Tragedy behind Australia’s world-class burns technology treatment RECELL: Robert Gottliebsen

The Australian, Tuesday, November 8, 2022, Link Here: One of Australia’s best known, and most successful medical breakthroughs has been the burns treatment process developed in Western Australia, which was highlighted after the 2002 Bali bombings.

But it is also one of the most tragic.

The US has now embraced the Australian technology as its burns standard treatment. It’s rare for the US to rank Australian technology first in an important medical treatment area like burns.

Australia’s next burns frontier will be Japan. And now the US has embraced the Australian burns technology the breakthrough looks set to revolutionise the US treatment of soft tissue injuries and vitiligo, which came into community prominence via the late Michael Jackson.

The tragedy arises because Australians not living in Perth who are badly burned must either fly to Perth or to the US to be treated with Australian technology.

How Australians lost at home but won abroad is one of the more remarkable stories involving. Australian technology.

Back in 2002 Professor Fiona Wood and colleague Marie Stoner at Royal Perth Hospital inspired Australians when they treated the badly burned victims of the Bali bombing with their unique “spray-on skin” technique.

Three years later Wood became Australian of the year and both Wood and Soner received our top science accolade, a Clunies Ross award. (I was on the judging panel).

Clunies Ross medals were given to scientists who took their invention to the development stage. Wood had led the formation of the public company Clinical Cell Culture to spread the Australian technology. It was listed on the ASX under the symbol “C3” which gave it a Star Wars image. It later changed its name to Avita Medical.

The Wood and Stoner skin culture technique (trademarked as RECELL) takes a small sample of the patient’s own skin, from which a “suspension” of skin cells is prepared, which is then sprayed onto areas of the patient requiring treatment.

The spray contains all of the cells necessary to promote healthy skin growth, including cells to promote healing and colour. Incredibly, the skin cells in the spray contain information to “know” what the person’s skin should look like – for example, facial skin cells “know” that they are facial skin cells – they can signal and recruit other cells, including nerve cells, to come in.

What Wood and the directors of C3 did not fully appreciate was that they had developed not just a technology, but a whole system of treating burns.

For it to be used in markets outside Perth, the whole system had to be transposed, which was a major and time-consuming undertaking. C3/Avita began marketing the technology as a product rather than a system, and on the east coast of Australia there was considerable resistance in the medical profession to changing their methods of treating burns. Frustrated, C3/Avita went to London and Italy. They made the same mistake, and Australian style resistance was duplicated.

The end of the road looked near for the Avita public company when Jeremy Curnock Cook, founder and managing partner of Melbourne and London based health care investment group BioScience Managers, became a major shareholder.

Cook and other investors were excited that, unlike other medical investments, RECELL was a proven system to treat burns. Rather than fight the prejudices that had been developed in eastern Australia and to a lesser extent in London and Italy, Cook and the new board chose to market in the US.

Avita sought US Food & Drug Administration (FDA) approval not just for the product but for the whole RECELL the system. It was granted in 2018.

But along the way, the US Army’s medical research establishment was so impressed with RECELL that it helped Avita by sponsoring clinical trials and described the system as offering a possible “paradigm shift” in skin injury treatment.

The US Department of Defence signed-on for purchase contracts years before RECELL was approved by FDA. Badly burned US soldiers in Afghanistan received the treatment. The Australian defence people did not follow their American counterparts.

Avita raised substantial capital in the US, where it is now listed and where its top management is based. Once Avita obtained FDA approval, it began rolling its systems out across the US, careful not to make the Australian mistakes. However, with the approval of FDA and the U S Department of Defence made the process was much easier.

But there was still one hazard to come. By 2019-20, Avita had spent large sums rolling out its system, but then Covid-19 struck the US population and the number of burns victims plummeted. Avita expensed the rollout and when the burns victims did not arrive as expected the share price slumped.

But with normality returning turnover is now rising, and the company has $90m in cash preparing for the day when its systems will be approved in soft tissues and vitiligo – both much bigger markets than burns.