Wound Monitoring Research Articles

A pH responsive tannic acid/quaternized carboxymethyl chitosan/oxidized sodium alginate hydrogels for accelerated diabetic wound healing and real-time monitoring

Treatment of diabetic wounds is a major clinical issue. Diabetic wound dressings have higher requirements for anti-oxidant, antibacterial and wound monitoring properties compared to conventional wound dressings. In this study, a novel tannic acid (TA)/quaternized carboxymethyl chitosan (QCMCS)/oxidized sodium alginate (OSA)@carbon quantum dots (CQD) (TA/QCMCS/OSA@CQD) hydrogels for promoting diabetic wound healing and real-time monitoring have been developed. The TA/QCMCS/OSA@CQD hydrogels exhibited excellent self-healing, antibacterial and antioxidant properties. Besides, these hydrogels possessed good biocompatibility and effective hemostasis in a mouse liver injury model and significantly facilitated the healing process in a diabetic wound model. In addition, these hydrogels can reliable and timely measure the diabetic wound pH information by collecting image signals of hydrogels to monitor the healing status. Therefore, the pH responsive TA/QCMCS/OSA@CQD hydrogels could be utilized as wound dressing for promoting diabetic wound healing and real-time monitoring.

Effectiveness of HealthTracker for post-caesarean section surgical site infection surveillance: An intervention study.

This intervention study aimed to implement and evaluate the effectiveness of HealthTracker, a post-discharge surgical site infection surveillance system. Participants were 730 women birthing by caesarean section at a large hospital over a 6-month period. Data were downloaded from clinical data systems and HealthTracker. Receiver operating characteristics were used to assess HealthTracker. Over a 6-month period, 382 women completed HealthTracker, with 83 scoring ≥6, indicating signs and symptoms of surgical site infection. Of this 83, 58 sought advice from health professionals, 29 returned to hospital, and 45 received antibiotics. A total of 20 infections from a total population of 730 were confirmed, with 14 out of 382 respondents confirmed via HealthTracker. Receiver operating characteristics identified HealthTracker as an excellent indicator of surgical site infection. HealthTracker is a feasible mHealth option for monitoring post-discharge surgical site infection post-caesarean section. In addition, by providing alerts, advising women to monitor their symptoms and seek treatment if necessary, HealthTracker has the potential to enhance self-efficacy for surgical wound monitoring at home.

Self‐Healing, Injectable Hydrogel Dressing for Monitoring and Therapy of Diabetic Wound

AbstractChronic diabetic wound repair is a global medical challenge. Developing a hydrogel dressing to effectively promote angiogenesis and detect wound state in diabetic wound management is an unmet medical requirement. Herein, a facile and efficient strategy to prepare self‐healing hydrogel with enhanced angiogenesis and real‐time monitoring for diabetic wounds is presented, by cross‐linking carboxymethyl cellulose (CMC) with precoordinated europium‐ethylenediaminetetraacetic acid (Eu‐EDTA) complexes. Benefiting from the dynamic and reversible coordination interaction formation, the hydrogel exhibits remarkable injectability and self‐healing properties, thus forming efficient coverage in irregular and deep wounds with minimally invasive procedures. Furthermore, the fluorescence of the hydrogel changes linearly with pH value in the range of 4.5–7.5 and enables real‐time pH measurement to monitor the wound state. More importantly, the hydrogel can effectively promote the proliferation and migration of endothelial cells and enhance tube formation ability, demonstrating great angiogenesis capacity in tissue remodeling. The in vivo experiments manifested that the hydrogel can enhance angiogenesis by upregulating the expression of angiogenesis‐related factors and downregulating matrix metalloproteinase‐9 (MMP‐9), contributing to granulation tissue formation, collagen deposition, and diabetic wound repair. This work can provide a promising strategy for diagnosis and therapy in clinical diabetic wounds.

Single-Walled (Magnetic) Carbon Nanotubes in a Pectin Matrix in the Design of an Allantoin Delivery System.

