Supraphysiological Wound Care: From Hot Water Bottle to Plexaa

Dr. Mehta first started exploring the topic of preconditioning the body for healing when he learned about skin-sparing mastectomy. He realized that while this procedure provided great benefit for reconstruction outcomes, it left behind thin, poorly perfused skin that was vulnerable to necrosis. Dr. Mehta started a clinical research project over heat stress and the subsequent chaperone protein and endogenous carbon monoxide release that allows for vasodilation and improved perfusion. His early studies involved mouse models and human patients who used hot water bottles over their skin on the day before surgery. The promising data led Dr. Mehta to apply for and win an NIHR grant to run a full clinical trial with heated water bottles. He found that preconditioning and applying supraphysiological heat stress to the skin prior to operation resulted in reductions in rates of skin necrosis, re-operation, and need for outpatient follow up.

Today, Plexaa is a bra insert that can be heated to an exact temperature using a phone app. The technology is made possible by a principal circuit board that ensures a safe and accurate heat delivery to breast cancer patients who may have altered sensation to skin sensation from prior radiation therapy and chemotherapy. Plexaa has partnered with institutions and is planning to help doctors and nurses incorporate the product into their pre-operative planning and send Plexaa directly to patients’ homes. In the future, Plexaa aims to bring its technology to other surgical specialties such as orthopedics and ENT.