Submitted by: Lindsay Gail W. Torralba-Garcia
Subject/ Section: Managerial Entrepreneurship/ MBAH-02
Topic: NU10
Submitted on: August 13, 2016
1. Hydrocolloidal antibiotic and anti-inflammatory dressing with an adhesive for sensitive skin.
Dermal fillers and botox treatments are among the top 3 most common aesthetic procedures being performed worldwide. (Clear skin MD, 2015) The trend is also not limited to the type of procedure but an important factor that most of aesthetic patients consider is the "downtime". Downtime is a term that provides the length of time from which a person will experience any unappealing sequalae of a procedure. For example, a patient that comes in for a dermal filler or botox treatment, both entailing tiny punctures from fine needles may have a 50% possibility of incurring bruises and inflammation after the procedure, however, these bruises and inflammation will spontaneously subside in 3 to 5 days, hence the downtime is 3 to 5 days. The current trend on patient demand is the desire to have minimally invasive procedures done, such as botox and fillers without any downtime, a feat that dermatologists and cosmetic surgeons must address. Hence having a post treatment dressing that is not in the form of a visible band-aid which not only provides protection to the puncture wound but at the same time administer an antibiotic and provide hemostasis will be a valuable tool for post procedure patient care.
A round transparent hydrocolloidal dressing with adhesive (suited for sensitive skin) would be a more attractive post procedure dressing than a typical band-aid as it would be barely noticeable due to it's size and transparent color. The size would not exceed 0.5x0.5cm, which would more than suffice in covering the entry point of needles. The dressing will serve as a temporary "plug" on the puncture sites, contributing to hemostasis, decreasing bruising and swelling after the procedure, decreasing downtime. An added benefit incorporated into the hydrocolloidal dressing would be the administration of an antibiotic. A topical antibiotic cream and ointment prevents any adhesive from attaching to skin, hence if the antibiotic is already incorporated into the dressing, this dilemma will be addressed.
The overall benefit would be better post procedure patient care and higher satisfaction rate from patients. In line with the current demand of patients who desire aesthetic procedures without the downtime, the hydrocolloidal dressing can offer a better option, decreasing the probability of downtime.
There are already existing hydrocolloidal manufacturers worldwide, however most of these products that are readily available in local pharmacies are limited to major surgical wound care such as trauma, burn and ulcers. The products are large in size and thick, not ideal for post aesthetic procedure wound care. There are manufacturers of "invisible" hydrocolloidal dressing in Korea and China which approximates the size of what can be acceptable to dress aesthetic procedures, the cost is at least P0.05 per piece without the antibiotic.
2. Fiber-less surgical sponge to reduce risk and probability of foreign body (fibers) being left behind in the operative field during surgery.
The most common post-operative complication that any surgeon can encounter is infection. Therefore all precautionary measures are taken before, during and after surgery to lessen the probability of this complication, typically with antibiotics and septic-aseptic technique. However, the materials from which sponges are made comprise of thin white fibers that has a tendency to fall apart. Any fiber that separates from the sponge which has already absorbed blood is sometimes difficult to notice and detect, hence there is a risk that these fibers may be left behind in the operative field during surgery which will later on be a cause of infection and delay wound healing.
The fiber-less surgical sponge would actually be a modified version of the sponge with the simple solution that the edges are folded inward and secured with either a hypoallergenic adhesive or mere suturing, so that no fiber edge will be exposed and prone to being detached.
The benefit of such a minor innovation will go a long way when it comes to preventing post surgical infection secondary to foreign body. A roll of surgical sponge which is the basic material costs PHP800-1,000 and can make at least 2,000 pcs. of 2x2 surgical sponges. Additional manufacturing expenses will be labor for the suturing of the folded ends and autoclaving the finished product for sterility.
3. Modified Silicone sheet with onion extract & polypeptides that can be left on a scar for a prolonged period of time (at least 24 hours) to increase patient compliance.
In the aesthetic industry, scars is one of the most common complaint of patients, may it be to avoid getting a scar after surgery or for treatment of scars that have been around for a long period of time. Either way, the reality is scars are one of the most difficult aesthetic problems to address. Available treatment for scars range from expensive laser procedures to over the counter creams/ gels. Most people in the Philippines can only afford the over the counter available products, which often times are purchased for self-medication without proper advice from physicians to be able to determine if such medication is ideal for the type of scar. Another concern is patient compliance, commonly seen in self- medication where patients expect immediate results and become impatient, abruptly stopping treatment, a common occurrence when physician supervision and advice is not present.