Single-walled carbon nanotubes (SWCNTs) outperform other materials due to their high conductivity, large specific surface area, and chemical resistance. They have numerous biomedical applications, including the magnetization of the SWCNT (mSWCNT). The drug loading and release properties of see-through pectin hydrogels doped with SWCNTs and mSWCNTs were evaluated in this study. The active molecule in the hydrogel structure is allantoin, and calcium chloride serves as a cross-linker. In addition to mixing, absorption, and swelling techniques, drug loading into carbon nanotubes was also been studied. To characterize the films, differential scanning calorimetry (DSC), thermal gravimetric analysis (TGA), Fourier transform infrared (FTIR) spectroscopy, surface contact angle measurements, and opacity analysis were carried out. Apart from these, a rheological analysis was also carried out to examine the flow properties of the hydrogels. The study was also expanded to include N-(9-fluorenyl methoxycarbonyl)glycine-coated SWCNTs and mSWCNTs as additives to evaluate the efficiency of the drug-loading approach. Although the CNT additive was used at a 1:1000 weight ratio, it had a significant impact on the hydrogel properties. This effect, which was first observed in the thermal properties, was confirmed in rheological analyses by increasing solution viscosity. Additionally, rheological analysis and drug release profiles show that the type of additive causes a change in the matrix structure. According to TGA findings, even though SWCNTs and mSWCNTs were not coated more than 5%, the coating had a significant effect on drug release control. In addition to all findings, cell viability tests revealed that hydrogels with various additives could be used for visual wound monitoring, hyperthermia treatment, and allantoin release in wound treatment applications.

Optimising wound monitoring: Can digital tools improve healing outcomes and clinic efficiency.

Chronic wounds present significant challenges for patients and nursing care teams worldwide. Digital health tools offer potential for more standardised and efficient nursing care pathways but require further rigorous evaluation. This retrospective matched cohort study aimed to compare the impacts of a digital tracking application for wound documentation versus traditional manual nursing assessments. Data from 5236 patients with various wound types were analysed. Propensity score matching balanced groups, and bivariate tests, correlation analyses, linear regression, and Hayes' Process Macro Model 15 were utilised for a mediation-moderation model. Digital wound tracking was associated with significantly shorter healing durations (15 vs. 35 days) and fewer clinic nursing visits (3 vs. 5.8 visits) compared to standard nursing monitoring. Digital tracking demonstrated improved wound size reduction over time. Laboratory values tested did not consistently predict healing outcomes. Digital tracking exhibited moderate negative correlations with the total number of nursing visits. Regression analysis identified wound complexity, hospitalizations, and initial wound size as clinical predictors for more nursing visits in patients with diabetes mellitus (p < .01). Digital tracking significantly reduced the number of associated nursing visits for patients with peripheral vascular disease. These findings suggest that digital wound management may streamline nursing care and provide advantages, particularly for comorbid populations facing treatment burdens. This study adhered to STROBE guidelines in reporting this observational research. By streamlining documentation and potentially shortening healing times, digital wound tracking could help optimise nursing resources, enhance wound care standards, and improve patient experiences. This supports further exploration of digital health innovations to advance evidence-based nursing practice. This study involved retrospective analysis of existing patient records and did not directly include patients or the public in the design, conduct, or reporting of the research.

Surgical Site Infection in the General Surgery Department at the Fousseyni Daou Hospital in Kayes

Objectives: To determine frequency, analyze risk factors, identify responsible germs and antibiotic susceptibility, and assess the cost of infection. Patients and Method: We conducted a prospective study (August 1, 2022 to February 2023) for a period of 6 months. During our series, we received 250 patients who had been operated on and hospitalized in the general surgery department. The diagnosis of surgical site infection was based on criteria set forth by the Atlanta CDC. Data collection was carried out by interviewing, consulting records and anaesthesia sheets. Surgical wound monitoring was done up to the 30th postoperative day. A sample was taken for each infection. The word processor and tables were made on Microsoft Word 2019. Data were captured and analyzed on SPSS software (version 25). Results: We collected a total of 250 patients in our study. 31 developed an infection of the surgical site, a frequency of 12.4%. There were 31 patients, including 23 men and 8 women, with a mean age of 34 years, with a standard deviation of 20.75. The most common type of infection was superficial incision infection with 70.9% followed by deep incision infection with 29.1%. Risk factors for Surgical Site Infection Were: haemoglobin level; the nature of the surgery; ALTEMEIR contamination class 3 and 4; NNISS index 1 and 2; the type of intervention with probability tests P&lt;0.05. The analysis of the 31 samples resulted in 31 positive cultures, i.e. a bacteriological yield of 100%. Echerichia coli was the most isolated germ with 25.8%, followed by Enterobacter cloacae 19.3% and Enterococcus 19.3%. The Treatment was: Carrying out local care based on antiseptics (dakin; Betadine; hydrogen peroxide) and general (adapt to susceptibility testing). The consequence of surgical site infection was the prolongation of the hospital stay by an average of 19 days for infected patients; with an estimated additional cost of 294712 and 0% mortality.

Pooperacinių antriniu būdu gyjančių žaizdų priežiūra: literatūros apžvalga

Abstract. According to the World Health Organisation (WHO) ‘Half the cases of post-operative hard-to-heal wounds can be avoided’ [1]. Foreign authors A. E. Boniakowski, A. S. Kimball, B. N. Jacobs, et al. (2017) state that ‘Wound monitoring and periodic post-operative wound care performed at periodically planned time are important at all stages of wound healing’ [2]. &#x0D; Objective of the literature review. To analyse scientific articles on risk factors and wound management of hard-to-heal wounds. &#x0D; Methods. The literature review was conducted using the PubMed, ECDC, and Google Scholar search in the electronic MEDLINE database. The search was carried out between September and December 2023. Keyword phrases and their combinations were used for the search. Twenty three articles on the examined topic were included in the literature review. &#x0D; Results of the literature review. The present article discusses the main risk factors for wound infection and preventive measures. After analysing scientific articles, the causes of hard-to-heal wounds have been elucidated, which depend on the nature of the surgery, different pathogenic microorganisms, and the selection of dressings at each stage of wound healing.&#x0D; Conclusions. 1. Favourable conditions must be created for wound healing. Regular assessment of the wound healing process based on clinical indicators is attributed to an important factor. 2. Topical antimicrobial agents are used when wound healing is suspected to be impaired; dressings are selected based on the type of wound healing.

The Viability and Acceptability of a Virtual Wound Care Command Centre in Australia.

The objective of this study was to assess the viability and acceptability of an innovative Virtual Wound Care Command Centre where patients in the community, and their treating clinicians, have access to an expert wound specialist service that comprises a digital wound application (app) for wound analysis, decision-making, remote consultation, and monitoring. Fifty-one patients with chronic (42.6%) wounds were healed, with a median time to healing of 66 (95% CI: 56-88) days. All patients reported high satisfaction with their wound care, 86.4% of patients recommended the Virtual Wound Care Command Centre with 84.1% of patients reporting the app as easy to use. The data revealed that the Virtual Wound Care Command Centre was a viable and acceptable patient-centred expert wound consultation service for chronic wound patients in the community.

Smart Wound Monitoring and Healing Assessment System With Deep Learning Methods - A Systematic Review

This review describes a Deep Learning Smart Wound Monitoring (DL-SWM) system, focusing on the healing process of both acute and chronic skin wounds. Recognizing the impact of various factors such as environment, patient characteristics, and wound features on the healing timeline, the review emphasizes the need for more efficient wound monitoring methods. The proposed DL-SWM integrates biosensors, a microcontroller, and a fuzzy inference system to assess critical wound indicators, primarily focusing on hydration levels. The hardware design incorporates an Arduino-based biometric sensor device, while the fuzzy inference system predicts the impact of biomarkers on wound hydration. The review study also explores the segmentation of wounds using a Convolutional Neural Network (CNN) called MobileNetV2, providing detailed insights into the wound healing stages. In the literature review, various advancements in wound monitoring technologies, such as hydrogels, clinical decision-making systems, and wearable biological sensors, are discussed. The proposed DL-SWM is compared with existing methods through simulation analysis, demonstrating superior efficiency, accuracy, and lower error rates. The study concludes with the potential prospects of DL-SWM in revolutionizing wound monitoring and treatment, offering a more convenient and effective approach for healthcare practitioners and improving patient outcomes.

Injectable Conductive Hydrogel with Self-Healing, Motion Monitoring, and Bacteria Theranostics for Bioelectronic Wound Dressing.

