Wound care
for the slow adoption of smart dressings is that, until very recently, the electronics and sensors needed to measure the healing of a wound and report back wirelessly to health professionals have not been cheap, flexible or low-profile enough to integrate into bandages. The systems have also been too power hungry. Disposal of contaminated electronic devices has been an additional challenge. However, many of these issues are now being overcome.
“Disruptive technologies such as biodegradable materials, flexible electronics and incinerable batteries have the potential to be used in smart wound dressings that could ultimately revolutionise the manner in which we care for chronic wounds.” Conor O’Mahony
O’Mahony also notes that new procedures will be needed alongside these kinds of smart medtech products. Usually doctors and nurses visually inspect wounds to check how they are healing. And while these bandages would have a long-term benefit, many just see the short-term issues of integrating them into an established way of working.
“Anything new is obviously quite challenging to treatment methods that have been best practice for decades,” O’Mahony says. “However, disruptive technologies such as biodegradable materials, flexible electronics and incinerable batteries have the potential to be used in smart wound dressings that could ultimately revolutionise the manner in which we care for chronic wounds”.
Prototype smart dressing, intended for wireless monitoring of exudate levels in the dressing pad.
Starting to evolve Dr Marta Tessarolo of the University of Bologna is another researcher who, together with her research
group of physicists and chemists led by Professors Beatrice Fraboni and Erika Scavetta, has developed a ‘smart bandage’, containing a sensor that can very sensitively measure wound moisture levels and transmit the data to a smartphone via radio- frequency identification (RFID) technology. The use of RFID was partly inspired by a trip to sporting goods retailer Decathlon, where there is no need for customers to stop at the till to pay thanks to a similar technology. Tessarolo agrees that while there are still technological hurdles to tackle – building sensors that are biocompatible with the skin is no easy task, nor is bringing together the different companies needed to fabricate a ‘smart’ dressing – her biggest challenge is finding clinicians willing to test these devices in a trial setting. “They are used to certain clinical procedures and
it’s difficult to get them to try new sensors that are in the research process, but we need to do this to understand which sensors we need to include and which parameters are the most interesting to know,” she says. “We have to convince doctors that it will be an improvement on standard procedures.” O’Mahony has had similar feedback from focus groups. “Many nurses don’t want an additional reader or a smartphone on their trolley, which is more hardware. It’s another procedure for them to do on their already busy rounds,” he says. “In addition, it involves passing the scanner from bed to bed, potentially increasing infection control risk, something that we didn't really consider but they were quite adamant about.”
While O’Mahony and his colleagues are looking at alternatives, such as low-power and long-range Bluetooth technology, he says both sides must be realistic. “There’s a joint push-pull here. Nurses and clinical staff will have to realise they can’t have an ‘ideal’ dressing, while biomedical scientists and engineers must be cognisant of the real-world challenge facing caregivers,” he says. “But we’re grateful for their feedback, and many clinicians are eagerly assisting with technology development”. Indeed, he is optimistic that when clinicians see the benefit of contactless technology and remote, non-invasive monitoring, they will change their way of thinking. “They’re very keen on the concept – anything that reduces work is obviously a positive thing for them,” he says “Many nurses are very responsive and we’re also seeing a new generation of people coming through who are very familiar with technology, who grew up with contactless scanning, smartphones, Google Pay and so on. Things have changed a lot.”
The attitudes of other healthcare stakeholders are also starting to evolve. “When we first started in this field, we saw a lot of concern about the additional cost associated with integrating smart electronics
38 Practical Patient Care /
www.practical-patient-care.com
Tyndall National Institute
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