professional Development (CPD) points awarded for the modules from 2 to 6 points per module in August 2017. The CRC, working closely with University of South Australia and clinical advisors from SA Health, is close to completing a new module on perineal wound care which will be targeted at midwives, with the long-term goal of ensuring that training in quality perineal wound care is embedded in undergraduate courses across Australia. Wound Innovations also provides professional training and development courses to wound care clinicians, and has internally delivered 2 masterclasses and a wound care seminar during the reporting period, each providing 2 CPD points. These workshops have been developed and delivered by internationally recognised wound care experts, and are targeted at providing beginner and advanced care practitioners with access to best practice training and research. During the reporting period, Wound Innovations further developed these workshops to expand the scope of training, and provide necessary skills to frontline health professionals, to ensure patients are receiving best-practice care. They now deliver ‘Fundamentals of Wound Management’ workshops, which run over 4 weeks and are worth 8 CPD points. In addition to this, Wound Innovations has presented webinars and seminars for the Australian Association of Gerontology, The Australian Diabetes Educators Association, the Australian Primary Health Care Nurses Association, the Australian College of Rural and Remote Medicine and Wounds Australia, delivering expert wound care research and training to an array of clinicians. Diabetic Foot Australia has delivered 3 ‘What’s new in DFU’ events, disseminating recent diabetic foot disease research. These events were attended by over 250 clinicians and researchers across multiple disciplines. Throughout the reporting period, DFA also developed the ‘National Strategy for Prevention of Diabetic Foot Ulcers’, which was released to clinicians and services in September 2017.

The framework was developed from a nationally accepted set of guidelines and provides opportunity for greater engagement and collaboration across key wound professionals and relevant associations. Credentialing will influence health care provision and policy and has the potential to facilitate funding opportunities for wound management education and further research.

Patient and Public Health Education Successful wound care is a partnership between clinicians and patients. Whilst much of the CRC’s educational focus has been directed at improving clinical proficiency and access to professional training on current best practice, the CRC is developing resources to educate patients and raise awareness of early intervention to avoid wounds. These initiatives include:

• •

The CRC’s Healthy Ageing Node has also delivered education workshops, webinars and presentations in concert with Industry Participants including Hartmann Pty Ltd, Acelity, Southern Cross Care (SA & NT), Wounds Australia and 3M Pty Ltd, which were attended by over 670 clinicians across 13 events.

Next Generation Wound Researchers

A national public awareness campaign during Wound Awareness Week in October 2016. The CRC worked with Participant Wounds Australia to reach millions of Australians through TV and media channels to educate those at risk to recognise the signs a wound is not healing and where to seek treatment. www.woundaware.com.au A patient information portal as part of Diabetic Foot Australia includes current evidence based information to empower patients. A Patient Passport was developed that allows those at risk of diabetic foot wounds to follow preventative actions, including an easy to use daily check. https://www.diabeticfootaustralia.org/for-patients/ Developing a national burn prevention and first aid campaign leveraging public health gamification expertise developed by a Queensland SME, iPUG that will launch in late 2017. The CRC is developing a wound care education module aimed at patients and their carers, to complement the clinical education modules as effective wound treatment is a partnership between clinicians, patients and their carers. This module will launch in late 2017. The CRC has provided education to residents living in residential aged care facilities for the prevention of wounds such as skin tears and pressure injuries and has developed and is rolling out a wound prevention and care education program targeted at people in retirement villages, to help them avoid wounds, and access appropriate clinical services if they do have, or develop chronic wounds. This program commenced in mid-2017.

52 13 10 PhDs

Honours Masters

11


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WOUND CRC ANNUAL REPORT 16-17

Utilisation and Commercialisation The Wound CRC has two Utilisation and Commercialisation themes – clinical translation of research outputs and industry guided development of promising wound technologies. In the reporting period, the Wound CRC achieved 7 of 9 utilisation milestones due, with achievement of the two remaining PhD graduate employment milestones expected by June 2018.

Clinical Translation The Wound CRC is leveraging completed CRC research to develop sustainable models of wound care services, drive implementation of wound prevention strategies (particularly in aged care), provide clinical education activities and mechanisms for increasing the uptake of evidence-based practice. These activities have been embedded in 5 clinical-translation focused operational units and are underpinned by a significant body of work in health economics to raise awareness, and drive improved reimbursement for cost effective treatment modalities. The CRC’s clinical translation operational units provide significant benefit to Industry participants as the med-tech industry is moving to a model providing holistic wound solutions to frontline clinical organisations with evidence based care front and central to this strategy. The quality of the educational, clinical and training opportunities has led to significant industry uptake of the clinical online education materials from the CRC, including for dissemination to customers as a service to build clinical knowledge and understanding. Unit specific outcomes are outlined below.

Wound Innovations The CRC’s clinic, Wound Innovations opened in January 2017. The clinic, based in central Brisbane, offers a holistic service for patients, their carers and treating clinicians to improve wound outcomes either in person or nationally via telehealth. The clinic also offers training for health professionals to give them the latest, evidence-based treatment methods and approaches for wound management. Wound Innovations also collaborates with health organisations to conduct research that advances wound knowledge and treatment. The clinic has already established two clinical trials, hosted two Masterclasses with Prof. Keith Harding (through the CRC’s collaboration with the Welsh Wound Innovation Centre) and provided clinical leadership via 13 conference presentations and webinars and is in the process of establishing institutional referral pathways and optimising services to meet the specific needs of aged care sector.

Wound Healing Institute Australia A key area of utilisation activities for the Wound CRC is the dissemination of evidence-based best practice clinical resources to health care providers. WHIA supports health professionals, patients and carers through the provision of education, training, advice, research and health promotion on wound prevention and management. WHIA’s services are offered nationally with a focus on education, practice and research reflected in the following key service delivery areas: • Online and clinical wound education service; • A wound advisory and clinical patient care service for patients with wounds; • Research and clinical audit services in wound management; and, • Health promotion services to prevent or improve health and social outcomes for people with wounds.

The WHIA educational models are endorsed for accrual of continuing profession or adult education points by The Australian College of Nursing, the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine. The CRC made a significant investment in rebuilding the clinical and digital content on the WHIA training platform, providing multi-platform compatibility and customised portals, launching in August 2017 as well as developing a new, and much needed module for perineal wound care. The new modules have been purchased by multiple health educators in tertiary education, public health and aged care and are increasingly used by individual health professionals and students.

Wound CRC Healthy Ageing Node Australia faces an ageing population, with an expected additional 3.9 million Australians to be aged 70 years and over by 2050. The aged care industry is currently going through major reforms with significant impact on funding models, standards, and accreditation. As a result, the industry is consolidating, facilities are growing in size and for-profit share of beds and revenue is increasing. There is also an increased focus on quality of life as life expectancy consistently rises. The Node focuses on utilising CRC research outcomes in the aged care sector, and fostering collaborative relationships with aged care providers and industry. The Node successfully demonstrated that applying WHIA’s education and audit tools in two residential aged care facilities resulted in a 43.8% reduction in preventable wounds over 12 months. Health economics modelling demonstrated that implementing the same education and audits across 6 facilities would reduce the cost of wound care by 39%, allowing a reallocation of approximately $1.5 million p.a. to other activities. This research and economic analysis is engendering broad interest both in the aged care and retirement living sectors. Complementing the aged care educational strategy, the CRC has facilitated its first aged care/medical device industry research partnership. This project aims to simplify wound care decision making for staff and improve quality of care.

Australian Wound Repository The Wound CRC funded a project to provide the initial infrastructure and support to establish an Australian Wound Repository, which could ultimately generate sufficient revenue to meet its own expenses. The CRC revised the scope of the project to ensure compliance with Australian privacy law and data control, initiating a revised project in late 2016. In June 2017, the CRC took a decision to discontinue the project as part of a review considering optimal deployment of the remaining CRC resources to ensure implementation of CRC clinical translation outputs beyond the CRC’s term. It is envisaged that the investment made can be utilised with success of Wound Innovations after the term of the Wound CRC.