Wounds at joints are difficult to treat and tend to recover more slowly due to the frequent motions. When using traditional hydrogel dressings, they are easy to crack and undergo bacterial infection, difficult to match and monitor the irregular wounds. Integrating multiple functions within a hydrogel dressing to achieve intelligent wound monitoring and healing remains a significant challenge. In this research, a multifunctional hydrogel is developed based on polysaccharide biopolymer, poly(vinyl alcohol), and hydroxylated graphene through dynamic borate ester bonding and supramolecular interaction. The prepared hydrogel not only exhibits rapid self-healing (within 60 s), injectable, conductive and motion monitoring properties, but also realizes in situ bacterial sensing and killing functions. It shows excellent bacterial sensitivity (within 15 min) and killing ability via the changes of electrical signals and photothermal therapy, avoiding the emergence of drug-resistant bacteria. In vivo experiments prove that the hydrogel can promote wound healing effectively. In addition, it displays great electromechanical performance to achieve real-time monitoring and prevent re-tearing of the wound at human joints. The injectable pH-responsive hydrogel with good biocompatibility demonstrates considerable potential as multifunctional bioelectronic dressing for the detection, treatment, management, and healing of infected joint wounds.

Collaborative biofluid analysis based multi-channel integrated wearable detection system for the monitoring of wound infection

The infection monitoring of chronic wounds can effectively improve the quality of wound care. However, the widely used single variable intermittent monitoring of wound provides little available information, which leads to inaccurate diagnosis and untimely warnings. In this study, a collaborative biofluid analysis based multi-channel integrated wearable detection system was constructed for the continuous detection of analytes such as pH, uric acid (UA), and C-reactive protein (CRP) in wound exudates with time division multiplexing. Based on the functionally modification with nanomaterials, integrated screen-printed electrodes (iSPE) with three working electrodes were designed for the collaboratively analyzing of wound exudates. Through the development of integrated circuits, the multi-channel wearable detection printed circuit board was constructed. With a self-designed interface, this iSPE was stably connected to the printed circuit board and realized the detection of three targets in the range of pH 3–8, UA concentrations 5–500 μmol/L, and CRP concentrations 1–1000 ng/mL at the same time. Combined with a smartphone, these results were collaborated analyzed and transferred for health management. Therefore, this integrated wearable multi-channel detection system can provide reliable and continuous evaluations for early warning of infection and further treatment of chronic wounds.

Injectable Hydrogels with Integrated Ph Probes and Ultrasound-Responsive Microcapsules as Smart Wound Dressings for Visual Monitoring and On-Demand Treatment of Chronic Wounds.

Hydrogel dressings capable of infection monitoring and precise treatment administration show promise for advanced wound care. Existing methods involve embedd ingorganic dyes or flexible electronics into preformed hydrogels, which raise safety issues and adaptability challenges. In this study, an injectable hydrogel based smart wound dressing is developed by integrating food-derived anthocyanidin as a visual pH probe for infection monitoring and poly(L-lactic acid) microcapsules as ultrasound-responsive delivery systems for antibiotics into a poly(ethylene glycol) hydrogel. This straightforwardly prepared hydrogel dressing maintains its favorable properties for wound repair, including porous morphology and excellent biocompatibility. In vitro experiments demonstrated that the hydrogel enabled visual assessment of pH within the range of 5∼9.Meanwhile, the release of antibiotics could be triggered and controlled by ultrasound. In vivo evaluations using infected wounds and diabetic wounds revealed that the wound dressing effectively detected wound infection by monitoring pH levels and achieved antibacterial effects through ultrasound-triggered drug release. This led to significantly enhanced wound healing, as validated by histological analysis and the measurement of inflammatory cytokine levels. This injectable hydrogel-based smart wound dressing holds great potential for use in clinical settings to inform timely and precise clinical intervention and in community to improve wound care management.

