1
|
Li X, Xue X, Xie P. Smart Dressings and Their Applications in Chronic Wound Management. Cell Biochem Biophys 2024:10.1007/s12013-024-01402-w. [PMID: 38969950 DOI: 10.1007/s12013-024-01402-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2024] [Indexed: 07/07/2024]
Abstract
During chronic wound healing, the inflammatory phase can endure for extended periods, heavily impeding or halting the process. Regular inspections and dressing changes are crucial. Modern dressings like hydrogels, hydrocolloids, and foam provide protection and an optimal healing environment. However, they have limitations in offering real-time wound bed status and healing rate. Evaluation relies heavily on direct observation, and passive dressings fail to identify subtle healing differences, preventing adaptive adjustments in biological factors and drug concentrations. In recent years, the clinical field recognizes the value of integrating intelligent diagnostic tools into wound dressings. By monitoring biomarkers linked to chronic wounds' inflammatory state, real-time data can be captured, reducing medical interventions and enabling more effective treatment plans. This fosters innovation in chronic wound care. Researchers have developed smart dressings with sensing, active drug delivery, and self-adjustment capabilities. These dressings detect inflammatory markers like temperature, pH, and oxygen content, enhancing drug bioavailability on the wound surface. As wound healing technology evolves, these smart dressings hold immense potential in chronic wound care and treatment. This comprehensive review updates our understanding on the role and mechanism of action of the smart dressings in chronic refractory wounds by summarizing and discussing the latest research progresses, including the intelligent monitoring of wound oxygen content, temperature, humidity, pH, infection, and enzyme kinetics; intelligent drug delivery triggered by temperature, pH, near-infrared, and electricity; as well as the intelligent self-adjustment of pressure and shape. The review also delves into the constraints and future perspectives of smart dressings in clinical settings, thereby advancing the development of smart wound dressings for chronic wound healing and their practical application in clinical practice.
Collapse
Affiliation(s)
- Xiaodong Li
- Center for Cosmetic Surgery, General Hospital of Lanzhou Petrochemical Company (The Fourth Affiliated Hospital of Gansu University of Chinese Medicine), Lanzhou, 730060, Gansu, China
| | - Xiaodong Xue
- Department of Plastic Surgery, People's Hospital of Gansu Province, Lanzhou, 730000, Gansu, China
| | - Peilin Xie
- Department of Plastic Surgery, People's Hospital of Gansu Province, Lanzhou, 730000, Gansu, China.
| |
Collapse
|
2
|
Shi C, Guo L, Song R, Xu H, Zhang Y. Prediction of pedicled flap survival preoperatively by operating indocyanine green angiography at 1,450 nm wavelength: an animal model study. Front Med (Lausanne) 2024; 11:1389384. [PMID: 38831995 PMCID: PMC11146014 DOI: 10.3389/fmed.2024.1389384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/01/2024] [Indexed: 06/05/2024] Open
Abstract
Background Predicting flap viability benefits patients by reducing complications and guides flap design by reducing donor areas. Due to varying anatomy, obtaining individual vascular information preoperatively is fundamental for designing safe flaps. Although indocyanine green angiography (ICGA) is a conventional tool in intraoperative assessment and postoperative monitoring, it is rare in preoperative prediction. Methods ICGA was performed on 20 male BALB/c mice under five wavelengths (900/1,000/1,100, /1,250/1,450 nm) to assess vascular resolution after ICG perfusion. A "mirrored-L" flap model with three angiosomes was established on another 20 male BALB/c mice, randomly divided into two equal groups. In Group A, a midline between angiosomes II and III was used as a border. In Group B, the points of the minimized choke vessel caliber marked according to the ICG signal at 1,450 nm wavelength (ICG1450) were connected. Necrotic area calculations, pathohistological testing, and statistical analysis were performed. Results The vascular structure was clearly observed at 1,450 nm wavelength, while the 900 to 1,100 nm failed to depict vessel morphology. Necrosis was beyond the borderline in 60% of Group A. Conversely, 100% of Group B had necrosis distal to the borderline. The number of choke vessels between angiosomes II and III was positively correlated with the necrotic area (%). The pathohistological findings supported the gross observation and analysis. Conclusion ICG1450 can delineate the vessel structure in vivo and predict the viability of pedicled skin flaps using the choke vessel as the border between angiosomes.
