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Decontamination of Open Wounds - Open Topic

Description:

OUSD (R&E) CRITICAL TECHNOLOGY AREA(S): Biotechnology

 

OBJECTIVE: The purpose of developing an effective man-portable capability that will rapidly remove chemical warfare agents (CWAs) and other toxic industrial chemicals (TICs) of interest to the U.S. Department of Defense from both intact and wounded human skin, under austere conditions is to bring potentially valuable small business innovations to the Chemical and Biological Defense Program portfolio to discover and develop chemical medical countermeasures (cMCMs) capable of neutralizing CWAs in wounds and on the skin for the treatment of the Warfighter.

 

DESCRIPTION:  Although decontamination issues have been studied since the onset of chemical warfare, decontamination of chemical warfare agents (CWAs) from the skin remains a thorny problem for a variety of reasons.

 

These include, first and foremost, the ability to rapidly and effectively remove a diversity of toxic chemicals that currently are, or could be, CWAs, without harming or damaging the contaminated skin or wound. Prompt and rapid post-exposure decontamination is critical to reduce the post-exposure effects of CWAs.

 

In addition, a practical decontamination product needs to satisfy a plethora of secondary requirements, which include but are not limited to:

  • Being simple to use in the field under harsh and likely confusing situations.
  • Be light weight, compact, and easily stowed in a soldier’s pack.
  • Be fast acting and effective under a wide range of environmental conditions.
  • Meet and satisfy Federal Drug Agency (FDA) requirements.
  • Meet and satisfy major DoD logistical requirements, i.e., long shelf-life, ease of transportation, manufacturability, and cost-effectiveness.
  • Last, but not least, in addition to removing the toxic agents from skin, the product should be able to detoxify these chemical agents, both while it is being applied on the skin and after its removal. Rapid agent detoxification and decontamination effectiveness are intricately linked because in-situ detoxification is an effective method of reducing agent concentration on the skin before the agent has time to diffuse into the sub-dermal region. Detoxification of the agent also attenuates or prevents secondary contamination of medical or other personnel, and of the environment.

 

Chemical warfare agents (CWAs) are among the most lethal and sinister substances manufactured by man (1). They are designed to kill, maim, immobilize, or psychologically threaten enemy troops.

CWAs can attack the skin which is not only the body’s interface with the outside environment, but also the largest organ of the body, with a surface area of roughly 1.6 m² for women and 1.8 m² for men (6).  Skin exposure to warfare agents is also a major problem during non- conventional war (5), or terrorist attack. Over the eons, a wide variety of materials in gas, liquid or solid form have been mobilized for this purpose. At present, CWAs of greatest concern in military operations are relatively low volatility organic liquids that attack the skin (vesicants) or attack the nervous system (nerve agents) (2-4).

 

Human skin, the largest human organ, developed as a physical barrier to the environment (to keep things out) but also maintains the aqueous nature of the human body (to keep things in). Mammalian skin consists of three major layers: stratum corneum, epidermis, and dermis. The stratum corneum, the thin outer layer of keratin-filled dead cells (corneocytes) bounded by densely crosslinked protein and embedded in crystalline lamellar lipids, represents the major barrier protecting the body from loss of internal components and entry of undesirable external materials. The stratum corneum, composed of keratinized dead cells that are continually being replaced, is the first major barrier to chemical agents. The layer underneath the stratum corneum, the epidermis, contains cells that differentiate from viable keratinocytes to corneocytes during their migration from the dermis to the stratum corneum. It also contains a large number of specialized cells. The dermis is the main component of living skin.

 

The purpose of decontamination is to reduce an initial amount of harmful material deposited on the surface of a person or object from the environment to a level that is low enough allow it to continue to safely function. It should be noted that permeability of the contaminant through the surface of the person or object is a complicating issue for any surface decontamination process. Contaminant permeability renders decontamination more difficult to perform, places time limitations on the window of opportunity for its performance.

 

The alternative to decontamination is discarding the object, which in the case of living beings, is not an option.

 

Current skin decontamination methods rely heavily on “wet” decontamination practices, which include washing the body with water, or soap and water (Roul et al., 2017). Alternatively, rapid decontamination makes extensive use of “dry” decontamination, which is based on adsorptive properties of powders, such as activated carbon or Fuller’s Earth (FE) (Roul et al., 2017).

 

Improved personal decontamination methods/products should consider:

  • The effects on both intact skin and open wounds.
  • Impacts on the subsequent wound healing process.
  • Agent variable decontamination efficiency.
  • Post-decontamination CWA detoxification capability. Rapid agent detoxification and decontamination effectiveness are intricately linked because in-situ detoxification is an effective method of reducing agent concentration on the skin before the agent has time to diffuse into the sub-dermal region. Post-decontamination detoxification of the contaminant(s)will also attenuate or prevent secondary contamination of medical or other personnel, and of the environment.

 

There is a clear need to develop an effective man-portable capability that will rapidly remove chemical warfare agents (CWAs) and other toxic industrial chemicals (TICs) of interest to the U.S. Department of Defense from human skin, both intact and wounded, under austere conditions.

 

PHASE I: A feasibility study to demonstrate the technical and commercial practicality of the concept to include an assessment of its technical readiness and potential applicability to military and commercial markets.

PHASE II: Businesses will produce practical and feasible prototype solutions that can operate in edge and austere environments. Companies will provide a technology transition and commercialization plan for Department of Defense and commercial markets. The DoD will evaluate each product in a realistic field environment and provide solutions to stakeholders for further evaluation. Based on Soldier field assessment, the DoD will request companies to update the previously delivered prototypes to meet final design configuration.

 

REFERENCES:

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KEYWORDS:

Decontamination; Chemical Warfare Agents; Personnel Decontamination; Casualty Decontamination; Skin Decontamination; Open Wound Decontamination; Chemical Agent Detoxification

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