Diabetic Foot Australia Diabetic Foot Australia was established by the CRC in 2015 as a national body seeking to use Australia’s expertise in diabetic foot ulcer (DFU) research and clinical practice to address the growing issue of DFUs in Australia. The key goal of DFA is to end avoidable amputations within a generation.


WOUND CRC ANNUAL REPORT 16-17

To achieve this, DFA aims to:

• • • •

Optimise national DFU evidence-based clinical practice, Stimulate national DFU clinical research, Reduce Australia’s national diabetes amputation rate, and, Empower Australia to become a leading nation in DFU management.

In FY16-17 DFA organised and held three “What’s new in DFU” events in Melbourne, Adelaide and an online webinar, with international and local experts providing in depth updates on diabetic foot ulcer care practices to improve clinical outcomes to clinicians, patients, researchers and industry. Presenters at these events included internationally renowned clinical researchers Prof. Keith Harding (Welsh Wound Innovation Centre, UK), Dr David Armstong (University of Arizona College of Medicine, USA) and Sicco Bus (University of Amsterdam, Netherlands) and were delivered to over 250 attendees across 3 states. Clinical best practice research presented at each of these events was also collated into the document ‘DFA Guides you through’, and disseminated to researchers and clinicians via the DFA web portal, with DFA’s Scientific Director also delivering workshops at conferences in Australia throughout the reporting period, and DFA associates have delivered on-site training sessions to clinicians for diabetic foot ulcer best practice management. DFA also developed the Australian Diabetic Foot Minimum Dataset, providing clinical teams across Australia with a well-defined set of nationally recognised evidence-based diabetic foot ulcer data items, and allowing practitioners to meaningfully capture, analyse and benchmark local practices against international standards. The dataset is available via the DFA web portal, and has been accessed 85 times across services in Australia (4 WA, 4 TAS, 20 QLD, 4 NT, 4 SA, 2 ACT 17 NSW, 25 VIC + 5 overseas). The data set provides a foundation for the implementation of national improvements in the treatment of diabetic foot disease, and provides readily accessible information to rural and remote primary care providers dealing with the burden of diabetic foot disease. In September 2017, DFA organised the inaugural Diabetic Foot Australia Conference which brought together International and Australian diabetic foot thought leaders and researchers. The Conference cumulated with the launch of the Australian Diabetes-Related Foot Disease Strategy 2018-2022; a national strategy to guide clinicians in the implementation of best practice care aimed at reducing the burden of diabetes-related foot disease in Australia.

Health Economics Afford-ability underpins many of the issues relating to access to best practice care. The CRC has taken a robust approach to health economics, integrating cost effectiveness analyses in research projects and initiatives so that the clinical impact of new interventions or care pathways is measured alongside the cost and potential savings to the health care system of this approach. The CRC health economics team

has also extensively investigated the cost/benefits of implementing best practice care wound care in Australia. A cost-effectiveness analysis published in August 2016 demonstrated that implementing best practice care for diabetic foot ulcers would provide savings to the Australian health system of AUD 2.7 billion over 5 years. The health economics team made the case for implementation of best practice wound care via the Plenary talk at the 2016 Wounds Australia Conference (Health economics; measurement/the case for wound funding and cost shifting), and opening address at the 2nd World Congress on Health Economic Policy & Outcomes Research. To support the health economics data analyses, the CRC established projects to determine the current costs of wound care in both community care settings and wound clinics. Data from the health economics team has underpinned high level discussions with the Federal government with a view to furthering reimbursement of compression garments for the treatment of venous leg ulcers. This change would radically improve outcomes for patients with venous leg ulcers whilst providing significant health system benefits. Average healing times for venous leg ulcers is 12 months without compression or 10 weeks with compression. The CRC has just completed recruitment of a clinical study which will provide accurate and up to date estimates of the cost effectiveness of implementing compression reimbursement. The health economics team collaborated closely with DFA on the “Australian Diabetes-Related Foot Disease Strategy 2018-2022” launched as part of the DFA National Conference in September 2017.

Industry Guided Development of Promising Wound Technologies The identification and development of promising wound technologies has been guided by the Development Advisory Committee which has provided commercial insight and high level expertise in selecting and managing the projects that have potential to move into the development phase. The Committee has also provided recommendations to the Governing Board where Projects have not met their milestones. As Projects have completed, the CRC has supported Utilisation of the technologies by Project Participants. In FY16-17 CRC supported the following development projects:

• • • • • • • •

New imaging systems for wound diagnosis/prognosis New materials for wound closure using negative pressure wound therapy Integrated fabric sensor for use in medical compression Pressure sensing insole with integrated biofeedback for the prevention of diabetic foot ulcers “Flightless” antibody for epidermidosis bulosa Plasma therapy for wounds A diagnostic/therapeutic strategy relating to monitoring and controlling the microbial status of a wound Oxygen releasing zeolite dressings

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WOUND CRC ANNUAL REPORT 16-17

IP Management The Wound CRC is committed to maximising impact from its research activities and has a strong focus on Intellectual Property (IP) management and protection. The CRC’s IP Policy is distributed to all Project Leaders and new students are expected to compete the CRC’s online IP training. The CRC’s Publication Clearance Policy ensures that all publications and conference presentations are screened to ensure appropriate patent protection is in place prior to disclosure.

All staff and students working on CRC projects sign Deed Polls in ensure that IP can be managed within the framework of the Wound CRC’s Participant Agreement. The CRC pro-actively manages the patent portfolio in conjunction with the Participants. Three new provisional applications have been filed this year. The Wound CRC adheres to the National Principles of IP Management for publicly funded research. Registered intellectual property rights being pursued by the CRC as of 30th June 2017 are listed below:

Active IP as at 30th June 2017 Type

Description of IP

Number

Priority date

patent

Optical Biosensor

PCT/AU2015/000118

12/06/2014

patent

Wound sensor

PCT/AU2014/000988

12/05/2014

patent

Plasma screens and uses thereof

PCT AU2015/000087

18/02/2014

patent

Compositions and methods for administering antibodies

PCT/AU2016/050314

30/04/2015

patent

Wound filler for negative pressure wound therapy

PCT/AU2016/050956

12/10/2015

patent

Compositions and materials for assisting in wound healing

2016904115

11/10/2016

patent

Detection of Pathogens

2017901551

28/04/2017

patent

Biomarkers for wound healing

US62/519,478

14/06/2017

TM

Diabetic Foot Australia logo mark and logo type

1730389

26/10/2015 Approved 09/06/2016

Unregistered TM

Wound Awareness Week ‘Wound Aware’ logo mark and logo type

01/09/2016

SME Engagement

The Wound CRC engages SMEs across its portfolio, particularly in technology development and the development and utilisation of educational and training assets.

collaborators within the Wound CRC has opened up opportunities in the medical device and wound healing spaces, that would otherwise have not considered.

Two SMEs are involved in Wound CRC Projects to develop new wound care technologies. CRC research in conjunction with the University of South Australia has helped identify monoclonal antibody drug candidates for the devastating skin blistering disease epidermolysis bullosa, and has supported definitive proof of concept studies which will enable Abregen Pty Ltd, based in South Australia, to move the antibodies into clinical development.

The CRC also engages SMEs in large translational projects such as the WHIA platform and module redevelopment project where SME’s colocated with the CRC’s South Australian Node in the Tonsley Innovation District converted the CRC’s vision into high quality multi-platform educational resources.

Tasmanian biotechnology company, Marinova Pty Ltd has a longestablished collaboration with the Surface Interactions and Soft Matter team headed by Assoc. Prof.. David Beattie, within the Wound CRC umbrella. Marinova’s Operations Manager Dr Damien Stringer in discussing this relationship commented that the expertise of our

In late 2017 the CRC will launch a national burn prevention and first aid campaign, in conjunction with iPUG, a Queensland-based start-up using gamification strategies to deliver public health messages. Economic evidence generated by the CRC has demonstrated to SMEs the long-term cost benefits of investing in early intervention and education for the prevention of chronic wounds.


