Proprietary Self-Assembling Peptide Can Jumpstart Wound Healing

A new product, AC5^® Advanced Wound System, which contains a self-assembling peptide, may allow for more aggressive debridement of chronic wounds to better prepare the wound bed for healing.

When the AC5 Advanced Wound System (Arch Therapeutics, Inc.) is applied to a wound, it is activated and locally self-assembles into a physical-mechanical seal that acts as a moisture-donating barrier to protect acute surgical and chronic wounds while mitigating both contamination and excessive inflammation. It also provides an extracellular matrix–like scaffold that creates a microenvironment conducive to tissue repair and wound healing, notes the manufacturer.

Arch Therapeutics reports the early leading use for AC5 is after interventions in complicated, chronic, and/or at-risk wounds. Examples include wounds stalled by inflammation, necrosis, or infection; wounds that require frequent dressing changes; wounds in patients on blood thinners; or wounds that are being prepared for application of cellular- and/or tissue-based products (CTPs).

“I was initially intrigued about a product that could control the peptide environment on the surface of the wound,” says Randall Wolcott, MD, CWS, Founder of the Southwest Regional Wound Care Center in Lubbock, TX.

Much of Dr. Wolcott’s previous work had been with small peptides such as RIP (a 7-amino acid quorum sensing inhibitor), substance P (an 11-aminoaciduria factor), several antimicrobial peptides and the complex small peptides of bacteria called effective proteins. In particular, he notes the innovation of AC5 is its self-assembling peptide.
 
“AC5 Advanced Wound System also has the ability to adhere to host tissues exposed in the wound bed. Since excess drainage does not dilute the product but rather percolates through, AC5 is able to coat even the most complex wound bed. The peptide assemblage provides some structure (scaffolding) as well as some physical barrier between the wound milieu and host tissue”, notes Dr. Wolcott.
 
Dr. Wolcott has used AC5 on many large complex wounds that were not healing. He notes aggressive debridement in an outpatient setting was difficult in that it could take far too long to stop the bleeding initially and then when the patients would transfer, the bleeding could recur. AC5 was able to achieve hemostasis in minutes and Dr. Wolcott emphasizes that he had very few patients with breakthrough bleeding over the next 24–48 hours. “This allowed us to be much more aggressive in the management of these wounds and improve their healing outcomes,” he notes.
 
Dr. Wolcott cites several advantages to using AC5, such as hemostasis, adherence of the peptide matrix to host tissue, the product’s antimicrobial properties, and its augmentation of host healing. He says the peptide matrix adhered to the wound bed is not diluted by wound exudate.
 
A potential concern, notes Dr. Wolcott, is that the vast majority of chronic wounds are in a high proteolytic state. “I was worried at first that the protease activity would just strip AC5 from the wound bed, but in our pilot group that this did not seem to happen,” he says.

How Can This Benefit the Wound Clinic?

Chronic wounds are chronic infections caused by biofilm. As Dr. Wolcott says, the number 1 strategy for suppressing biofilm is physical disruption, which in the wound clinic is debridement.

“In my experience I have found that the hemostatic properties of AC5 are a major benefit for the clinic,” says Dr. Wolcott. “AC5 has allowed our wound care providers to debride much more aggressively in an outpatient setting and this is leading to better outcomes.”

“The ability to control the surface of a freshly debrided wound, acting as a barrier to the subversive strategies of biofilm infection as well as augmenting host healing is AC5’s main benefits,” says Dr. Wolcott.

The AC5 recently received clearance from the Food and Drug Administration (FDA) as a medical device for managing partial and full thickness wounds, including chronic or surgical wounds.¹

Click here to download a PDF of this article.

Reference

1. Food and Drug Administration. 510(k) Premarket notification.