The most current innovation in scar treatment is somewhat like a "transdermal patch". The most effective active ingredients for scar treatment are silicone, onion extract and polypeptides which are all delivered in different mediums. The silicone is delivered in a silicone sheet, while the onion extract and polypeptides are delivered in a cream/gel. Hence, why not incorporate the onion extract and polypeptides within the silicone sheet with adhesive, so that when the sheet is applied, transdermal delivery of the active ingredients are accomplished. The adhesive which has a life-span of 2 weeks can address patient compliance problems as they no longer need to worry about remembering to apply cream/gel several times a day, instead just leave the silicone sheet, a form of "patch" and just replace every 2 weeks.
4. Topical anesthesia for the skin that can be delivered through spray which can penetrate up to the dermal layer of the skin in less than 30 minutes and can last for at least 2 hours.
One of the top five most common dermatologic office based procedures are the treatment or removal of skin lesions such as warts, syringoma, and skin tags. The procedure entails the application of a topical anesthetic that is typically delivered in a form of cream which takes a minimum of 40 minutes to take effect and lasts for 2 hours. The 40 minute waiting time for the anesthetic cream to take effect contributes to the waiting time of the patient and prolongs the procedure. The minimum 40 minute waiting time for the anesthetic cream to take effect is attributed to the heavy thick cream as its delivery medium. Another problem is that the penetration of anesthesia is limited at the epidermal layer which can no longer offer a pain free procedure for skin lesion that take root in the dermal layer of the skin.
There is much development and innovation in cosmeceuticals that creams have evolved into lighter forms and can be delivered via spray. The technology such as that used in sunscreen for faster penetration/ absorption into the skin called liposomal technology may be adapted with these anesthetic creams to decrease waiting time and make procedures more efficient and shorter in duration, increasing customer satisfaction.
5. A topical antibiotic packaged in a small barrel (like that of a lip balm) with an attached snap on cap for ease of use, portability, convenience and compliance of the patient. The possibility of loosing the screw caps from topical creams or ointments can be lowered and sterility of medications can be maintained.
Skin infections and allergies are among the most common chief complaints of dermatology patients. Both complaints are easily addressed and treated as long as patient compliance with prescribed medications is not a problem. Often times, failure of treatment and improvement on the skin condition is unattained due to poor compliance of patients. A couple of reasons that contributes to low patient compliance are the following (1) most antibiotic creams/ gels comes in tubes with a screw cap which can get lost when removed, (2) some patients get embarrassed to be seen using said products in public, (3) some products come in big tubes that may be inconvenient and lacks ease in portability. Taking into considerations some of the minor problems as enumerated which contributes to lower patient compliance, antibiotic or anti-allergy medications can be stored and contained in a barrel to mimic a lip-balm which can address any public assumption that one is being treated for a skin infection or disease. The barrel would come with an attached snap cap so that this cover cannot be misplaced or lost, maintaining the sterility of the container and medication. The size of the barrel will also be a compact and convenient way to make these medications portable and easily carried around by patients. The minor modification in packaging may go along way in increasing patient compliance and decreasing antibiotic/ medication resistance.
6. A press powder that can deliver SPF 50 UVA/UVB protection as well as anti-acne medication to address acne eruptions from over the counter cosmetics.
Atleast 90% of women use over the counter make-up as a daily ritual, even at times viewed as a daily necessity for aesthetic purposes or even required for work. However, a lot of these products have ingredients that predispose the user to acne formation called acne cosmetica. So when an acne patient uses these products, his or her acne only worsens or there may be no improvement at all despite proper medications.
Another major factor related to acne is the post inflammatory hyperpigmentation that occurs after acne heals. These are black marks that can be disfiguring and contribute to an acne patient's decreased self-confidence. These marks can be easily addressed and prevented with appropriate use of a good sunscreen with at least SPF50. However, one major drawback with women who use cream based Sunscreen is the inability to reapply this during the day after they have applied their make-up because the cream would clump up their make-up.
Taking into consideration the two problems enumerated above, a make-up without the comedogenic ingredients in the form of press powder with SPF50 with UVA & UVB protection, and incorporated anti-acne ingredients can truly contribute in helping out these acne patients, addressing & preventing two problems in one product. The form and delivery of sunscreen and preventive anti-acne medications can be easily achieved with fine powder particles that may be conveniently applied by the patient at any time of the day. The packaging is a typical portable press powder container adding to the patient's convenience. In the end, patient compliance to applying and reapplying sunscreen is also addressed without the worry of their make-up clumping up.
