Paul Santerre
"Innovation in science rides on the coattails of decades of fundamental discovery," says Dr. Paul Santerre, Co-Chair of UHN's Techna Institute, whose team’s basic science research in bio-adhesives and degradable plastics have come together to create the basis of bone tape – a surgical adhesive to fix facial fractures. (Photo: University of Toronto)

Wouldn't it be cool if we could fix broken bones with tape?

By 2014, Dr. Paul Santerre in collaboration with Drs. Cari Whyne, and Jeff Fialkov had finalized the science on a basic concept: making an adhesive material to replace the plates and screws that are normally used to surgically fix cranial and facial fractures. By combining existing basic research with some he was already working on, Dr. Santerre realized it could be done.

"The possibility of tape replacing plates and screws in facial surgery is a game changer," says Dr. Santerre, Baxter Chair, Commercialization in Health Technology, UHN.

"Bones in the face are thin and fragile, and it's more difficult to shape metal plates to the contours of the face. Tape use can also shorten the time required for surgery."

But of course, this wasn't just any old "tape" but a material built on the foundation of decades of existing basic science research.

"Innovation in science rides on the coattails of decades of fundamental discovery," he explains. "Many scientists had already examined natural or bio-adhesives materials, like zebra mussels, and published studies on adhesive amino acids. The findings from these discoveries became one of the building blocks for bone tape."

The Independence

'You need to be thinking 10 years ahead'

Though it was exciting to have the chemistry to create this sticky substance, one challenge to getting a bio-adhesive to the market place is that they are not only difficult to process, sterilize and produce but it is also expensive to do so.

As it were, Dr. Santerre was also doing research on another important component for bone tape: degradable plastics. In collaboration with Drs Eli Sone and Michael Floros in 2017, the team combined the plastic with the adhesives to not only create a flexible material that could be used for the delicate work of repairing facial fractures, but it could also be produced on a large scale.

Happy ending, right? Not so fast. At UHN, we often hear how our researchers are focused on making discoveries that will go from their lab bench right to a patient's bedside. It sounds as simple as needing one great scientific discovery to get from point A to point B, but there is actually so much more to consider and anticipate in between.

"When you're trying to translate promising science into a treatment, you need to be thinking 10 years ahead," says Dr. Santerre. "At the bench today, figuring out the chemistry of what you're working on, finding solutions when chemical reactions don't work, every decision you make influences the cost of generating, and the practicality of developing, that product."

Michael Floros
Dr. Michael Floros explains how bone tape works. As a post-doctoral fellow in biomaterials research, he was recruited by Dr. Paul Santerre to figure out how to make the scientific concept of bone tape into a material that could be mass produced and used for treatment. Five years later, his company Cohesys is getting closer to bringing it to market. (Photo: Dr. Michael Floros)

It sounds like a challenge with more hurdles than homeruns but, over the last few years, UHN has become part of a whole ecosystem of scientific innovation building in and around in Toronto that helps its researchers successfully navigate translating basic scientific discoveries into treatment.

A cornerstone of this hub is The Techna Institute for the Advancement of Technology for Health, co-launched by UHN and the University of Toronto (U of T) in 2011 to integrate and fast track research, development and commercialization of new healthcare technologies.

So how does Techna help bring science to the market while also ensuring the end product is cost effective and can be reproduced on a mass scale?

In the case of bone tape, the same year that the early science of it came together, Dr. Santerre also launched Health Innovation Hub (H2I) in partnership with Techna and U of T. Where Techna provides support and guidance to UHN's scientists to bring their innovations to market, H2I would do the same for university trainees.

"Students earning PhDs, graduate degrees or fellowships get the opportunity to create their own companies through H2I," explains Dr. Santerre, who is also a co-director of Techna. "The program is an opportunity to work with Techna scientists, learn the basics of building a tech company, apply that to a healthcare idea and get them thinking about scaling and how to turn it into an exciting story for investors."

Bone tape sounded like a very interesting idea to Dr. Floros, a postdoctoral fellow in biomaterials research at U of T, who decided to work with Dr. Santerre to develop the idea.

"It was a big step for me to build a company on this concept," Dr. Floros says. "I'd always been an entrepreneur, and from the start, bone tape was a neat idea with huge potential for developing something that could improve the standard of care."

Five years on, bone tape continues to show promise

To do that, Dr. Floros founded Cohesys to address remaining challenges, test the promising product and ensure it was ready for mass distribution.

Initial studies showed the material could stick to bone in the lab, but Dr. Floros also needed to consider many other factors: toxicity of the material, processing, whether the tape would stick to clinicians' gloves when handled, and the many other considerations when launching a product.

"One nice thing about being in an ecosystem with support from clinical partners is getting to see surgeries and having that visual and first-hand experience instead of reading about it or assuming what it looks like," Dr. Floros says.

"Being able to talk directly with surgeons during procedures really helped them explain the workflow and challenges to me:  'I could really use tape here; look at these fractures, these plates can't properly bend to fit this geometry, these screws don't work well in this poor quality bone, etc.'"

Five years on, bone tape continues to show promise and is now a patented material with more intellectual property in the pipeline, inching closer to the market. Next steps involve acquiring more financing from investors, further testing through clinical trials and demonstrating how much faster tape would work versus the current plates and screws practice.

Thanks to health innovation partnerships between UHN, Techna, H2I and their collaborators, many more new product boxes can be ticked. When H2I launched in 2014, it had seven companies, most from UHN. Today, it has now trained more than 150 from all over the Toronto Academic Health Science Network.

"It's a big luxury in Toronto that we can invite entrepreneurial scientists and engineers to dance with the end user, the clinician," says Dr. Santerre. "Techna is huge at doing that and we are a centre for medical technology innovation as a result."

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