Handheld Wound Analyzer for in situ Healing

摘要 由诸如交通事故和烧伤的创伤性损伤引起的急性创伤占大量伤亡， 残疾人，给公共卫生系统带来沉重负担。仅仅是医疗保险在伤口上的花费 仅在美国，每年的医疗费用就高达1000亿美元。这些损伤具有高度的患者特异性， 通常对治疗提出复杂的临床挑战，包括广泛的软组织缺损、全层 烧伤、出血、污染和组织缺氧，使得愈合极具挑战性 特别是对于大面积和深度创伤。尤其是微循环障碍， 由于氧气供应不足，在缺氧情况下伤口愈合可能严重受损，并因此延长或 甚至会影响愈合过程初次手术是治疗的第一线，也是决定性因素。 恢复预后和生存能力。然而，目前的战略使用干绒毛纱布和绉纱， 用于初始和术后伤口管理的绷带与患者的特定 伤口状况，并且通常不足以克服这些具有挑战性的愈合过程。这些非- 差异性方法还需要对伤口进行二次清创，增加感染的风险， 增加了额外的重建手术所需的成本和时间，并且依赖于供体组织。 在这里，我们提出了一个范式转变的临床方法，促进伤口闭合和恢复， 伤口地形和氧合信息的原位分析，即时数据分析，以及随后的 自动应用程序化的生氧生物材料，可快速填充缺损部位 以空间和时间可控的方式来以患者特定的方式愈合伤口。实现 为此，我们将结合尖端的生物打印和光声成像技术，开发一种 手持式生物分析-生物打印混合智能施用器。这种方法将具有显著的临床效益 在推进现有的伤口敷料技术以高效和有效地治疗局部伤口方面 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.