7. A software that can automatically measure distances between facial features to better aid the doctor in explaining existing asymmetry to patients prior cosmetic surgery or aesthetic procedure, as well as help a patient come to terms with a realistic expectation for the result.
99% of the population has asymmetric human anatomy, meaning that the right side of the body is not 100% equivalent in measurement, size and appearance as the left side of the body. Most patients are not aware of this, hence when they consult for surgical or aesthetic procedures, these asymmetries are noted and pointed out to them to enable them to reach and accept a realistic expectation for results after the surgery or treatment. Often times, asymmetries are addressed and corrected, however there are instances wherein correcting them are impossible. In cosmetic surgery, patient dissatisfaction is considered a complication, hence detailed patient pre-operative consultation is important to decrease the incidence of dissatisfied patients.
In the dermatologic industry, they use a machine called the facial skin analyzer that determines the patient's skin condition such as dryness, dark spots that are apparent and about to appear. This machine is operated by a software that can be upgraded from time to time with new features added, hence why not add a software that can measure anatomical distances of the face. With the addition of this software, the consultation with regards to asymmetries will be facilitated and backed-up by documented data from the machine which can validate the objective perspective of the surgeon. The results from the machine can aid the physician during consultations like that of typical laboratory procedures aiding in diagnosis explanation and planning for treatment.
8. An ampule breaker that does not need any manipulation by a human hand, to prevent risk of accident.
Some medications come in an ampule packaging that is made out of glass. The typical ampule breaker entails manually inserting the neck of the ampule into the apparatus and break/open the ampule with a motion of tilting the body of the ampule to either the left or the right side. The action of opening the ampule predisposes the operator to glass injury which will be a health hazard, increasing the liability of the medical facility and inefficiency of customer service.
A modified version of the ampule breaker apparatus will have an entry point of the entire ampule where human contact ends, no manual glass manipulation or tilting needed. The ampule is placed in a specific ampule slot within the opening of the apparatus. The apparatus is only activated whenever an ampule is placed in it. Within the apparatus, the neck of the ampule is precisely broken using sharp blades, an attached disposable container accumulates the removed heads of the broken ampules. The opened ampule is then delivered at the other end of the apparatus where it can be easily picked up and ready to use.
Decreasing human contact when opening ampules can definitely lower accidents, decrease facility liability and make patient care more efficient.
9. Puncture proof examination and surgical gloves to lower risk of contamination and infection.
A big problem that healthcare professionals continue to face is the risk of infection; hence gloves are an important part of ones uniform. Any puncture on the gloves predisposes the healthcare practitioner and patient to infection or contamination of a sterile area.
The material for this puncture proof gloves can be made of thick nitrile material however the thickness must not compromise the ability of the fingertips to feel or palpate as this sensation is important during physical examination. These puncture proof gloves will increase safety measures in ensuring decreased transmission of infection and diseases as well as contamination of surgical operative field.
10. A portable mirror that can show 2 perceptions of ones face. One that shows what a right eye dominant person can see, and the other showing what a left eye dominant person can visualize. To aid doctors and patients in cosmetic surgery and aesthetic procedures.
Beauty is always in the eyes of the beholder and is very subjective. It must be considered that the subjectivity of such perception is partly due to the eye dominance of a person. A left eye dominant individual may not appreciate what may be appealing to the right eye dominant person, and vice versa. So when a left eye dominant physician encounters a right eye dominant patient, some anatomical asymmetries may not be detected by the naked eye and perceptions in beauty may differ leaving the two to have difficulty understanding each other and being on the same page.
It is of utmost importance that a patients definition or perception of beauty or his/ her desired result is understood by the physician so that patients expectations are met. On the other hand, a mirror that is able to show what each dominant eye can see will aid the patient and physician to reach an understanding sooner by seeing what the other person actually perceives, in the end reaching an agreement on what will be the expected realistic result.
Lindsay Gail Wilson Torralba-Garcia, M.D. 3,5
Cosmetic Surgeon
Wilson & Ayache Clinic
Lower ground floor, Legaspi Park View Bldg.
134 Legaspi St., Legaspi Village, Makati City 1229
Philippines
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