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Startup Saturday: A helping hand gadget for diabetic foot cure

Startup Saturday: A helping hand gadget for diabetic foot cure

The seeds of innovation for a tissue imaging technology known as the ‘wound healing assessment and prediction’ (WHAP) gadget were sown in a workshop for Deepak Kumar, founder of Epocare private limited. He, says, “After completing engineering I had attended a workshop on imaging technologies at the Indian Institute of Technology (IIT) Bombay. It was when I was playing around with different imaging devices, an idea struck me. So I thought why not see if the same technology can be used to ‘look’ inside a wound or a diabetic foot to know the vascular status of tissues in a wound?”

So Deepak, an electronics engineer and his co-founder Kumar Kalika, a software engineer decided to use their skills to figure out a system for tissue imaging technology. But before getting down to work the duo did their homework to test their ideas with several people before surging on.

“On our visits we saw that a lot of doctors who worked with diabetic foot injuries would take pictures on their mobile phones. When we would ask they would say that this would help them gauge the success of their treatment. We asked about 30 doctors and 90 per cent of them indicated that such a gadget would be of great use to them. And 10 per cent felt that they would continue to use their conventional methods,” said, Deepak.

He pointed out that traditionally, a person with an injury, whether a burn or a diabetic foot will go see a consultant. The consultant will see the wound, examine it for size of wound, colour and odour and clinically arrive at a treatment module.

“But all these are subjective, as in complicated cases, symptoms like size and depth of wound does not address the cause for non-healing. Such assessment techniques become ineffective and may end up with a foot amputation,” he said.

There is, however, no quantification of the blood supply or oxygenation to the wound which is vital for healing. In many cases there is a need to determine the availability of fresh blood supply in the wounded tissue such as visualisation of the vessel with poor circulation and oxygen demand and supply within the wound surface to know its progress.

The entrepreneurs studied literature that also pointed in the same direction. “Mistakes made in treatment of wounds amount to 50 per cent. These may be treated by juniors in the medical fraternity,” said, Deepak.

Armed with this information, the team decided to develop a technology to quantify the blood supply and oxygenation to a wound. This way a treating doctor could gauge how well or not his treatment was working. “Often people with diabetes have their foot injuries get smaller and look like it has healed. But after a few months, many will return with greater complications on the same wound,” said, Deepak.

How it all started

Luckily for the duo, Deepak was doing his internship at IIT Bombay and had started work with a start-up there. A mentor Amaldev Venugopal guided them and got them incubation at society for innovation and entrepreneurship (SINE) hosted by IIT Bombay. SINE offers start-to-end support to innovators and entrepreneurs in the form of prototyping grants, incubation and also runs accelerator programmes.

Deepak is also mentored by biomedical engineering and technology incubation centre (BETiC) at IIT Bombay that focuses on bringing doctors, researchers, entrepreneurs and investors together for indigenous and affordable medical device innovation. BETiC helps in developing proof-of-concept, patent filling, product validation, device certification and regulation.

From January 2017 to June 2018 the two partners worked on their gadget and filed for a patent.

The technology involves the use of a laser camera and (light-emitting diode) LEDs. When blood flows, the laser lights will get reflected in a certain way indicating how much blood is flowing in the tissue which is being examined. Their start-up is now working with InfraRed technology to find a way to get a reading of oxygenation to the tissues.

Challenges ahead

By June they had their beta product ready for testing and some hospitals in India and Switzerland have been approached for using the gadget on patients with diabetic wounds.

“Dr Dhananjay Kelkar from Deenanath Mangeshkar hospital has agreed to let us use our WHAP. We intend to use it on 200 or even more patients with foot injuries,” said Deepak.

The advantage WHAP aims to offer is to provide a gadget that will cost about one hundredth of a laser doppler which costs upwards of Rs one crore. “Our WHAP currently costs Rs two lakh and we aim to bring the costs down to Rs one lakh.” WHAP is currently being sent to Indian certification for medical devices 13485 (ICMED) and for a CE (a global standard for electronic products) for approval.

Funding

Given that Epocare was being incubated at SINE, they received seed funding of a few lakhs from them, but now they are looking for more money.

According to Kumar, the company needs about Rs 5 crore to Rs 6 crore to develop the technology to assess oxygenation as WHAP currently gives only blood supply readings. “We want to do more clinical trials and find cheaper and better alternatives so we can bring down cost. We are planning to apply for a government grant or get an ‘understanding’ equity investor.”

An ‘understanding investor’ will be one who does not look at his returns only. “If he wants us to turn in profits it will have to wait till we complete our clinical trials and until we find ways to further reduce costs. The investor should understand our issues rather than focus only on profits,” says, Kumar.

The company plans to tie up with a medical devices distributor to be able to sell their product across hospitals and doctors. Diabetic foot may get legs up with this WHAP!

Functioning of WHAP

• Gives instant diagnosis of a wound: the image can tell how much blood is being supplied to the wound

• Can forecast healing time: based on blood supply and oxygenation

• Can determine the effectiveness of different medical interventions like hyperbaric, laser treatments

• Gives an objective assessment (is not influenced by a doctor’s bias)

• Can track healing progress: with instant images on the computer

Expert Opinion

“In my opinion I think the gadget can be very helpful to doctors treating diabetic foot. A clinician will see a wound surface and gauge the extent of the wound and its healing. It can happen that a wound looks small as it heals but may not actually be so. A colour doppler can give us the blood supply status but it does with large blood vessels and he smaller blood vessels status is not known. The only other way to know this is via a laser doppler but that is a very expensive machine and is huge. The WHAP is portable and can tell us about the micro blood vessels supplying blood to the wound. We are doing a study at our hospital and we will see the results. But about 10 to 15 per cent of patients with diabetic foot need amputation. And if a doctor can get information on the micro level blood supply and oxygenation, it will save amputations greatly.”

-Dr Avijan Sinha, consultant foot problem, Deenanath Mangeshkar hospital

First Published: Nov 10, 2018 15:28 IST

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