WOUND CRC ANNUAL REPORT 16-17

The support of Wound CRC has been invaluable to the early stage development of our antibody wound therapy. The Wound RC project has enabled the company to further develop its antibody candidates for wound healing applications, and has been vital to the generation of the key pre-clinical data sets that will underpin the company’s fund raising and clinical development program. Abregen Pty Ltd (SME)

The expertise of our collaborators within the Wound CRC has opened up opportunities in the medical device and wound healing spaces, that we would otherwise have not considered. The researchers and CRC administrators are a pleasure to work with, and understand the imperatives of industry partners – meaning that engagement with the CRC is seamless and allied with our interests. Marinova Pty Ltd (SME)

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WOUND CRC ANNUAL REPORT 16-17

Communications The CRC internally manages its key translation activities including all communication activities. As the CRC moves towards sustainability and viability of its key translation activities, communications strategies adopted by the National Office have been focused on supporting their establishment and growth. This strategy has resulted in both sales growth and brand awareness as the CRC becomes the recognised national leader in chronic wound management. The CRC still meets its obligations in communicating key results and outcomes of CRC research outputs throughout the reporting period. The CRC works collaboratively with its partners to release joint announcements and disseminate media where possible. This includes, but is not limited to: MTP Connect Industry Growth Centre, Participant communication departments, Cooperative Research Centres Association, Life Sciences Queensland, Department of Industry, Innovation and Science, KnowHow and trade magazines.

Key Events and Media July 2016: National Diabetes Week: DFA conducted the very first diabetic foot dedicated campaign across social media during National Diabetes Week 10th - 16th July, using data from CRC research to highlight the devastating impact of diabetic foot disease which causes over 4,400 foot amputations each year in Australia. Day 1: DFA released an updated version of the popular ‘Canberra’ infographic. The infographic highlights some alarming new statistics in light of CRC research: • Total number of Australians with diabetic foot disease has increased from 300,000 to 380,000 people • 4 people die daily as a result of diabetic foot disease • Hospitalisations have increased hugely – previously there were 500-600 people in hospital each night, now nearly 1000 people are in hospital each night – which is the total capacity of Canberra’s hospitals • The conservative cost of hospitalisations is approximately $1 million dollars PER DAY. Day 2: DFA released a benchmark document that compares Australian and International guidelines on diabetic foot disease prevention and management.

Day 3: DFA released a brand new resource “DFA Passport to Foot Disease Prevention”. Diabetic Foot Australia aims to empower people at risk of diabetic foot disease, their carers and families, with knowledge and pathways to foot disease prevention. This passport will help people at risk of foot disease to talk to health professionals to get best practice foot care, provide their feet with the right daily care and minimise their risk of developing foot disease. Day 4: DFA launched the Australian Diabetic Foot Ulcer Minimum Dataset Dictionary. The new resource will help busy health professionals and researchers start the process of collecting minimum data on diabetic foot disease, a task difficult to start without the right tools. The purpose of the dictionary is to provide Diabetic Foot Services with a reference guide of standardised terminology. Day 5: DFA’s very own Scientific Director Dr Jaap van Netten spoke to a packed crowd in Melbourne on everything from the international diabetic foot guidelines, to the “DFA guiding you through” series to his extensive range of innovative research on offloading and communication strategies for diabetic foot disease. Day 6: First release information of the What’s New in DFU event in Melbourne on the 14th September, two international speakers confirmed. Day 7: DFA released a daily statistic on the devastating impact of diabetic foot disease in an email campaign. On the final day of Diabetes Week, DFA released a new infographic that displays the alarming statistics that occur in just 7 days. As a part of DFA’s National Diabetes Week campaign, the CRC released research outcomes demonstrating the massive and cost and burden of diabetic foot disease. The CRC’s study showed one in every 22 patients in our hospitals have active diabetic foot disease. The study found there are 27,600 hospitalisations each year caused by diabetic foot disease in Australia costing annually $350 million for hospitalisation alone. In collaboration with Participant QUT, the CRC and DFA the story was shared nationally through major online news outlets, social media and was a prime time feature story on Channel Nine evening news with key researchers and one of our very grateful patients, Glenn.

Below: Dr Charlie Day of Innovation and Science Australia officially opening Wound Innovations on the 7th March 2017, Dr Sicco Bus presents the keynote at the Melbourne ‘What’s New in DFU’ on the 14th September 2016.


17

WOUND CRC ANNUAL REPORT 16-17

2016 day1

National Diabetes (Foot) Week: An Overview Foot Exam Passport

Canberra Infographic update. New statistics based on latest research

To prevent foot disease, your feet should be examined at least annually by your health professional. We recommend you complete this passport at all of your foot examinations

Passport

to foot disease prevention

Please make an appointment to see your health professional if you notice a sore that does not heal, redness or an infection, a lack of feeling or pain in your feet

1. Date of foot examination: 2. Name of Health Professional:

https://diabeticfootaustralia.org/dfwp/ wp-content/uploads/2016/07/DFA_ UpdatedCanberraInfographicJuly2016.pdf

3. What is my risk of foot disease?

Low

4. Do I need to see a diabetic foot team?

Moderate/Increased Yes

High

No

5. What can I do to help me avoid foot disease?

Daily Foot Care Checklist

1. Date of foot examination: 2. Name of Health Professional: 3. What is my risk of foot disease?

Low

4. Do I need to see a diabetic foot team?

Moderate/Increased Yes

High

CHECK

No

DFA Guides You Through

Look for damage •

Damage includes ulcers, sores, cuts, redness, bruises, new calluses or other signs of damage If you have trouble getting down to

Foot disease is preventable

5. What can I do to help me avoid foot disease?

see your This passport helpsfeet you:it might be useful to use

1. Date of foot examination:

Convenient timesis aare before Diabetic foot disease major cause of hospitalisation your shower or and amputation. Footbefore diseasebed includes poor circulation, poor sensation, ulcers and infections. Foot disease is preventable with the right foot care. The best 4 things you can do are:

2. Name of Health Professional:

1.

Use this passport to start your journey to good foot Clean daily health.

3. What is my risk of foot disease?

Low

4. Do I need to see a diabetic foot team?

Moderate/Increased Yes

High

No

5. What can I do to help me avoid foot disease?

WASH

See your health professional for an annual foot risk examination 2. Ask your health professional about your risk of foot disease 3. Ask your health professional if you need to see a Keeping your diabetic footfeet teamclean will helpCheck reduce riskif you notice damage see 4. yourinfection feet daily and your health professional

• •

Feel your feet

Check foot temperature

Take note of changes in feeling in your feet This includes numbness, tingling or loss of feeling to touch

Be aware of any hot or cold changes in the temperature of your feet

a mirror or ask a carer

Talk to your health professionals to get the right foot care for your feet Provide your feet with the right care

• Use soap/body wash and warm (not For more on diabetic foot disease go to: hot) water, including between toes www.diabeticfootaustralia.org

Dry your feet

Ask for help

Dry your feet well, including between toes

If you have difficulty reaching your feet, discuss options with your health professional

Preventing foot disease is a joint effort between your health professionals and you.

CARE

Australian and International Guidelines on Diabetic Foot Disease

Care for your feet and your general health and wellbeing

Manage your diabetes

Maintain toenails

Moisturise feet

• • • •

• •

Note that this document is a guide only and is not intended as a substitute for advice from your health professional.

July 2016

380,000 people have diabetic foot disease in Australia, the approximate population of Canberra.

The daily cost of these hospitalisations is approximately $1M.

