Wound care
A diagram showing the concept behind the wireless smart bandage designed by Simiao Niu and colleagues.
burn wounds to different types of chronic wounds since they often lead to poor outcomes.” Regarding production and cost, Tee believes the
PETAL patch will be much more cost-effective than other products that need batteries or other electronics. “The patch and biomarkers are fairly scalable and we think it should be no more than the typical cost of a regular bandage,” he says. “The software would take some of the cost, but it too is scalable because it is just an application.” Tee and his team have filed an international patent for the PETAL patch and plan to advance to human clinical trials.
Wireless Smart Bandage On the North American continent – more specifically in the state of New Jersey – Simiao Niu, assistant professor at the Department of Biomedical Engineering at Rutgers University is part of a team not just aiming to monitor chronic wounds, but treat them too – all using a single device. He explains that the traditional standard-of-care approach to wounds consists of a plain dressing meant to passively heal by keeping the area covered and safe from bacteria and infection. “But passive wound dressings don’t work for chronic wounds,” Niu adds. “Because once you have issues like diabetes, the wound will not heal naturally.” To overcome this issue and integrate active treatment into the care pathway, Niu and colleagues designed a smart bandage that addresses the many challenges of chronic, non-healing wounds. It does this through multimodal sensors and electronic stimulators, allowing the technology to monitor and treat wounds without constant clinical intervention. Electrical stimulation, also known as galvanotaxis, promotes healing by hastening the movement of keratinocytes to the wound, limiting bacterial growth on its surface, and promoting tissue growth and repair. Niu believes traditional bandages incorporating wired electrical stimulation for wound healing have three important limitations. The wired design prevents patients from moving comfortably, they can stimulate the wound, but have no sensing capabilities, and finally, they impair the bandage-to-
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skin interface. “These three limitations inspired us to design our smart bandage,” said Niu. “We designed a fully wireless, battery-free bandage for better patient comfort and mobility. The bandage utilises a closed-loop design with an AI algorithm that can sense and stimulate, and we designed a better bandage-to-skin interface that uses hydrogel to adhere the flexible circuit board to the skin.” The result is a wireless, closed-loop, smart bandage that accelerates healing by accurately sensing the state of a wound and sending the correct amount of electrical stimulation to reduce infection and promote healthy skin restoration.
“Once the sensing circuit senses skin impedance, we have software that automatically analyses the sensor and emits the right amount of power to stimulate the wound.” The wireless smart bandage circuitry is a scant 100 microns thick and incorporates a microcontroller unit, radio antenna, memory, electrical stimulator, and biosensors that sit on a rubbery patch. A hydrogel seal adheres the bandage securely to the wound surface. “The hydrogel seal is imperative to proper wound healing,” Niu explains. “We needed good skin adhesion, but if it is too good, it will harm the healing skin underneath when removed. At normal body temperature, the adhesion is excellent, but if we slightly increase the hydrogel temperature to about 48 degrees, it can be removed safely without harming the skin.”
The bandage and circuitry can be removed and reapplied for practical use in the clinical setting. “The only thing that would need changing is the hydrogel; the patch and its circuitry are completely reusable.” Just like the team behind PETAL, Niu and his Rutgers colleagues have considered the affordability of the device, and they believe it will be cost-effective for hospitals. “We calculated the cost for each smart bandage, and even without mass production, at the lab level, one smart bandage costs about $15-$20 for the circuit board, and for the hydrogel, it’s even cheaper.” The PETAL patch and the wireless smart bandage are innovative, proof-of-concept designs. Researchers admit that more work must be done, specifically with expanding and perfecting the AI algorithms associated with the dressings. Even so, both provide a snapshot of the innovation that is now possible with the state of technology. Whether either device has the potential to make the journey out of the lab and into the clinic will likely be determined once they reach the stage of human clinical trials. But if that potential includes dramatically transforming how clinicians monitor and treat chronic wounds at a cost that is not prohibitive, it is surely worth finding out.
Practical Patient Care /
www.practical-patient-care.com
Simiao Niu/Rutgers University
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