Wearable Organic Integrated Sensors for Healthcare: Smart Dressings, A Step Change in Wound Management

慢性伤口是那些不能以有序和及时（通常是三个月）的方式愈合的伤口。慢性伤口的例子包括糖尿病足溃疡、压疮和腿部静脉溃疡。由于生活方式的改变和人口老龄化，慢性伤口的发病率正在增加。例如，到2030年，估计全世界约有5.52亿人患有糖尿病。据估计，这些患者中多达25%将在其一生中发展为糖尿病足溃疡；这些溃疡中有一半会感染，20%会截肢。据估计，到2030年，慢性伤口（包括护理时间和敷料）对全球经济的年度经济影响将达到200亿英镑。伤口处理的常见做法是用合适的敷料覆盖伤口，以促进愈合过程。然而，标准的敷料并不能洞察伤口的状况。因此，经常更换敷料以检查和评估伤口。这反过来又阻碍了伤口的正常愈合过程，并给患者带来压力和疼痛。评估过程还消耗大量护理时间和敷料，这导致伤口护理的医疗费用螺旋式上升。此外，目前的治疗方法没有根据伤口的情况使用物理或化学反馈来修改或调整治疗方法，因此成功率有限。有人建议将传感器嵌入敷料中，使临床医生和护士能够在不更换伤口敷料的情况下做出有效的伤口诊断和治疗管理决策；从而提高患者的舒适度。然而，现有的传感器不满足将其嵌入敷料所需的操作（例如灵敏度、特异性）和物理（例如灵活性）特性。该项目将开发一种传感器系统来克服这些限制。该传感器系统将由一个小型激光器组成，该激光器将根据伤口表面流体界面中感兴趣的生物标志物的浓度发出不同颜色的光。发射光的颜色变化将通过在包含传感器系统的敷料上挥动移动设备（如手机、平板电脑）来测量。捕获的数据将传输给医疗保健专业人员，进行处理和存储，以保持伤口历史记录，并用于诊断和治疗。拟议的项目将通过有效的诊断和治疗慢性伤口使患者受益。关于伤口状况的信息将允许及时识别难以愈合的伤口，也将用于创建一个反馈循环，为个体患者量身定制完全优化的治疗。例如，消炎药的释放速度将根据伤口情况量身定制。这在慢性伤口管理方面是至关重要的，已经证明，给予适当治疗的延迟时间越长，伤口就越难以愈合。

Chronic wounds are those that fail to heal in an orderly and timely (typically three months) manner. Examples of chronic wounds include diabetic foot ulcers, pressure ulcers and venous leg ulcers. The incidence of chronic wounds is increasing as a result of lifestyle changes and the ageing population. For example, ~552 million people worldwide are estimated to have diabetes mellitus in 2030. Up to an estimated 25% of these patients will develop diabetic foot ulcers in their lifetime; half of these ulcers will be infected and 20% will undergo amputation of their lower limb. The annual economic impact of chronic wounds, which includes nursing time and dressing materials, on the global economy is estimated to be ~£20 billion by 2030.A common practise in wound management is to cover wounds with suitable dressings to facilitate the healing process. Standard dressings, however, do not provide insights into the status of the wound underneath. Thus, dressings are often changed to examine and assess the wound. This in turn hampers the process of normal wound healing and cause stress and pain to patients. The assessment process also consumes a significant amount of nursing time and dressing materials, which contributes to spiralling medical costs in wound care. In addition, current treatment methods do not use physical or chemical feedback to modify or adjust the treatment based on wound's condition, and hence have limited success. It has been proposed to embed sensors in dressings to enable clinicians and nurses to make effective diagnostic and therapeutic wound management decisions without changing wound dressings; therefore improving patient comfort. Existing sensors, however, do not satisfy the operational (e.g. sensitivity, specificity) and physical (e.g. flexibility) characteristics required for embedding them in dressings. This project will develop a sensor system to overcome these limitations.The proposed sensor system will consist of a small laser that will emit light of different colour based on the concentration of a biomarker of interest in the fluid interface at the wound surface. The change in the colour of emitted light will be measured by waving a mobile device (e.g. phone, tablet) over the dressing containing the sensor system. The captured data will be transmitted to healthcare professionals, processed, stored to keep a record of wound history, and used for diagnostics and therapeutics. The proposed project will benefit patients by effective diagnostics and treatment of chronic wounds. The information on wound condition will permit timely identification of hard to heal wounds and will also be used to create a feedback loop for fully optimised treatments tailored to individual patients. For example, the rate of release of anti-inflammatory drugs will be tailored based on wound condition. This is critical in terms of chronic wound management, where it has been shown that the longer the delay in administering appropriate treatment, the more difficult a wound is to heal.