The next time you cut your finger and need wound care, stitches and a bandage, wouldn’t it be reassuring to know that your wound is being monitored for signs of infection--and if you need antibiotics, they will automatically be dispensed by the bandage itself?
Sounds like this is a futuristic concept, but this may soon be how you and your health care provider manage your cut, receiving data in a continuous feedback loop that lowers the chance of a wound infection--not to mention reduces the need to make an office or clinic visit for a wound check.
Now, a group of researchers from Tufts University have done just that--developed a “smart bandage” that has the ability to monitor a chronic wound for infection, and deliver antibiotics, growth factors or even pain medicine if needed.
Results of their
research were recently published in the Journal,
Small. The aim of the researchers is simple: how can they design a bandage to improve the rate of healing of chronic wounds? One way is by creating a “smart bandage” to monitor the pH and temperature of the wound, since these are important indicators of the “health” of a healing wound. The normal pH of a healing wound is 5.5—6.5. A pH greater than 6.5 is an early sign that that the wound may be at greater risk for infection. Meanwhile, the temperature of a wound is also an important indicator of inflammation, which elevates in the setting of infection. The stark reality is that chronic, non-healing wounds are a major economic and medical dilemma in the U.S. In fact, recent
data indicates that close to 15 percent of Medicare beneficiaries require treatment for at least one type of chronic wound or infection at an annual cost of an estimated $28 billion. Such patients are typically older, bed-bound or minimally ambulatory, and have difficulty caring for themselves independently. Such wounds are also generally treated in the home setting, or may require costly and repeated visits to healthcare providers to ensure that infection is not developing. Some of the wounds--the result of long standing diabetes, burns, or trauma--can also lead to amputations if wound infections are not rapidly diagnosed and treated with antibiotics, debridement or other invasive surgical procedures. The key advance is that such smart bandages could provide real-time data to determine if the wound is healthy, deliver antibiotics if necessary, and communicate this information with healthcare providers, all while reducing the need for routine visits and virtual visits via telemedicine specialists. "We've been able to take a new approach to bandages because of the emergence of flexible electronics," said Sameer Sonkusale, Ph.D. professor of electrical and computer engineering at Tufts University's School of Engineering and corresponding co-author for the study said in a
press release. "In fact, flexible electronics have made many wearable medical devices possible, but bandages have changed little since the beginnings of medicine. We are simply applying modern technology to an ancient art in the hopes of improving outcomes for an intractable problem." Sonkusale and his team of researchers have also developed flexible sensors for oxygenation--another important marker of healing--which are part of the makeup of the bandage. While inflammation in healing wounds can be indicated by temperature elevation, measuring levels of specific biomarkers (i.e. IL-1 , IL-6, matrix metalloproteinases) may also be of value in determining degrees of inflammation and risk for infection. Sonkusale and his team developed a re-usable microprocessor that is able to translate data from the sensors and release drug on demand from its carriers by heating the gel. The entire set- up for wound monitoring is attached to transparent medical tape to form a flexible bandage which is less than 3 mm thick. "The smart bandage we created, with pH and temperature sensors and antibiotic drug delivery, is really a prototype for a wide range of possibilities," said Sonkusale. "One can imagine embedding other sensing components, drugs, and growth factors that treat different conditions in response to different healing markers." The smart bandages are not yet ready for prime time, but pre-clinical trials are now in progress that will compare traditional bandages and wound care products (topical ointments and antibiotics) with the new approach by the researchers. “R and D advances in smart bandages are part of a much broader movement to make all kinds of medical and healthcare products connected to people and the internet, said Steve Papermaster, Chairman and CEO of
Nanovision, and former science and technology advisor to George W. Bush. “Nanoscale AI computing will enable this connectivity on and eventually in the body, enabling smart monitoring, care and cures.” The idea of a using nanotechnology to help monitor the wound environment, but also deliver antibiotics, represents a novel approach to wound care that not only cuts down on inappropriate antibiotic prescribing, but also reduces the need for multiple in-person or televisits with a health care provider. That said, its ideal use will likely be in chronic non-healing wounds in diabetics that have the potential to develop infection, but also in monitoring post-operative wounds as well as routine cuts and lacerations as well. The use of such technology on the battlefield, a place where deadly pathogens exist, may also help to spot and treat infection before it has a chance to develop. Using tech to monitor wounds has been an evolving science over the past 10 years, with researchers making significant strides. In fact, one group from the University of Nebraska-Lincoln, Harvard Medical School and MIT reported their research
findings last year in the Journal,
Advanced Functional Materials, successfully creating a bandage capable of dose-dependent drug release, while also allowing the release of multiple drugs with different release profiles. The researchers have also integrated a unique platform using a smartphone to assist with drug delivery. But it’s the ability of new generation “smart” bandages to deliver an antibiotic, growth factor or even pain medication--without the need for a medical provider to evaluate a wound--that represents a game change. Stay tuned for rapid advances in this field, as your smartphone may now be part of your regimen for monitoring your wound healing and ongoing care.