©Diabetic Foot Australia 2016 nationaloffice@diabeticfootaustralia.org www.diabeticfootaustralia.org

day2

Put moisturiser all over your feet to keep your skin supple But, don’t put moisturiser between toes or on broken skin, as this may lead to infection

Check for corns or calluses

• • •

The nerves in your feet may be less efficient at communicating temperature and pain messages Avoid exposure to hot pavements, sunburn, heaters, hot or very cold water, or exposure to the cold

These are signs that your feet are getting too much pressure In people who have limited feeling, corns and calluses are a warning sign of ulcers coming, if you don’t see your health professional soon Don’t use over-the-counter corn or callus removal methods as these can cause wounds

https://diabeticfootaustralia.org/ dfwp/wp-content/uploads/2016/07/ DFAPassportToFootDiseasePrevention_ July2016.pdf

DFA Guides You Through the Australian and International Guidelines on diabetic foot disease

12 people have an amputation procedure each day in Australia due to diabetes, almost an entire football team.

Cut toenails straight across Check long or ingrown toenails for ulcers or infections If required, seek assistance from a carer or health professional

Avoid heat or cold

Protect your feet with well-fitting footwear, both indoors and outdoors Shoes that stretch to fit your feet are too tight and can cause ulcers Wear clean socks to protect skin from rubbing. Avoid seams if possible Check your feet for signs of damage when removing footwear Ask your health professional if you need custom-fitted shoes or insoles

DFA passport to foot disease prevention and management

Approximately 4 people will die daily as a direct result of diabetic foot disease.

900-1000 people are in hospital around Australia each night due to diabetic foot disease. Canberra hospitals combined have 1000 beds.

• • Be aware that you may not feel pain from injuries due to loss of sensation in your feet. These injuries still need attention even if they are not currently causing you pain.

Monitor your blood sugar levels, Take your prescribed medications Eat a healthy diabetes-friendly diet Talk to your health professional about an exercise program that suits you

Wear good shoes

https://diabeticfootaustralia.org/dfwp/ wp-content/uploads/2016/07/DFAGuides-you-through-guidelines.pdf

day3 day4

day5 Dr Jaap van Netten spoke to a packed crowd in Melbourne at the ‘DJO Global Diabetes Education Day’

Australian Diabetic Foot Ulcer Minimum Dataset Dictionary

7. Service referral received date Metadata item type

Data Element

Official METeOR name

Health service event—service request received date

Short METeOR name

Health service request received date

Synonymous names

Date referral received; Date referred

METeOR identifier

447938

METeOR registration status

Health, Standard 07/12/2011

Definition

The date on which a request (referral) for assessment, care, consultation and/or treatment is received by the health care provider (DFU service), expressed as DDMMYYYY. For more detailed definition information please visit: http://meteor.aihw.gov.au/content/index.phtml/itemId/447938 .

Values

Class Date Example

Relation to KPAs

This data item should be used for KPA: A: Access to services

Only complete this item if this is the person’s Initial Visit.

Diabetic Foot Australia

Date DDMMYYYY 01042016

Page 22 of 60

day6 An evening with international and industry leaders in diabetic foot disease

International guest speakers: Dr Sicco Bus Dr. Sicco Bus is a human movement scientist and works as a principle investigator and as head of the Human Performance Laboratory at the Department of Rehabilitation of the Academic Medical Center (AMC) in Amsterdam, the Netherlands. After two years of post-graduate research at Penn State University in USA, Sicco completed his doctoral dissertation on the structural and functional aspects of the neuropathic diabetic foot at the AMC in Amsterdam in 2004. Since 2003, Sicco also works as a clinical researcher on the diabetic foot at the Ziekenhuisgroep Twente in Almelo (since 2005 as secondment). In his current work at the AMC in Amsterdam Sicco divides his time with leading the Human Performance Laboratory and initiating, coordinating, and supervising research, mostly on (the biomechanics of) the diabetic foot. Sicco is member of the editorial board and two guideline work groups of the International Working Group on the Diabetic Foot.

Wednesday 14th September 2016 6pm-9:30pm Storey Hall, Building 16, 336–348 Swanston St, Melbourne Tickets: $75.00

Tickets include drinks and canapes

Dr. Jaap van Netten Dr van Netten is the Secretary of the International Working Group, on it’s Diabetic Foot Editorial Board and Prevention Working Group. He is co-authoring the evidence-based international consensus guidance on the prevention and management of foot problems in diabetes. In addition, he has published 30+ manuscripts and presented 50+ conference papers on ‘intelligent monitoring systems for the diabetic foot’ in recent years; including investigating novel in-shoe plantar pressure systems, hyperspectral imaging, infrared imaging and other smart material technologies. In 2016, Dr van Netten is a Research Fellow at Queensland University of Technology and Scientific Director of Diabetic Foot Australia.

Diabetic Foot Australia invites you to this exclusive event to hear ‘What’s new in diabetic foot ulcers (DFU)’ from the world’s best in diabetic foot disease research, clinical treatment and technology.

Located in the heart of Melbourne’s creative and innovative hub, Story Hall offers the perfect backdrop to update you on the latest cutting edge research, treatments, technologies and practice in diabetic foot disease.

to network with international and national leaders from Diabetic Foot Australia.

With thanks to Platinum Sponsor, you will enjoy canapes, drinks and the opportunity

BOOK NOW: link

10-16 July

First release information: What’s New in DFU event in Melbourne on the 14th September, two international speakers confirmed. https:// diabeticfootaustralia. org/whats-new-dfuevent-melbourne/

This event is open to all health professionals and researchers who treat or have an active interest in diabetic foot disease.

On the final day of Diabetes Week we released a new infographic that displays the alarming statistics that occur in just one week across Australia https://diabeticfootaustralia.org/dfwp/wp-content/uploads/2016/08/ DFA_diabetesweek2016statoverview.pdf

day7

Australian Diabetic Foot Ulcer Minimum Dataset Dictionary + Implementation Starter Kit https://

diabeticfootaustralia. org/for-researchers/ australian-diabetic-footulcer-minimum-datasetdictionary/


18

WOUND CRC ANNUAL REPORT 16-17

August 2016: Webinar August 17th: Live webinar ‘Understanding biofilms: how science is changing the clinical practice’ was broadcast to thousands of people nationally in a partnership between industry Participant Smith & Nephew and WHIA. This nation event featured Terry Swanson and DFA Steering Team member Matt Malone.

September 2016:

International Diabetes Day 14th: The CRC with DFA and partners released a new research outcome,’ The “silent burden” of foot disease’ showing that diabetic foot disease afflicts one in ten hospital patients, costing taxpayers billions and filling nearly 5,000 hospital beds each night in Australia. The study, published in the International Wound Journal, also found a quarter of people in hospital have diabetes, with one in five of those suffering foot disease. This result was released through media channels in conjunction with Participant QUT.

What’s New Seminar 14th: DFA held the second in the national “What’s New in DFU” series with Participant RMIT University and industry collaborators. The event brought together three International & two Australian expert speakers in Melbourne to a packed audience.

Radio announcement: DFA and CRC researcher/DFA Co-Chair Dr Pete Lazzarini was an invited speaker on 98.9fm “Stayin’ Strong” Health Promo Segment for Brisbane Indigenous Media Association program, discussing diabetic foot nerve damage and prevention (link to listen is here: https://www.diabeticfootaustralia.org/radio-annoucement-foothealth/).

October 2016:

December 2016:

Wound Awareness Week 16th - 21st: the CRC partnered with Wounds Australia during October 16 -21 to put wounds on the map through a week long public health campaign. Participant Wounds Australia had approached the CRC in the previous year for assistance to enable a national campaign with wider reach and impact.

Wound Innovations industry launch 8th: The CRC held an intimate event to introduce Wound Innovations to key referral bodies and industry collaborators. The event provided an update of the clinic construction to date, provided service referral information and an opportunity to meet the brand new team (approx. 8 were in attendance).