A Conformable Holographic Sensing Bandage for Wound Monitoring

AbstractChronic wound monitoring can provide personalized pathophysiological information for wound management and treatment. Continuously monitoring the wound milieu via the holographic pH sensor can reflect the wound healing processes. However, the integration with wearable devices is hindered by its inherently restricted interrogation angle dependency within 5°. Herein, a ball bearing‐based double photopolymerization method is developed to fabricate holographic pH sensors with a broader interrogation angle range of 15°–60° in wound exudates. The fabricated holographic pH sensor is then integrated with the flexible ultrathin polyurethane substrate, which replays a total Bragg peak shift of approximately 150 nm with physiological pH changes from 7.00 to 8.75. The conformable holographic pH sensing bandages demonstrate the ability to quantify the pH value under various bending manipulations, simulating the mounting on the body surface. The reversibility in artificial wound exudate demonstrates the durability and capability of real‐time pH monitoring in the wound milieu with minimal effect on the replay wavelength. The addition of electrolytes, albumin, urea, uric acid, lactate, and glucose does not interfere with the readout over the physiological pH range of wound exudates. The obtained conformable holographic sensing bandage benefits the wound healing process monitoring through colorimetric interrogation at point‐of‐care (POC) settings.

A comprehensive exploration of hydrogel applications in multi-stage skin wound healing.

Hydrogels, as an emerging biomaterial, have found extensive use in the healing of wounds due to their distinctive physicochemical structure and functional properties. Moreover, hydrogels can be made to match a range of therapeutic requirements for materials used in wound healing through specific functional modifications. This review provides a step-by-step explanation of the processes involved in cutaneous wound healing, including hemostasis, inflammation, proliferation, and reconstitution, along with an investigation of the factors that impact these processes. Furthermore, a thorough analysis is conducted on the various stages of the wound healing process at which functional hydrogels are implemented, including hemostasis, anti-infection measures, encouraging regeneration, scar reduction, and wound monitoring. Next, the latest progress of multifunctional hydrogels for wound healing and the methods to achieve these functions are discussed in depth and categorized for elucidation. Finally, perspectives and challenges associated with the clinical applications of multifunctional hydrogels are discussed.

A bioactive multifunctional dressing with simultaneous visible monitoring of pH values and H2O2 concentrations for promoting diabetic wound healing.

Wound healing in diabetes is a complex physiological process with risks of ulceration and amputation. Real-time monitoring and treatment of diabetic wounds is an effective prevention of further deterioration. Herein, a multifunctional dressing is developed by encapsulating europium-containing bioactive glass (EuBG) and MoO3-x in a biocompatible sodium alginate (SA) dressing (MoO3-x-EuBG-SA), aiming to simultaneously monitor the wound pH value and hydrogen peroxide (H2O2) concentration, establish an anti-inflammatory microenvironment, and promote wound healing. The pH-responsive fluorescence quenching effect of EuBG contributes to visible monitoring of pH values, and MoO3-x enables high responsiveness and accurate colorimetric indication of H2O2 variability to understand the dynamic wound status. Then, these fluorescent and colorimetric changes can be captured using a smartphone and transformed into signals for wound pH values and H2O2 concentrations, enabling rapid and convenient real-time assessment of wound dynamics. Furthermore, the MoO3-x-EuBG-SA dressing can reduce inflammation and promote the proliferation, differentiation, and migration of fibroblasts and endothelial cells in vitro with the help of the released bioactive Si, Ca, and Mo ions. Notably, the MoO3-x-EuBG-SA dressing exhibits excellent abilities to monitor a wound microenvironment and immune regulation and promote diabetic wound healing in vivo. Overall, the multifunctional dressing has great potential for managing diabetic wounds and promoting wound healing.

Optimizing Recurrent Neural Network-Based pH Prediction System of Halochromic Film for Chronic Wound Monitoring

Optimizing Recurrent Neural Network-Based pH Prediction System of Halochromic Film for Chronic Wound Monitoring

Nanotechnology-based Approaches for Efficient Wound Monitoring and Healing

Wound healing is a complex physiological process consisting of several biological and immunological mechanisms which are mutually inclusive. Wounds are commonly categorized as acute and chronic wounds. Acute wound healing is dynamic and chronic wound healing proceeds in a prolonged and irregular manner; thus, it calls for proper management. Certain problems associated to wound healing have triggered the researchers to come up with a promising approach and so nanotechnology-based approaches have evolved as a driving force in wound healing. Nanotechnology has led to the fabrication of nanoparticles, biomolecule loaded dressings and smart dressings to accelerate the wound healing. Nanobiosensors are also being developed which can monitor wound conditions with great precision and incredible sensitivity. This review concentrates on novel nanoscale approaches for instance, nanoparticles such as gold, silver, polystyrene, chitosan, zinc peroxide and nanomaterials such as nano-sensors, nanoflares, nanofibers, etc. for effective wound monitoring and healing. The efficacy of nanomaterial based therapeutic agents in wound healing has been expressed herein. The significance of nanoscale systems in wound healing in terms of anti-microbial activity, angiogenesis, drug delivery, collagen deposition and stem cell delivery has also been addressed.

