Development of an infection detecting wound dressing

感染是烧伤后并发症的主要原因。即使是很小的热水烫伤也会感染，这可能会导致疼痛加剧、愈合延迟、疤痕增加、治疗时间延长（包括使用抗生素和手术）。这不仅破坏了患者的治疗效果，而且增加了NHS与治疗相关的成本，也增加了患者的费用，包括休假、去医院的费用和相关的收入损失。在极少数情况下，感染可通过中毒性休克综合征等并发症导致死亡，特别是大面积和深度烧伤，甚至是小范围烧伤的儿童。尽管识别感染很重要，但目前这仍然是临床医生面临的主要挑战。很大的困难是由于烧伤患者的感染症状很难与烧伤本身引起的炎症反应以及其他疾病（如感冒、喉咙痛等）引起的其他症状区分开来。由于这些挑战，临床医生在其他情况下用于诊断感染的标准方法对治疗烧伤患者的价值有限。大多数伤口都有正常的细菌水平，除非细菌达到一定的水平，否则不需要治疗，这一事实使情况进一步复杂化。然而，临床医生可能要等3天才能确认伤口中是否存在细菌，但这些测试不能区分开始的背景水平和那些代表感染的水平。总的来说，这些限制也可能导致患者被“过度治疗”，导致过度和不必要的抗生素处方，换药（通常是痛苦的，可能增加疤痕的风险），以及延长住院时间。在这个研究项目中开发的敷料表明，烧伤伤口内存在严重的细菌感染，而不需要将其移除。当伤口中与临床相关的细菌达到需要治疗的水平时，敷料会通过简单的颜色变化来表示感染。这可以由临床医生直接在患者床边使用，以提供更准确和更有效的治疗。这样一来，我们的技术不仅可以改善患者的治疗效果，还可以减少NHS的成本和不必要的抗生素使用。

Infection is the primary cause of complications following a burn injury. Even a small hot water scalds can become infected, which can lead to a great increase in pain, delayed healing, increased scarring, and a greater time in treatment (including antibiotic usage and surgery). This not only undermines the outcome for patients, but also increases costs to the NHS related to treatment, but also patients, in terms of days off work, travel to hospital, and related loss of income. In rare cases infection can lead to death, particularly in large and deep burns and even in children with small burns, via complications such as toxic shock syndrome. Despite the importance of identifying infection, this currently remains a major challenge for clinicians. Much of the difficulty arises from the fact that the symptoms of infection in burn patients can be very difficult to distinguish from other symptoms arising from inflammatory response to the burn itself, as well as other illness such as cold, sore throat etc. Because of these challenges, the standard methods that clinicians use to diagnose infection under other conditions are of limited value in treating burns patients. The situation is further complicated by the fact that most wounds have normal background level of bacteria, which does not need to be treated unless bacteria reach a certain level at which they begin to cause harm. However, clinicians may wait ~3 days to confirm the presence of bacteria in a wound, but these tests do not distinguish between beginning background levels and those representative of infection. Collectively, these limitations can also lead to patients being 'over treated', resulting in over and unnecessary prescription of antibiotics, dressing changes (which are often painful and may increase the risk of scarring), and extended hospital stay. The dressing being developed in this research programme indicates critical bacterial infection within a burn wound without the need to remove it. The dressing will signal infection by a simple colour change, that occurs when clinically relevant bacteria in the wound reach a level at which treatment is necessary. This can be used by clinicians directly at the patients bedside to provide more accurate and more effective treatment. In doing so our technology would not only improve outcomes for patients, but also reduce NHS costs and unnecessary antibiotic use.