The CRC worked with Wounds Australia and other SMEs to develop a solid campaign strategy along with a new visual identity and touch points (developed internally by the CRC). The campaign was targeted at patients and those most at risk of wounds with a simple message of being ‘wound aware’ and iconography of wound warning signs – in summary, a call to action for wound prevention. The CRC assisted Wounds Australia to source and appoint a national ambassador who would appeal to the target market - Australian TV legend of 40 years, Denise Drysdale. The broad reach included: a dedicated campaign website, social media campaign, popular print media coverage (Australian Women’s Weekly) over 4 editions, patient story and promotional videos, social media posts, media releases and PR, informational TV ads using ‘Tonic TV’ in GP waiting rooms and a national TV segment on Studio 10 where CRC research and the national burden of wounds were discussed. Overall, we reached nearly 3 million people - a feat never before achieved that will pave the way for Wounds Australia’s ongoing wound awareness activities. The campaign is a sign of things to come for members and will bring both the Wound CRC and Wounds Australia closer together in achieving common goals in wound management.

November 2016: Wounds Australia Conference 9-12th: Wounds Australia held their inaugural conference in November with outputs from the CRC’s research portfolio featuring strongly. CRC research represented a significant proportion of all presentations at the conference. This substantive representation highlights the breadth and depth of the CRC’s research and included plenary sessions on health economics (Dr Rosana Norman), wound dehiscence (Kylie Sandy-Hodgetts) and presentations from 12 past and present CRC students. The CRC hosted a dedicated 2 hour session outlining the CRC’s research translation highlights and future activities. The session was incredibly well received with standing room only. Featured presenters were: Dr Peter Lazzarini, Prof. Keryln Carville, Prof. Nick Santamaria and Nurse Practitioner Tabatha Rando and included the concept launch for the CRC’s credentialing system. What’s New Seminar 8th: The third in the ‘What’s New in DFU’ series, held in the Tonsley Innovation Precinct, Adelaide, featured informative presentations from Prof. David Armstrong – one of the world’s most influential diabetic foot researchers. This sell out event was strongly supported by Industry sponsors and over 60 clinicians.

January 2017: Student Video Workshop: The CRC held an internal competition for current higher degree students to develop an abstract and 3 minute video. The two best entries received flights, accommodation and registration to a professional development conference of their choice within the wound management industry. Additionally, the CRC held a workshop morning for students in Brisbane that enabled students to storyboard and film videos for entry in the CRCA’s Annual ECR 30 second Video Competition. This event was well attend by students who enjoyed the opportunity to practice presenting their research as a part of their ongoing academic career.

March 2017: Wound Innovations public media launch: The CRC invited Prof. Keith Harding (Wales) the CRC’s Principal Advisor and the CEO of Innovation and Science Australia CEO Dr Charlie Day to officially open the service. The launch event was attended by key stakeholders from Wound CRC Participants, Primary Health Networks, industry partners and other health bodies and included a dedicated media briefing. Masterclass and Seminar with Prof. Keith Harding: In conjunction with the clinic opening and Prof. Keith Harding’s visit, Wound Innovations held three further special events – two workshops for health professionals (Advanced and Beginners Wound Management) and a wound seminar where he outlined the development of the Welsh Wound Innovation Centre. These events were well attended by invited guests. Webinar 6th: DFA, in collaboration with Podiatry Association Australia, delivered its first What’s New in DFU national webinar event with Prof. Keith Harding and Dr Jaap van Netten.

April 2017: ACT PHN sign as Participant: The CRC announced the joining of Capital Health Network as Participant. The new partnership signifies the commitment of both organisations to driving exemplary primary health care outcomes, and a mutual confidence in the investment of the CRC’s future. CHN Chief Executive Gaylene Coulton visited the Wound Innovations facilities and trialled the nationally connected telehealth system along with a tour of the world class treatment facilities. After


WOUND CRC ANNUAL REPORT 16-17

19

During 17-21 October 2016: 3million advert views

811,516

views of campaign ad in GP clinics Be Wound Aware Look out for the signs your wound needs to be seen by a healthcare professional:

50,000

Denise Drysdale Wounds Australia Ambassador

WOUND AWARENESS WEEK

17TH - 21ST OCTOBER 2016

Live TV viewers Pain and heat Wounds that are red, swollen, hot to touch and very painful

Odour

Excess Fluid

Wounds with a strange or unpleasant smell

Wounds that have a thick, yellowish fluid

Slow healing Chronic Disease and ageing Wounds taking longer than a month to heal

People over 65 years and/or with chronic diseases such as diabetes, are more at risk of wound complications

11,628

YouTube views Nearly half a million Australians a day suffer from chronic wounds

An initiative An initiative of Wounds of Wounds Australia Australia and Wound and Wound Management Management Innovation Innovation Cooperative Research Cooperative Research CentreCentre

Look out for signs your wound needs attention such as pain, heat, odour and slow healing. See your health professional.

An initiative of Wounds Australia and Wound Management Innovation Cooperative Research Centre

Wounds are not for life and are treatable. See your health professional.

Chronic disease and ageing can impact on wound healing. See your health professional.

An initiative of Wounds Australia and Wound Management Innovation Cooperative Research Centre

An initiative of Wounds Australia and Wound Management Innovation Cooperative Research Centre

Wounds can cost up to $10,000 per patient and are estimated at $3billion

to the health system

An initiative of Wounds Australia and Wound Management Innovation Cooperative Research Centre

2,000

Website views

Above: Some of the Wound Awareness Week campaign touch-points created by the CRC, including: Website, TV segment, posters, patient story video, Australian Womens Weekly article, social media campaign.

meeting the acclaimed team and facilities, Ms Coulton expressed excitement for what the future holds for wound sufferers in the primary health sector, and together finding improvements outside of the traditional health sector.

May – June 2017: Parliament House CRC Showcase: The CRC participated in the CRC Showcase during the CRCA Conference 2017 at Parliament House. Featured at the conference was a looping video of the CRC’s key highlights from WHIA, WI and Healthy Ageing Node. National press coverage: Release of article in The Age nationally via print and online “Wounds left to fester for years because of poor treatment, research centre says” featuring interviews with CRC staff and Wound Innovations patient.

Email Marketing

reporting period and now has 233 Twitter Followers. DFA’s website posted 13 news articles, 30 research articles and the diabetic foot dataset dictionary and minimum dataset attracted 85 downloads. There were 14,816 website sessions and 35,775 DFA website pageviews, a 418% and 318% increase respectively compared to the previous reporting period. DFA also launched its conference website during the reporting period attracting 4,232 sessions and 12,823 page views. DFA’s email database base grew to 846 subscribers. Wound Innovations: Wound Innovations built a supporter base from the ground up to 260 Facebook page likes with 30 Facebook posts published since March 2017 and over 200 email and website subscribers. There were 2,949 website sessions and 9,445 page views during the reporting period. Wound CRC: The CRC maintained over 700 email subscribers and attracted 9,031 website sessions and 20,535 page views.

The CRC’s targeted and curated e-mail databases enable email campaigns and event marketing to efficiently reach thousands of relevant subscribers. Delivering meaningful and relevant content has been a driver of the success of the CRC’s activities across all digital channels. During the reporting period, a total of 74 email campaigns were delivered across the CRC’s activities.