Collapse
Affiliation(s)
- Chenchen Shi
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linxiumei Guo
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruihu Song
- Molecular Imaging Center, State Key Laboratory of Chemical Biology, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Heng Xu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yixin Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
3
|
The Challenges of O 2 Detection in Biological Fluids: Classical Methods and Translation to Clinical Applications. Int J Mol Sci 2022; 23:ijms232415971. [PMID: 36555613 PMCID: PMC9786805 DOI: 10.3390/ijms232415971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Dissolved oxygen (DO) is deeply involved in preserving the life of cellular tissues and human beings due to its key role in cellular metabolism: its alterations may reflect important pathophysiological conditions. DO levels are measured to identify pathological conditions, explain pathophysiological mechanisms, and monitor the efficacy of therapeutic approaches. This is particularly relevant when the measurements are performed in vivo but also in contexts where a variety of biological and synthetic media are used, such as ex vivo organ perfusion. A reliable measurement of medium oxygenation ensures a high-quality process. It is crucial to provide a high-accuracy, real-time method for DO quantification, which could be robust towards different medium compositions and temperatures. In fact, biological fluids and synthetic clinical fluids represent a challenging environment where DO interacts with various compounds and can change continuously and dynamically, and further precaution is needed to obtain reliable results. This study aims to present and discuss the main oxygen detection and quantification methods, focusing on the technical needs for their translation to clinical practice. Firstly, we resumed all the main methodologies and advancements concerning dissolved oxygen determination. After identifying the main groups of all the available techniques for DO sensing based on their mechanisms and applicability, we focused on transferring the most promising approaches to a clinical in vivo/ex vivo setting.
Collapse
|
4
|
Müller M, Cascales JP, Marks HL, Wang-Evers M, Manstein D, Evans CL. Phosphorescent Microneedle Array for the Measurement of Oxygen Partial Pressure in Tissue. ACS Sens 2022; 7:3440-3449. [PMID: 36305608 DOI: 10.1021/acssensors.2c01775] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The knowledge of the exact oxygen partial pressure in tissue is crucial for patient care and in the treatment of ischemic medical conditions. However, current methods to assess oxygen partial pressure in tissue suffer from a variety of disadvantages, including complex equipment and procedures that necessitate trained personnel. Additionally, the barrier function of the stratum corneum reduces oxygen exchange and can consequently hamper surface measurements of rapidly changing oxygen partial pressure in tissue. To overcome these challenges, a novel, easy-to-use technique to monitor the oxygen partial pressure in tissue using microneedle arrays (MNAs) has been developed. The MNAs can be made from poly(ethyl methacrylate) and poly(propyl methacrylate) and overcome the skin's barrier function to measure oxygen in the capillary bed and interstitial fluid of the skin. The MNAs' tips are embedded with an oxygen-sensitive phosphorescent metalloporphyrin, where the oxygen partial pressure inversely correlates to changes in both emission intensity and phosphorescence lifetime of the in-house developed red emitting Pt-core porphyrin. It was demonstrated that the oxygen-sensing MNAs are sufficiently robust to puncture human skin via rupture of the stratum corneum, and that the MNAs can detect changes in oxygen partial pressure in skin within the physiologically relevant range (0-160 mmHg). Additionally, the MNAs can be combined with a wearable wireless optical readout system, making these oxygen-sensing MNAs a novel wearable and portable method for user-friendly monitoring of oxygen partial pressure in skin.
Collapse
Affiliation(s)
- Matthias Müller
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts02129, United States
| | - Juan Pedro Cascales
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts02129, United States
| | - Haley L Marks
- Cutaneous Biology Research Center, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts02129, United States
| | - Michael Wang-Evers
- Cutaneous Biology Research Center, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts02129, United States
| | - Dieter Manstein
- Cutaneous Biology Research Center, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts02129, United States
| | - Conor L Evans
- Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts02129, United States
| |
Collapse
|
5
|
Halani SH, Hembd AS, Li X, Kirby B, Beard CC, Haddock NT, Suszynski TM. Flap Monitoring Using Transcutaneous Oxygen or Carbon Dioxide Measurements. J Hand Microsurg 2022; 14:10-18. [PMID: 35256823 PMCID: PMC8898164 DOI: 10.1055/s-0040-1718862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Free tissue transfer is a cornerstone of complex reconstruction. In many cases, it represents the last option available for a patient and their reconstruction. At high-volume centers, the risk of free flap failure is low but its occurrence can be devastating. Currently, the mainstay for flap monitoring is the clinical examination. Though reliable when performed by experienced clinicians, the flap exam is largely subjective, is performed discontinuously, and often results in significant time delay between detection of flap compromise and intervention. Among emerging flap monitoring technologies, the most promising appear to be those that rely on noninvasive transcutaneous oxygen and carbon dioxide measurements, which provide information regarding flap perfusion. In this article, we review and summarize the literature on various techniques but primarily emphasizing those technologies that rely on transcutaneous gas measurements. We also define characteristics for the ideal flap monitoring tool and discuss critical barriers, predominantly cost, preventing more widespread utilization of adjunct monitoring technologies, and their implications.
