Medical services still face snags in treating chronic wounds despite impressive advancements in wound care. The healthcare system has expressed disquiet over the steadily rising number of patients with chronic wounds and the associated pecuniary load. Chronic wounds are intricate and dynamic, which lengthens the healing process and makes using regular bandages more challenging.
New bandages with real-time monitoring, data analysis and medicine administration capabilities are necessary for these wounds to heal well because they avert infection and hasten the healing process.
Through the integration of “smart” technology into clinical practise, the latest advancements in smartphone applications and digital medical equipment provide a chance for a considerable improvement in wound care. The main goal of this piece is to give readers a broad overview of how cell phones and other digital technology are now used to treat wounds in vitro and in vivo.
Human and animal patients with wounds experience discomfort, stress, and functional difficulties. The difficult and protracted process of wound healing includes age, body type, nutrition, vascular insufficiencies, chronic illness, and immune-suppression. Pressure, oedema, necrosis, infection, desiccation, and maceration are other environmental influences. Common chronic wounds like diabetic foot ulcers and bedsores are increasing at an alarming rate as a result of the rise in the number of associated diseases, including diabetes, paralysis, sickle cell anaemia, vasculitis, renal impairment, epidermolysis bullosa, and autoimmune disease.
Both patients and healthcare systems are faced with significant problems such as impairments, numerous hospitalisations, and even amputation as a result of these wounds.
The healthcare system is thus working to implement a proactive and preventative approach to wound treatment. Smart technologies that provide non-invasive quantitative data from the wound healing process and address effective wound evaluation and characterization are one of the key components of this technique.
By continually gathering physicochemical data from the wound and wirelessly communicating it to the clinical centre to get remote on-demand therapies, modern smartphone-based wound dressings are able to perform real-time monitoring and offer a diagnosis of the chronic wound.
The most eye-catching benefit of this smartphone-based wound dressing is that the patient’s decreased hospital visits minimise the danger of infection, the cost of care, and the length of the therapy.
Smartphone-based wound dressing
Healthcare systems now have the chance to pursue changes in wound treatment thanks to the deployment of smartphone-based technology in medical settings.
The entire smart wound monitoring system is anticipated to be quick, non-invasive, affordable, user-friendly, and, in the end, deliver accurate and error-free information to clinical operators.
Patients may monitor wounds at home with the help of smartphone-based wound dressings.
As a result, the data generated by this type of smart dressing is crucial for the straightforward prediction of the wound healing process. Smartphone-based procedures have the potential to be non-contact in their most basic forms and employ digital picture processing, in contrast to conventional wound evaluation techniques.
Recent smartphones have high-quality photography capabilities that can considerably improve the precision and dependability of wound measurements without the requirement for specialised training or other tools.
Common wound dressings like gauze and cotton wool are intended to protect the body’s injured parts from the environment and pathogens, but as was already mentioned, they may also be combined with smart platforms for remote and real-time monitoring.
Modern smartphone-based dressings can also work biologically on their own or release medications and bioactive chemicals that are included in the dressing composition.
Miniaturised pump arrays are wirelessly controlled by an internal smartphone application in a novel smartphone-based wound dressing that is intended for the regulated and programmable release of numerous medications.
The efficacy of this strategy was effectively demonstrated by the in vitro research findings. To increase the bioavailability of medications in deeper layers of the wound tissue, miniaturised needle arrays (MNAs) are used throughout the dressing structure in island formations. The practical potentials of the entire system were examined by delivering VEGF (vascular endothelial growth factor) to 5-day-old full-thickness skin injuries in diabetic mice. The test animals that received VEGF through MNAs demonstrated full and effective recovery without any signs of scar formation.
The development of enhanced smart gadgets that may cure chronic wounds by interfering with the healing process and avoiding infection has been made possible by recent innovations in electronic and mobile application design. The main variables in wound monitoring include pH, temperature, wound oxygenation level, and uric acid content. Wound restoration processes typically function best in an acidic environment.
However, the pH of chronic wounds is often neutral or basic. As a result, monitoring skin pH during wound healing offers trustworthy evidence on the healing process and early signs of infection or non-healing. Studies show that the newly developed smart dressing has advantages over currently available commercial technologies, including the ability to map the pH of a diabetic wound using a variety of printed sensors, to maintain the ideal moisture required for wound healing using a hydrogel structure, and to conform to the injured tissues.
Smart phone based dressing alternatives being inexpensive, quick, and more dependable are now created by immobilising pH indicator molecules on the cellulose particles. An electronic chip attached to the wound dressing is responsible for reading colour changes caused by these indicator molecules instead of the patient, and it is able to send a real-time report of the gathered data to the patient’s smartphone via novel radio-frequency identification (RFID)-based contact-less platform. Additionally, the electronic reader may wirelessly communicate quantitative pH data to a medical computer and is always informed of the state of the wound.
Increased temperature in chronic wounds denotes bacterial infection. Most often, clinical staff or patients would palpate the wound area to ascertain its warmth. Therefore, inexpensive electronic temperature sensors are now commercially accessible and easily integrated with conventional wound dressings for early detection of temperature changes along with infection monitoring and on-demand antibiotic treatment for infected wounds. In this technology, an electronic sensor continually checks the wound temperature, and an electronic transformer uses Bluetooth to transmit data from the sensor to the smartphone.
Consuming more oxygen may be a key component in improving wound healing, but at low oxygen levels, injured tissue experiences hypoxia, which disrupts the healing process and, as a result, lengthens hospital stays. To address this, a bioactive wound dressing is now integrated with a miniaturised oxygen monitoring device, allowing the clinical staff to rapidly and conveniently administer a treatment regimen determined by the particular patient condition.
Elevated uric acid can be a symptom of wound severity and oxidative stress in chronic wounds. As an inflammation enhancer, uric acid can drive chronic wounds to an acute state by increasing the concentration of reactive superoxide radicals in the wound bed, which can disrupt the normal activity of bio-macromolecules such as proteins, lipids, and nucleic acids.
Real-time tracking of this biomarker concentration by using amperometric uric acid biosensors in the wound can provide reliable information about the wound healing process.
Chronic wounds are a major concern for the healthcare system because they are difficult, expensive, and time-consuming to cure. Any effective technique must thus be tailored to the needs of each patient. With the use of smart sensing, data processing, data transfer, and automated medicine administration to the chronic wound, smartphone-based wound dressings are a novel and innovative technique to enhance chronic wound management. In order to address issues with chronic wound healing, this article highlights the dearth of multidisciplinary research on smartphone-based wound dressings that have not yet been put to human testing.
The author is Assistant Professor cum Junior Scientist, Dept. of Medicine, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab.