EPSRC-NIHR HTC Partnership Award 'Plus': Medical Devices and Vulnerable Skin: Intellegent sensing to promote self-management.

现代医学在最近几十年发生了变化，进步导致预期寿命延长，相当数量的人生活在长期健康状况下。这在一定程度上是由于先进医疗设备的发展，这些设备提供了一系列干预措施，包括呼吸支持和行动辅助设备。这些设备中的许多都必须与身体对接，这会对底层皮肤和软组织产生机械力。一个人抵抗这些力量的能力取决于皮肤组织的脆弱性，年龄、血管和既往创伤等因素影响了他们的耐受性。临床医生提供的医疗设备与患者在安装时的需求相匹配，确保设备既有功能又舒适。对于个人来说，情况和需求不可避免地会随着时间的推移而变化，这可能会损害设备的有效性，在某些情况下还会造成伤害。事实上，有证据表明，在医院获得的压疮中，有30%以上与医疗设备有关。这些压疮造成了NHS每年40亿英镑的伤口护理财政负担。随后，许多设备被丢弃，从而损害了个人需求，并耗费了医疗保健提供者的宝贵资源。医疗设备和脆弱皮肤网络Plus(MDVSNplus)将整合研究专业知识，并激励临床医生和工业家提供智能策略，以在一系列临床环境中保持医疗设备的寿命和患者舒适度。它汇集了传感、成像和计算机模拟领域的领先者，提供必要的专业知识，以评估附着在脆弱皮肤上的新的和现有的医疗设备的影响。我们的目标是利用这些能力开发一系列智能机制，例如传感器，这些机制可以随着时间的推移监控设备的功能和安全。MDVSNplus还将针对检测设备何时对脆弱的皮肤造成伤害的方法，并为患者和护理人员创建早期预警系统。MDVSNplus将通过为一系列与我们的核心目标一致的可行性项目提供资金来鼓励新的研究合作伙伴。L将由一个独立的创新小组审查每个潜在的提案，并根据将研究成果转化为实践的临床需求和可行性进行评估。MDVSNplus的资金还将用于为临床医生和最终用户举办外联活动，以便就医疗器械的选择和应用提供循证指导和教育。MDVSNplus还将与医疗保健部门的同事密切合作，他们专门从事医疗器械和创伤预防，以弥合研究结果与应用于临床实践之间的差距。通过这些资助项目，MDVSNplus将提供创新，以提高依赖医疗器械使用的个人的生活质量。这也将为NHS提供机会，降低与医疗器械相关的皮肤损伤及其潜在复发的治疗成本。它还将确保当前供应的设备在功能和寿命方面得到优化，提供最佳性价比。我们还预计，新的医疗设备和传感技术将吸引医疗行业的兴趣，对新的医疗设备技术进行再投资。为了维持研究结果的影响，申请者将游说关键机构，如MHRA(英国医疗器械监管机构)，以提高对医疗器械相关伤害的认识，并告知有关器械设计和应用的立法。MDVSNplus的研究成果还将有助于围绕医疗器械应用的临床指南，并在必要时有助于医疗器械测试的新标准。

Modern medicine has been transformed in recent decades, with advances leading to increased life expectancy and a significant number of individuals living with long term health conditions. This has, in part, been due to the development of advanced medical devices which provide a range of interventions, including respiratory support and mobility aids. Many of these devices have to interface with the body, which creates a mechanical force against the underlying skin and soft tissues. An individual ability to withstand these forces depends on the vulnerability of skin tissues, with factors such as age, vascularity and previous wounds contributing to their tolerance. Clinicians provide medical devices to match the patient needs at that time of fitting, ensuring the device is both functional and comfortable. Inevitably, circumstances and demands change with time for the individual, which can impair the effectiveness of the device and in some cases cause harm. Indeed, evidence has implicated medical devices in the development of over 30% of pressure ulcers acquired in hospitals. These pressure ulcers contribute to an NHS financial wound care burden of £4Bn/yr. Subsequently, many devices are discarded, thus compromising individual needs and costing the healthcare provider valuable resources.Medical Devices and Vulnerable Skin NetworkPlus (MDVSNplus) will integrate research expertise and motivate clinicians and industrialists to provide intelligent strategies to maintain medical device longevity and patient comfort in a range of clinical settings. It brings together leaders in the fields of sensing, imaging and computer simulation to provide the necessary expertise to evaluate the impact of new and existing medical devices which attach to vulnerable skin. We aim to use these capabilities to develop a series of intelligent mechanisms, for example sensors, which can monitor the functionality and safety of devices over time. MDVSNplus will also target methods of detecting when a device is causing harm to vulnerable skin and create an early warning system for patients and carers.MDVSNplus will encourage new research partners by offering funding for a series of feasibility projects which are aligned with our core aims. Each potential proposal will l be reviewed by an independent innovation panel and assessed based on the clinical need and feasibility to translate the research findings to practice. Funding to the MDVSNplus will also be used to host outreach events for clinicians and end users in order to provide evidence based guidance and education on the choice and application of medical devices. The MDVSNplus will also work closely with colleagues based in the healthcare sector, who specialise in medical devices and wound prevention, to bridge the gap between research findings and the application into clinical practice.Through these funded projects the MDVSNplus will provide innovation to improve quality of life in individuals who depend on the use of medical devices. This will also offer the opportunity for the NHS to reduce costs associated with treatment of medical-device related skin damage and their potential recurrence. It will also ensure that devices which are current being supplied can be optimised in terms of functionality and longevity, providing the best value for money. We also envisage that new medical devices and sensing technologies will attract interest from the healthcare industry to reinvest in novel medical device technologies. In order to sustain the impact of the research findings the applicants will lobby key agencies such as the MHRA (UK medical device regulator), to raise the awareness of medical device related injuries and inform legislation surrounding device design and application. Research output from the MDVSNplus will also contribute to clinical guidelines surrounding the application of medical devices and, where necessary, new standards of medical device testing.