Bacterial Cellulose-Based Bandages with Integrated Antibacteria and Electrical Stimulation for Advanced Wound Management.

Bandages for daily wounds are the most common medical supplies, but there are still ingrained defects in their appearance, comfort, functions, as well as environmental pollution. Here, novel bandages based on bacterial cellulose (BC) membrane for wound monitoring and advanced wound management are developed. The BC membrane is combined with silver nanowires (AgNWs) by using vacuum filtration method to achieve transparent, ultrathin (≈7 µm), breathable (389.98-547.79gm-2 d-1 ), and sandwich-structured BC/AgNWs bandages with superior mechanical properties (108.45-202.35 MPa), antibacterial activities against Escherichia coli and Staphylococcus aureus, biocompatibility, and conductivity (9.8 × 103 -2.0 × 105 Sm-1 ). Significantly, the BC/AgNWs bandage is used in the electrical stimulation (direct current, 600 microamperes for 1 h every other day) treatment of full-thickness skin defect in rats, which obviously promotes wound healing by increasing the secretion of vascular endothelial growth factor (VEGF). The BC bandage is used for monitoring wounds and achieve a high accuracy of 94.7% in classifying wound healing stages of hemostasis, inflammation, proliferation, and remodeling, by using a convolutional neural network. The outcomes of this study not only provide two BC-based bandages as multifunctional wound management, but also demonstrate a new strategy for the development of the next generation of smart bandage.

Monte Carlo simulations and phantom modeling for spatial frequency domain imaging of surgical wound monitoring.

Postoperative surgical wound infection is a serious problem around the globe, including in countries with advanced healthcare systems, and a method for early detection of infection is urgently required. We explore spatial frequency domain imaging (SFDI) for distinguishing changes in surgical wound healing based on the tissue scattering properties and surgical wound width measurements. A comprehensive numerical method is developed by applying a three-dimensional Monte Carlo simulation to a vertical heterogeneous wound model. The Monte Carlo simulation results are validated using resin phantom imaging experiments. We report on the SFDI lateral resolution with varying reduced scattering value and wound width and discuss the partial volume effect at the sharp vertical boundaries present in a surgical incision. The detection sensitivity of this method is dependent on spatial frequency, wound reduced scattering coefficient, and wound width. We provide guidelines for future SFDI instrument design and explanation for the expected error in SFDI measurements.

Photothermally Enhanced Cascaded Nanozyme‐Functionalized Black Phosphorus Nanosheets for Targeted Treatment of Infected Diabetic Wounds

AbstractDue to the limitations of H2O2 under physiological conditions and defective activity, nanozyme‐catalyzed therapy for infected diabetic wound healing is still a huge challenge. Here, this work designs a novel multifunctional hybrid glucose oxidase (GOx)–CeO2@black phosphorus (BP)/Apt nanosheet that features GOx and CeO2 dual enzyme loading with photothermal enhancement effect and targeting ability for the treatment of infected wounds in type II diabetic mice. Combined with the photothermal properties of the BP nanosheets, the cascade nanozyme effect of GOx and CeO2 is extremely enhanced. The synergistic effect of peroxidase activity and photothermal therapy with targeting aptamer allows for overcoming the catalytic defects of nanozyme and significantly improving in vitro bacterial inhibition rate with 99.9% and 97.8% for Staphylococcus aureus and Escherichia coli, respectively, as well as enhancing in vivo antibacterial performance with the lowest wound remained (0.05%), reduction of infiltration inflammatory cells, and excellent biocompatibility. Overall, this work builds a nanodelivery system with a powerful therapeutic approach, incorporating self‐supplying H2O2 synergistic photothermal and real‐time wound monitoring effect, which holds profound potential as a clinical treatment for infected diabetic wounds.