Development of smart medical textiles for treating breast cancer related lymphoedema

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Lymphoedema is the swelling of soft tissues, caused by the accumulation of protein-rich fluid in extracellular space. It occurs as a result of disruption to the lymphatic system, usually of one or more limbs. Approximately 140-250 million people worldwide are currently suffering from different types of lymphoedema and it was estimated that 365,000 are affected by lymphoedema each year in the U.K alone. There is no cure for this chronic condition however there are treatments designed to reduce related pain and discomfort. The current recommended treatment is decongestive lymphatic therapy. This combines manual lymph drainage massage techniques with compressive bandaging, skin care and decongestive exercises. Once these therapy sessions are stopped the patient is fitted with a custom-made compression garment, which is worn every day. Unfortunately, this solution causes several issues for the patient. Firstly, the size and appearance of compression garments makes them inconvenient. For instance, a recent study reported that 80% of participants feel that compression treatments interfered with work and daily activities because of limited daily physical movement, difficulty in finding clothing that would fit over the compression, restricted ability to drive, being unable to do household work and impacts on their psychosocial life. Second, compression effectiveness is highly variable as the operating pressure is impacted by washing and wear, and pressure distribution changes based on body contours. Third, because of this variable effectiveness, patients must regularly visit healthcare providers to monitor the garments. This is an additional burden on both the patient and the NHS who bear the cost of these visits. There is therefore a need for an effective, unobtrusive, easy-to-use, device for treating lymphoedema that can be used at home. In response, this project will develop a breakthrough smart medical textile garment (SMTG) designed to be effective and improve the quality of life of patients. The SMTG will use electrical stimulation (ES) in an unobtrusive and convenient wearable format to enable swelling reduction. This builds on previous work that has shown that ES can stimulate lymph circulation.To achieve this aim, the project has several key steps. First, my team will need to develop new printed circuits with increased flexibility and reliability. I have used a number of bespoke inks to successfully achieve electrodes and conductive tracks on fabric, however body movement has been shown to cause hairline cracks, resulting in open circuits. By optimising the printing parameters and ink formulation, we will develop a more resilient printed circuit that can be applied over a large area of the body. Second, the layout of the electrode pair positions in the garment needs to be refined. Our early pilot work only uses two electrodes to prove that the system accelerated movement of lymph within the patient's body. The influence of positioning, dimensions and number of electrodes therefore needs to be understood in order to generate a design rule that can be adapted for different patients.Third, a new set of stimulation parameters for an array of printed electrodes will need to be developed. This will require the understanding of control in which the signal with correct frequency is applied when needed through the same or different pairs of electrodes. Fourth, we will develop an integration method to connect printed electrodes to the stimulation circuit. The printed electrodes are currently connected using snap fasteners. This option provides a temporary solution and cracks often happens at the join between the fastener and printed tracks. Finally, we will evaluate the washability of SMTG and propose an optimised standard that would allow the electronic textiles to be washed safely.