Media Releases

Website and Social Media Engagement

• •

DFA: Diabetic Foot Australia’s Facebook page ‘likes’ grew from 374 to 1,200 likes. The page published 130 posts including events, media, videos, external links and research articles. DFA posted 82 tweets in the

• • •

CRC Research Finds Massive Diabetic Foot Disease Costs Wound Awareness Week profiles Australia’s Hidden Health Epidemic: Chronic Wounds New database designed to drive better outcomes for national health sector, thousands of patients Statement regarding wound care training in General Practice CRC’s Breakthrough Service, Wound Innovations, Officially Launched Wound CRC Signs Capital Health Network As Participant


20

WOUND CRC ANNUAL REPORT 16-17

Governance –Board, Committees, and Key Staff Governance Overview The Wound CRC has 24 research, community and industry Participants. These Participants in the Wound CRC are bound by the Commonwealth Agreement and the Participants Agreement. The Participants established an Unincorporated Joint Venture (UJV) which in turn established a privately-held management company, the Wound Management Pty Ltd (WMPL) as the vehicle for implementing Wound CRC processes and securing the outcomes of the Joint Venture. The Wound CRC’s National Office is located in West End in Brisbane with activities in Queensland, South Australia, Western Australia, Victoria, New South Wales and Tasmania. The fully independent Board of Directors is the same for both the Unincorporated Joint Venture and Wound Management Pty Ltd. Given the size of the current Board (3 members), the whole Board has assumed responsibility for the two Governing Board sub-committees: Financial Audit and Risk, and the Nomination and Review Committee. The UJV is exempt from GST, whereas the WMPL is subject to GST. In January 2016, WMPL commenced operations of its wholly owned subsidiary, Wound Healing Institute Australia (WHIA). WHIA is a notfor-Profit with charitable status, governed by its own board. However, as a subsidiary WHIA financials are included in WMPL’s consolidated accounts along with the CRC’s operational units including DFA and Wound Innovations.

WMPL and Wound Management Innovation CRC Governing Board

in the table on the next page. Dr Ian Griffiths and Mr Ian Landreth attended all 7 Board meetings by invitation. The issue of the Board size was addressed as per the Participant’s Agreement and with no further nominations being forthcoming, the Board was confirmed with its current number of three. The focus of Corporate Governance in FY16-17 (the penultimate year of trading) was on addressing the issues relating to ensure a future for the legacy vehicles beyond the life of the CRC.

Advisory Committees Research Advisory Committee The Research Advisory Committee (RAC) has 3 expert advisors, who provide independent expert advice to the Wound CRC Governing Board and Management on the appropriateness of research projects across the research portfolio. The RAC reviews projects on request to evaluate the relevance of research projects, ensuring that project objectives align with overall CRC goals, and ensure high quality projects are delivered, which support and enhance end-user adoption. The RAC provide advice on the composition and relevance of the Wound CRC’s research portfolio in terms of commercialisation potential, and clinical and social impacts. They also advise on future wound research needs, including gaps and opportunities. They leverage their professional expertise and linkages to act as ambassadors for the CRC, building strategic relationships with between the CRC and wound research organisations.

Membership of the Board, including the key skills of Board Members, is detailed below. The Board conducts activities of the Wound CRC through the Chief Executive Officer (CEO) and delegates specific powers and responsibilities to the CEO.

As the CRC’s focus has moved from research to ensuring that the outputs of the CRC are implemented there have been no formal meetings of the RAC this year, with individual committee members providing advice and recommendations to the board in their specific areas of expertise.

Board members serving for FY16/FY17 are:

Development Advisory Committee

• • •

The CRC Development Advisory Committee (DAC) is comprised of expert advisors, with extensive international experience working in the MedTech and BioTech industries. The DAC provides advice to Wound CRC Management and Governing Board on intellectual property matters, commercialisation, regulatory processes, relevance of projects and competitive landscape.

Prof. Rob Sale (Chairman) Dr Susan Pond AM FTSE FAAHMS Mr Stephen Carmody

The Board is responsible for ensuring that an effective internal control framework is in place. The development of a set of policies, procedures and practices enables the Board to monitor compliance to statutory, legal, stakeholder and best practice requirements. This framework is regularly reviewed. The Board’s role is to govern the Wound CRC by provision of appropriate leadership, contributing to and approving the Wound CRC’s strategic plans, approving operational plans and budgets to ensure consistency with the goals and objectives, monitoring performance of the Wound CRC and its management, assessing risks and ensuring that appropriate risk management strategies are in place; and setting and promoting appropriate values and standards. The Board met 7 times over the reporting period, with dates and attendance listed

The DAC convened in July 2017 by teleconference to critically review the CRC’s development portfolio, and has provided additional support and written commentary on development stage projects through the year.


WOUND CRC ANNUAL REPORT 16-17

Prof. Robert Sale Chairman • • •

Prof. Sale has 25 years of accomplishment in the research, medical device and technology/innovation sectors. Prof. Sale is Innovation Professor at RMIT, Special Advisor to the Chief Defence Scientist and Defence CRC Lead. Prof.. Sale has a strong background in commercialisation, governance and leadership skills with operations, finance, clinical understanding and management, fund raising in both private and public sectors and international IPO success.

Mr Steven Carmody Director

Dr Susan Pond Director

Brisbane, Australia Independent Extensive medical device and commercialisation experience From 1 April 2016

• • •

21

Sydney, Australia Independent Extensive health care and science industry leadership, commercialisation, policy and strategic development experience From 1 Apr 2016

• • • •

Perth, Australia Independent Extensive science industry leadership and management experience From 1 Apr 2016

Stephen has spent 30 years in health care, working in a variety of settings in the private and public sector, metropolitan, rural and remote environments. Stephen was previously COO of Silver Chain Group and held various managerial roles with the organisation for 15 years. Stephen’s professional qualifications began in 1982 with the completion of a hospital based Diploma of Nursing, followed by a Certificate in Midwifery in 1986. He also has completed Bachelor of Health Science (1987), Master of Business (1999) and Graduate Diploma in Pastoral Studies (2000).

Dr Susan Pond has a distinguished record in academia and industry. After her tenure as Professor of Medicine at the University of Queensland, Susan held senior executive roles in Johnson & Johnson, including as Chairman & Managing Director of Johnson & Johnson Research Pty Limited, and has held numerous Board positions on a range of prestigious biotech organisations.

Board Meeting Attendance FY 16-17

2016

2017

1 August Face to Face

20 September Face to Face

16 November Telco

14 December 3 February Telco (SPECIAL PURPOSE) Telco

20 February Telco

18 May Telco

Dr Susan Pond

Professor Robert Sale

Mr Stephen Carmody


22

WOUND CRC ANNUAL REPORT 16-17

Research Advisory Committee A. Prof. Nick Gough RAC Chair • •

Melbourne, Australia Independent

Prof. Gough has extensive experience in biomedical research and cancer biology, in the biotechnology industry, and in the Australian Cooperative Research Centres program. Inventor of technologies underpinning biopharmaceuticals and biotechnology products, marketed internationally and in clinical trials, including GM-CSF – one of the first pharmaceuticals based on Australian science and intellectual property. Key past appointments include: Head, Molecular Haematology Laboratory, The Walter and Eliza Hall Institute of Medical Research; Research Director AMRAD Corporation Limited, CEO Cerylid Biosciences Limited; CEO Cooperative Research Centre for Genes for Common Human Diseases; Director, Molecular and Genomic Discovery ES Cell International Pte Ltd (Singapore); Chairman and Principal Consultant, Nick Gough & Associates Pty Ltd - Biotechnology and BioIndustries Consultants; Associate Professor (Honorary), Department of Medicine, University of Melbourne; and External Scientific Advisor, Cancer Therapeutics Cooperative Research Centre.

Prof. Nick Santamaria RAC Member • • •

Melbourne, Australia Independent

Nick is the Professor of Nursing Research, Translational Research at the University of Melbourne and the Royal Melbourne Hospital. He chairs the Skin Integrity Committee for Melbourne Health and was involved in establishing the Wounds West Project in WA. He has recently completed a large RCT investigating the effectiveness of silicone dressings in the prevention of pressure ulcers in critically ill ED/ICU patients. Other areas of Nick’s research include the calculation of healing rate methods in diabetic foot wounds and venous leg ulcers and the investigation of the antimicrobial properties of electrolyzed water in infected wounds.

