Handheld Wound Analyzer for in situ Healing

摘要 交通事故和烧伤等创伤性伤害造成的急性创伤造成了大量人员伤亡和 残疾，给公共医疗系统带来了很大的负担。只是医疗保险在创伤方面的支出 仅在美国，每年的医疗费用就高达1000亿美元。这些损伤是高度特定于患者的， 通常对治疗提出复杂的临床挑战，包括广泛的软组织丢失，全层 烧伤、出血、污染和组织缺氧，使愈合变得极其困难 尤其适用于大面积和深度创伤。尤其是微循环受阻，因此 氧气供应不足，在低氧条件下伤口愈合会严重受损，从而延长或 甚至会对治愈过程产生偏见。一期手术是治疗的第一线和关键决定因素 恢复、预后和存活率。然而，目前使用干毛纱布和双纱的策略 用于初始和术后伤口处理的绷带没有区别于患者的具体情况 伤口条件复杂，往往不足以克服这些具有挑战性的愈合过程。这些非- 不同的入路还需要对伤口进行二次清创，增加感染的风险，以及 增加了额外重建手术所需的成本和时间，并依赖于供体组织。 在这里，我们提出了一种范式转换的临床方法，通过在 伤口地形和氧合信息的现场分析、即时数据分析和后续 程序化产氧生物材料的自动应用，可以快速填充缺陷部位 以空间和时间可控的方式以患者特定的方式愈合伤口。要实现 这一目标，我们将整合尖端的生物打印和光声成像技术，以开发一种 手持式生物分析-生物打印混合智能涂布器。这种方法将在临床上带来显著的益处。 推进现有的伤口敷料技术，以高效和有效地治疗局部伤口 例如现场烧伤和爆炸伤。

Abstract Acute wounds by traumatic injuries such as traffic accidents and burns account for large casualties and disabilities, posting a large burden of the public healthcare system. Just the Medicare spending on wound care in the US alone totals ~100 billion dollars annually. These injuries are highly patient-specific and usually present complex clinical challenges for treatment, including extensive soft tissue loss, full-thickness burns, hemorrhage, contamination, and tissue hypoxia, making the healing extremely challenging especially for large-area and deep traumas. In particular, with disrupted microcirculation and thus insufficient oxygen supply, wound healing can be severely impaired under hypoxia, and thus prolong or even bias the healing process. Primary operation is the first line of treatment and key determinants of recovery prognosis and survivability. However, current strategies using dry fluffed gauze and crepe bandages for initial and post-operative wound management are non-differential to the patients’ specific wound conditions, and are often insufficient to overcome these challenging healing processes. These non- differential approaches also require secondary debridement of the wound, increase the risk of infection, and increase the cost and time required for additional reconstructive surgery and depend on donor tissues. Here, we propose a paradigm-shifting clinical approach that promotes wound closure and recovery by in situ analysis of the wound topographic and oxygenation information, instant data analysis, and subsequent automated application of programmed oxygen-generating biomaterials, which can rapidly fill the defect site in a spatially and temporally controllable manner to heal the wound in a patient-specific manner. To achieve this aim, we will integrate the cutting-edge bioprinting and photoacoustic imaging technologies to develop a handheld bioanalysis-bioprinting hybrid smart applicator. This approach will be of significant clinical benefit in advancing the existing wound dressing technologies to efficiently and effectively treat topical wounds such as burn and blast injuries in situ.