Smart Bandages Monitor and Treat Chronic Wounds

Smart bandages under development could revolutionize wound care by automatically sensing and adapting to changing conditions inside a chronic wound. The research, which leverages breakthroughs in materials science, nanotechnology, and digital health to achieve a proof-of-concept study, is described in a recent article in Nature Materials.

Chronic wounds can be deadly — the five-year survival rate is worse than for breast or prostate cancer — and treatment is expensive, costing an estimated $28 billion each year just in the United States, according to the Keck School of Medicine of USC.

To advance chronic wound healing, researchers from Keck-USC and the California Institute of Technology (Caltech) are applying various technologies in next-gen dressings that would provide continuous data on healing and potential complications. If an infection or abnormal inflammation is detected, for example, the wound-care product could deliver medications or other treatments in real time.

The research, supported in part by the National Institutes of Health, thus far has resulted in the development and testing of a smart bandage in animal models.

‘Cyber skin’ helps wounds heal.

“We’re creating a new kind of ‘cyber skin’ that can help these wounds heal, while measuring and managing them along the way,” said co-senior author David G. Armstrong, PhD, DPM, a professor of surgery and neurological surgery at the Keck School of Medicine and co-director of the Southwestern Academic Limb Salvage Alliance (SALSA). “This paper combines these recent insights to chart a way forward in the wound healing space, so that we can move quickly to help our patients recover,” Armstrong said in a prepared statement.

Smart dressings powered by Bluetooth and sensors.

Chronic wounds are more complex and less predictable than acute wounds. They carry a higher risk of infection which, in severe cases, may lead to amputation or life-threatening complications, such as sepsis, according to a news release on the Keck School of Medicine of USC website. Smart dressings could mitigate these risks by using wireless technology to detect inflammation, infections, or problems with blood flow, and alerting patients and healthcare providers via Bluetooth while administering real-time treatment.

Many smart bandages integrate flexible hydrogels, capable of storing and releasing drugs. Image courtesy of Wei Gao, California Institute of Technology.

Smart bandages under development typically incorporate bioelectronic materials that can deliver electrical signals to tissues and cells to help with healing. Many also integrate advanced hydrogels, which are soft, flexible, and capable of storing and releasing drugs in response to pH, temperature, or other environmental factors, said the news release. Various types of embedded sensors can detect changes within the wound and track healing progress.

The paper in Nature Materials reviews these and other technologies relevant to advanced wound care as well as the hurdles that smart bandages must overcome before they can enter standard medical practice. Notably, the researchers point to outdated approaches to wound care by practitioners and a complex FDA approval process.

In contrast with the current practice of visual assessment of a wound and classification without standardized criteria, smart dressings collect data that can be processed and analyzed using machine learning tools. This can even be done remotely.

Armstrong likens this new approach to detecting high cholesterol in the early stages of heart disease and providing preventive treatment.

“What’s amazing is that in wound healing, we haven’t been using those interim measures,” said Armstrong. “All we’ve done is the equivalent of measuring someone in the middle of a heart attack. Developing these interim companion diagnostics is critical.”