Prof. Ann Gardner RAC Member • •

Canberra, Australia Independent

Professor Anne Gardner is a retired Professor of Nursing at the School of Nursing, Midwifery and Paramedicine at the Australian Catholic University. Prof. Gardner has an extensive health industry background in clinical nursing practice, post-registration education and clinical research. Her clinical interests are primarily in the areas of infection control and wound care. She has an international Profile as a researcher into nurse practitioner competency standards and scope of practice, and is one of the four researchers on the recently completed nationally funded research project entitled “Reforming Healthcare: Nurse Practitioners and workforce re-design”.

Development Advisory Committee

Mr Chris Selwa DAC Member • •

Brisbane, Australia Independent

Chris is Managing Director and Founder of MediGroup EBI, a successful SME medical device distribution and manufacturing business. Chris has a successful track record in the medical device and pharmaceutical industries with experience gained in the USA, UK, and Mainland Europe. His P&L, sales and marketing experience includes start-up phase, mid-size growth and large corporate. Prior to MediGroup, Chris established a peripheral vascular intervention business for Guidant (now Boston Scientific) in the UK, and went on to run their national cardiac intervention marketing in the UK, during his tenure market share more than doubled. He has successfully led the launch of 24 medical devices at the national level. Later, based in Belgium, he was an Associate Director for International Sales and Marketing Organization at AstraZeneca - a role that spanned all non-US sales and marketing and all therapeutic areas. In California, USA he advised the medical device industry on the development of new products: R&D processes, organization and strategy. Chris holds a Bachelors and Masters of Engineering from Cambridge University in the UK and an MBA, with distinction, from INSEAD, France.

Dr Kishore Udipi DAC Member • •

California, United States Independent

Dr. Kishore Udipi received his Ph.D. in Polymer Science from the University of Akron and was a NASA postdoctoral fellow at Princeton. He has had over 30 years of successful industrial experience at Phillips, Monsanto and Medtronic Cardiovascular. There he led projects in areas such as biomaterials, drug delivery, polymer blends, coatings, implantable polymers among others. He was a Senior Science Fellow at Monsanto, a position less than 1% of the scientists attain. At Medtronic, Dr. Udipi was Director of Polymer Research and Distinguished Scientist. He is the co-inventor of BioLinx® Polymer System employed in Resolute, one of the two leading drug eluting stents globally generating billions of dollars of revenue. He has 45 awarded US patents; and scores of awarded foreign patents. He has authored and co-authored book chapters and >40 papers in peer reviewed journals. He has made presentations and chaired sessions at national and international polymer and biomedical conferences.

Dr Jason Loveridge DAC Member • •

Southampton, UK Independent

Dr Loveridge has been working with growth orientated businesses in the biotech and medtech industries for over 20 years. As an active venture investor he has established a lengthy track record of successful participation in European, US and Israeli-based healthcare companies. Based in Europe he also has considerable international experience at board level. Dr Loveridge’s current directorships include: Warambi Sarl; JDS BioPharma Limited; Actionogen Medical Pty Ltd and he is CEO of 4SC AG.


WOUND CRC ANNUAL REPORT 16-17

Key staff As of 30 June 2017, the Wound CRC employed 17.3 FTEs including National Office (9.9 FTE), Wound Innovations (5.8 FTE) and WHIA (1.6 FTE). Key personnel employed and consultants/advisors engaged by the CRC from 1 July 2017- 30 June 2018 are listed in the table below.

Key staff Name

Organisation

CRC position/role

Time Commitment

Dr Ian Griffiths

Wound CRC

Chief Executive Officer

100

Ian Landreth

Wound CRC

Chief Operating Officer and Company Secretary

100

Dr Anthony Dyer

Wound CRC

Special Projects and Initiatives Director

100

Dr Tamsin Terry

Wound CRC

Director of Research and Development

70

Dr Michelle Gibb

Wound CRC

Clinical Director

100

Emma Gierke

Wound CRC

Corporate Services Manager

100

Dr John Bingley

Wound CRC

Vascular Surgeon

40

Shelley Morris

Wound CRC

Branding & Communications

100

Peter Arnold

Independent Contractor

Consultant

As required

Professor Keith Harding

Welsh Wound Innovation Centre

Principal Advisor

As required

Wound Healing Institute Australia (WHIA) Governance WHIA is a wholly owned subsidiary of WMPL, with not-for-profitable and charitable status. WHIA has an independent governance structure to that of the CRC. The membership of the WHIA Board is:

• • •

Mr Peter Francis (Director and Chair) Dr Ian Griffiths (Executive Director) Mr Stephen Carmody (Director)

WHIA Board Meeting Attendance FY 16-17 2016 13 July

12 October

5 December

Mr Peter Francis

Dr Ian Griffiths

Mr Stephen Carmody

*

*Not eligible to attend 13 July 2016 meeting

23


24

WOUND CRC ANNUAL REPORT 16-17

Participants

Wound CRC Participants are shown in the table on the following table. Participants include five “Essential Participants” as listed in the Commonwealth Agreement as well as 19 “Other Participants” that are not listed in the Commonwealth Agreement, but are party to the Participants Agreement. The breadth of projects across the CRC’s research, development and translation portfolios demonstrates engagement across a wide variety of participants from industry, clinical bodies, research organisations,

SMEs and end-users, including third parties who are not signatories to the Participants Agreement. Other Participants the University of Tasmania, Swinburne University of Technology and Capital Health Network Ltd joined the CRC in FY16-17. Metropolitan Health Service (WA Health) have provided notice of intent to withdraw from the CRC effective November 2017. The reduction in contributions from Metropolitan Health is offset by contributions from the additional participants joining the CRC in the last two years.

Participants FY16-17 Name

Participant Type

ABN/ACN

(Essential/Core or Other/ Supporting or Third Party)

Organisation Type (Australian Government, State Government, University, Industry/ Private Sector, SME, International or Individual)

Curtin University of Technology

Essential

99 143 842 569

University

Queensland University of Technology

Essential

83 791 724 622

University

Royal Melbourne Institute of Technology University

Essential

49 781 030 034

University

Smith & Nephew Pty Limited

Essential

68 000 087 507

Industry/Private Sector

University of South Australia

Essential

37 191 313 308

University

3M Australia Pty Ltd

Other

90 000 100 096

Industry/Private Sector

Acelity

Other

47 056 073 468

Industry/Private Sector

ACT Capital Health Network

Other

82 098 499 471

Federal Government

Blue Care

Other

96 010 643 909

Industry/Private Sector

Department of Health South Australia

Other

97 643 356 590

State Government

Department of Health Victoria

Other

74 410 330 756

State Government

Ego Pharmaceuticals Pty Ltd

Other

86 005 142 361

Industry/Private Sector

Metropolitan Health Service (WA Health, departing)

Other

13 993 250 709

Industry/Private Sector

Mölnlycke Healthcare

Other

65 096 897 657

Industry/Private Sector

Paul Hartmann Pty Ltd

Other

35000 099 589

Industry/Private Sector

Queensland Health

Other

66 329 169 412

State Government

Royal District Nursing Service Limited

Other

49 052 188 717

Industry/Private Sector

Silver Chain Group (Incorporating RDNS SA)

Other

77 119 417 018

Industry/Private Sector

Swinburne University of Technology (new participant)

Other

13 628 586 699

University

The University of Queensland

Other

63 942 912 684

University

University of Melbourne

Other

84 002 705 224

University

University of Tasmania (new participant)

Other

30 764 374 782

University

University of Western Australia

Other

37 882 817 280

University

Wounds Australia (formerly Australian Wound Management Association Inc.)

