King's College London

Role within the HTCkcl

King’s College London’s role within the WoundTec HTC is focused on patient and carer involvement in co-designing medical device and systems development in relation to wound care.

King’s will engage users (patients, carers, clinicians) in a co-design and evaluation process for technologies, devices and systems to improve the quality of care for a diverse range of conditions which give rise to skin breakdown and wounds.

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Key projects

In 2001 the Engineering and Physical Research Sciences Council (EPSRC) funded the Woundcare Research for Appropriate Products (WRAP) project led by King’s.
In WRAP, industry, academics and clinicians worked collaboratively to develop methodologies to identify and evaluate patients’ needs in relation to dressings for exudate management (GR/R39023/01).

WRAP’s legacy is a model of non-competitive working to gain shared understanding of clinical problems and how to develop effective solutions. WRAP focused on wound exudate, and developed new methods and measurement tools. One outcome was a method of capturing clinical data of the exudate problem as experienced by patients.

The clinical data system and the collaborative working are being replicated in further projects to find solutions to other clinical problems. The core group and strategic partners in this initial research collaborative have continued to meet and develop their shared interests, through the Health Tech & Medicines KTN ‘Advanced Woundcare Official Group’; the HTC builds on this early work.

The Woundcare for Epidermolysis Bullosa (WEB) produced a range of commercialised dressing retention garments for people with EB who have extensive and whole body wounds (http://www.skinniesuk.com/category/web).
The garments, by the patients’ own accounts, reduce the burden of these wounds on a day-to-day basis. The empirical data, accrued in an n-of-1 research design, demonstrate a reduction in costs (products and time), reduced deterioration of outcomes and improved patient experience because of improvements in dressing stability

The positive impact of body wrap dressing systems for people with EB can be replicated for people with other conditions giving rise to extensive wounds because the common problem is the extensive loss of skin over the body.

WEB was awarded the 2013 Guardian Higher Education Award for ‘outstanding research impact’ (http://www.theguardian.com/higher-education-network/gallery/2013/feb/28/university-awards-widening-participation).

Projects in the pipeline for King’s build on WEB’s outputs, specifically the model of user and industry engagement, co-design and digital data capture tool for example:
a) Expanding the Skinnies WEB™ garment range for other patient groups, acute and chronic.
b) Body wrap sterile wound dressings, to replace single pre-sized and shaped patch dressings, to work in a two-layer system with reusable stretchy dressing retention garments (Skinnies WEB™) developed in the Woundcare for Epidermolysis Bullosa project
c) Developing online data capture systems, with 3D imaging, for routine clinical charting and patient recorded outcomes measurement tools and applications for telewound care applications

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Areas of Expertise

Clinical Validation, Clinical Evaluation, Co-design strategies, User engagement,

Services Provided

King’s currently:

  • Undertakes rigorous formative research of user experiences of the technologies and devices they currently use in their own wound care, in order to prevent future skin damage where possible and to promote palliation, symptom control and wound healing
  • Facilitates the co-design of wound care technologies, devices and systems with the users, HTC researchers, as well as researchers and networks outside the HTC including assimilating technologies, devices and systems into clinical and care pathways
  • Evaluates clinical effectiveness, patient safety and patient experience outcomes of the technologies, devices and systems by using secondary data sources and patient recorded outcome measures


Selected Publications
Bate SP and Robert G. (2007) Bringing user experience to health care improvement: the concepts, methods and practices of experience-based design. Oxford; Radcliffe Publishing (pp. 207)
Robert G. (2013) ‘Participatory action research: using experience-based co-design (EBCD) to improve health care services’. In: S Ziebland, J Calabrase, A Coulter and L Locock (eds). Understanding and using experiences of health and illness, Oxford; Oxford University Press
Greenhalgh T, Robert G, MacFarlane F, Bate SP and Kyriakidou O. (2004) ‘Diffusion of innovations in service organisations: systematic review and recommendations’, Milbank Quarterly, 82(4): 581-62
Grocott P, Graham T, Blackwell R, Currie C, Pillay E, Clapham J, Hon J, Graham-King P, Snelson K. (2013 Individualising wound care research: Woundcare for Epidermolysis Bullosa (WEB) project. Wounds UK. 9 3 23-32.
Graham T, Grocott P, Probst S, Wanklyn S, Dawson J. (2013) How are topical opioids used to manage painful cutaneous lesions in palliative care? A critical review. Pain. 154 10 1920-1928.
Grocott P, Gethin G, Probst S. (2013) Malignant wound management in advanced illness: new insights. Current Opinion in Supportive and Palliative Care. 7 1 101-105.

Grocott P, Blackwell R, Currie C, Pillay E, Clapham J, Hon J, Graham-King P, Snelson K. (2013) Woundcare Research for Epidermolysis Bullosa: Designing products with the users. Dermatological Nursing. 12 1 30-35.
Grocott P, Blackwell R, Currie, C, Pillay E, Robert G. (2012) Co-producing novel wound care products for Epidermolysis bullosa; an empirical case study of the use of surrogates in the design and prototype development process. International Wound Journal . 10 3 265–273.

Grocott P, Blackwell R, Weir H, Pillay E. (2012) Living in dressings and bandages: findings from workshops with people with Epidermolysis bullosa. International Wound Journal. 10 3 274–284.
Grocott P, Campling N. (2009) A methodology for evaluating wound care technologies in the context of treatment and care. European Wound Management Association Journal. 9 27-38.
Grocott P, Weir H, Bridgelal Ram M. (2007). A Model of User Engagement in Medical Device Development. International Journal for Health Care Quality Assurance. 20 6 484-493.

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