Other

69 104 482 963

Individual SME

AbRegen Pty Ltd

Third Party

38 128 282 800

Individual SME

iPug (AUS) Pty Ltd

Third Party

40 612 197 583

Individual SME

Marinova Pty Ltd

Third Party

7 103 342 801

Individual SME

Mater Misericordiae Ltd

Third Party

83 096 708 922

Industry/Private Sector

Metro North Hospital and Health Service

Third Party

18 496 277 942

State Government

Metro South Hospital and Health Service

Third Party

86 834 068 616

State Government

Southern Cross Care (SA and NT) Inc

Third Party

53 682 143 626

Industry/Private Sector

Southern Cross University

Third Party

41 995 651 524

University


WOUND CRC ANNUAL REPORT 16-17

Collaboration

Core to the CRC Programme is the unique collaboration between Australian academia, industry and end-user organisations to drive research to output. The Wound CRC has facilitated an extensive amount of collaborative research with Participants, end-users and non-participant organisations from a broad background of Australian wound care practitioners, clinical researchers, and related industry organisations. Collaborations have occurred in both city centres and regional and remote areas, involving key researchers resulting in the direct uptake and utilisation of CRC research outcomes. Major translational projects have also provided external linkages with industry partners. Wound Innovations, Diabetic Foot Australia and WHIA have not only engaged CRC Participants in projects and utilising CRC outputs, but also provide a bridge to small organisations in the wound care industry that would not typically have capacity or access to leading research, such as nursing and allied health organisations. These types of collaborations therefore increase the scope of dissemination of best-practice knowledge, and develop Australia’s wound care innovation capacity. Recognising the value of CRC collaborative research, 3 additional Participants have joined the CRC in FY16-17, The University of Tasmania, Swinburne University of Technology and Capital Health Network Ltd. The CRC has also developed agreement structures that enable SMEs to collaborate with research institutes on projects that align with the CRC aims, with 3 such projects active in the reporting period. A key tenet of the CRC’s activities has been clinical research, where accessing specific patient populations is key to success. As well as using sites at Participant organisations, CRC clinical research collaborations have been established with a range of non-participant organisations who contribute significantly to the CRCs aims by facilitating recruitment into clinical studies. These non-Participant collaborators include 42 aged care facilities, 10 hospitals and 10 community clinics.

Recent highlights demonstrating the innovative and collaborative approach of the Wound CRC include:

• • • •

• •

a collaboration between Capital Health Network (ACT’s Primary Health Network ), and the CRC’s health economics team based at QUT to estimate the social and economic cost of wounds in the ACT. Blue Care, the Mater Hospital (Brisbane), Wound Innovations and QUT working together on a clinical study to provide much needed current data on the cost of wound care in different clinical settings. UniSA, the CRC’s South Australia-based healthy ageing Node. WHIA, and the CRC’s QUT health economics team working with Southern Cross Care (a third party) to measure the practical impact of the CRC’s aged care wound training and auditing suite. The project reduced wound incidence by 43.8%, demonstrating that residential aged care facilities could improve care at the same time as reducing care costs. This project led to an additional project addressing the need for a simplified wound management protocol in aged care and other health settings. QUT and Swinburne University working together on a clinical trial sponsored by the CRC to test smart insole technology in people at risk of developing diabetic foot ulcers. Industry Participants Smith & Nephew, 3M, BSN Medical, Acelity and Hartmann Pty Ltd have collaborated with the CRC to provide education and training during the establishment of Wound Innovations.

In FY16-17 the CRC supported 39 full research projects and 29 student projects, leveraging collaborations between CRC Participants, 42 aged and residential care facilities, 11 hospitals, 10 community clinics and 3 SMEs.

Wound CRC Collaborations in FY16-17 included:

39

Research Projects

29

Student Projects

42

Aged and residential care facilities

11

Hospitals

25


26

WOUND CRC ANNUAL REPORT 16-17

Financial Management The Wound CRC continues to use RNA Solutions to provide outsourced bookkeeping services, and the preparation of management accounts. UHYN Accountants provide accounting, tax and audit advice and SRJ Walker were appointed auditors for FY16-17.

Cash contributions In FY16-17 the Wound CRC received cash contributions from Participants of $1,835,000, $ 512,800 over the total budget of $1,518,000 agreed with the Commonwealth for this financial year. This positive variance encompasses late contributions for FY15/16 from 7 Participants, additional Participants joining the CRC, and additional tied contributions from Participants. As of June 30th 2017, 4 participants were overdue on Payments, of which 3 were paid shortly after year end.

Expenditure Expenditure for the year totalled $7.973.000. This figure includes expenditure relating to the establishment of the CRC’s legacy vehicles including Wound Innovations and funding for the CRCs major RCTs. These strategic investments utilise cash reserves built up over previous years. The Wound CRC is in a sound financial position as at 30 June 2017. The CRC has instituted robust financial controls to ensure that the CRC prudently manages finances to achieve maximal outcomes in the last year of the CRC. The following table indicates the total contributions over the 2017 Financial Year. Total funding over the year amounted to $12,896,800.00.

The Wound CRC has no bad debts for this financial year.

In kind and Non-staff in kind contributions For FY16-17, Wound CRC Participants contribute 16.5 FTE (Full Time Equivalent) for staff in-kind contributions, 0.6 FTE over agreed contributions. The Wound CRC reported total non-staff in kind contributions of $3,450,000 from Participants against the original CRC budget for FY16-17 of $3,790,000. As in previous years, as the CRC moves closer to the end of its term, the CRC has directly employed staff to manage the translation activities that will form the CRC’s legacies, which has reduced in-kind commitments derived from employment of staff at Participant organisations.

FY16-17 Contributions Source of Funding

Amount

Agreement

Variance

Commonwealth Funding

$3 000 000

$3 000 000

0

Cash from Participants

$1 835 000

$1 518 000

$317 000

Staff in-kind

$4 284 800

$3 772 000

$512 800

Non-staff in-kind

$3 450 000

$3790 000

-$340 000

Other income

$327 000

0

$327 000

Total

$12 896 800

$12 080 000

$ 816 800


WOUND CRC ANNUAL REPORT 16-17

CRC Future Plans and Transition Arrangements The Wound CRC is now entering the final year, and is focused on ensuring that the outcomes of the CRC are sustained beyond the term of the CRC. The CRC has already made the following arrangements in preparation for closure:

• • •

The CRC’s operational units are being prepared for transition beyond the CRC to provide sustainability for the professional educational and training programs developed by the CRC. These operational units are: Wound Innovations, WHIA, Diabetic Foot Australia, Credentialing, Healthy Ageing Node.

All substantive Research Projects will complete by 30th June. Participants are aware of the proposed final reporting requirements and proposed payment schedule for final invoices. All students will have completed their CRC funded scholarship terms by 30th June 2018, except for 3 students. For these students, arrangements have been made for Participants to administer funds on the CRC’s behalf. The CRC is working with Participants to effect transfer of IP, to maximise utilisation.

Other Activities The CRC continues to work with the MTP Connect Industry Growth Centre and the organisations have developed an MOU to collaborate on a number of activities that progress the mutual objectives of each organisation. During the last Financial Year, the team commenced a Stage 1 bid for a Round 19 CRC in the area of chronic disease interventions focusing on a number of key issues that will lead to reducing avoidable hospitalisations. The team were successful in obtaining $150,000 from the South Australian Government CRC assistance program toward the CRC due to the bid’s strong alignment with SA industry and economic priorities.

27


About Us

Our Vision

The Wound Management Innovation Cooperative Research Centre (Wound CRC) has been a catalyst for change in the wound industry since its inception in 2010. The Wound CRC is an industry led, cooperative organisation whose activities are transforming wound outcomes by addressing the key issues affecting wound healing and prevention. The Wound CRC brings together the best of industry, academia and end user organisations

Transforming Wound Outcomes

Our Mission We will improve wound healing and quality of life for people with wounds and implement cost effective wound care that lessens the burden on the Australian Health System

Annual Report FY16-17  

The Wound Management Innovation Cooperative Research Centre Annual Report for FY 16-17

Annual Report FY16-17  

The Wound Management Innovation Cooperative Research Centre Annual Report for FY 16-17

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