Collapse
Affiliation(s)
- Sameer H Halani
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Austin S Hembd
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Xingchen Li
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Ben Kirby
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Courtney C Beard
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Nicholas T Haddock
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Thomas M Suszynski
- Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| |
Collapse
|
6
|
Witthauer L, Cascales JP, Roussakis E, Li X, Goss A, Chen Y, Evans CL. Portable Oxygen-Sensing Device for the Improved Assessment of Compartment Syndrome and other Hypoxia-Related Conditions. ACS Sens 2021; 6:43-53. [PMID: 33325684 DOI: 10.1021/acssensors.0c01686] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Measurement of intramuscular oxygen could play a key role in the early diagnosis of acute compartment syndrome, a common condition occurring after severe trauma leading to ischemia and long-term consequences including rhabdomyolysis, limb loss, and death. However, to date, there is no existing oxygen sensor approved for such a purpose. To address the need to improve the assessment of compartment syndrome, a portable fiber-optic device for intramuscular oxygen measurements was developed. The device is based on phosphorescence quenching, where the tip of an optical fiber was coated with a poly(propyl methacrylate) (PPMA) matrix containing a brightly emitting Pt(II)-core porphyrin. The optoelectronic circuit is highly portable and is based on a microspectrometer and a microcontroller readout with a smartphone. Results from an in vivo tourniquet porcine model show that the sensor is sensitive across the physiological oxygen partial pressure range of 0-80 mmHg and exhibits an appropriate and reproducible response to changes in intramuscular oxygen. A commercial laboratory oxygen sensor based on a lifetime measurement did not respond as expected.
Collapse
Affiliation(s)
- Lilian Witthauer
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts 02129, United States
| | - Juan Pedro Cascales
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts 02129, United States
| | - Emmanuel Roussakis
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts 02129, United States
| | - Xiaolei Li
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts 02129, United States
| | - Avery Goss
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts 02129, United States
| | - Yenyu Chen
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts 02129, United States
| | - Conor L. Evans
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts 02129, United States
| |
Collapse
|
7
|
Cascales JP, Roussakis E, Witthauer L, Goss A, Li X, Chen Y, Marks HL, Evans CL. Wearable device for remote monitoring of transcutaneous tissue oxygenation. BIOMEDICAL OPTICS EXPRESS 2020; 11:6989-7002. [PMID: 33408975 PMCID: PMC7747925 DOI: 10.1364/boe.408850] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 06/12/2023]
Abstract
Wearable devices have found widespread applications in recent years as both medical devices as well as consumer electronics for sports and health tracking. A metric of health that is often overlooked in currently available technology is the direct measurement of molecular oxygen in living tissue, a key component in cellular energy production. Here, we report on the development of a wireless wearable prototype for transcutaneous oxygenation monitoring based on quantifying the oxygen-dependent phosphorescence of a metalloporphyrin embedded within a highly breathable oxygen sensing film. The device is completely self-contained, weighs under 30 grams, performs on-board signal analysis, and can communicate with computers or smartphones. The wearable measures tissue oxygenation at the skin surface by detecting the lifetime and intensity of phosphorescence, which undergoes quenching in the presence of oxygen. As well as being insensitive to motion artifacts, it offers robust and reliable measurements even in variable atmospheric conditions related to temperature and humidity. Preliminary in vivo testing in a porcine ischemia model shows that the wearable is highly sensitive to changes in tissue oxygenation in the physiological range upon inducing a decrease in limb perfusion.
Collapse
|
8
|
Marks H, Bucknor A, Roussakis E, Nowell N, Kamali P, Cascales JP, Kazei D, Lin SJ, Evans CL. A paintable phosphorescent bandage for postoperative tissue oxygen assessment in DIEP flap reconstruction. SCIENCE ADVANCES 2020; 6:eabd1061. [PMID: 33355131 PMCID: PMC11206211 DOI: 10.1126/sciadv.abd1061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 11/17/2020] [Indexed: 06/12/2023]
Abstract
Flaps are common in plastic surgery to reconstruct large tissue defects in cases such as trauma or cancer. However, most tissue oximeters used for monitoring ischemia in postoperative flaps are bulky, wired devices, which hinder direct flap observation. Here, we present the results of a clinical trial using a previously untried paintable transparent phosphorescent bandage to assess the tissue's partial pressure of oxygen (pO2). Statistical analysis revealed a strong relationship (P < 0.0001) between the rates of change of tissue oxygenation measured by the bandage and blood oxygen saturation (%stO2) readings from a standard-of-care ViOptix near-infrared spectroscopy oximeter. In addition, the oxygen-sensing bandage showed no adverse effects, proved easy handling, and yielded bright images across all skin tones with a digital single-lens reflex (DSLR) camera. This demonstrates the feasibility of using phosphorescent materials to monitor flaps postoperatively and lays the groundwork for future exploration in other tissue oxygen sensing applications.
Collapse
Affiliation(s)
- Haley Marks
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
| | - Alexandra Bucknor
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Emmanuel Roussakis
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
| | - Nicholas Nowell
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
| | - Parisa Kamali
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Juan Pedro Cascales
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
| | - Darya Kazei
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Samuel J Lin
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
| | - Conor L Evans
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA.
| |
Collapse
|
9
|
Roussakis E, Cascales JP, Marks HL, Li X, Grinstaff M, Evans CL. Humidity‐Insensitive Tissue Oxygen Tension Sensing for Wearable Devices
†. Photochem Photobiol 2020; 96:373-379. [DOI: 10.1111/php.13198] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/22/2019] [Accepted: 11/16/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Emmanuel Roussakis
- Wellman Center for Photomedicine Massachusetts General Hospital Harvard Medical School Boston MA
| | - Juan Pedro Cascales
- Wellman Center for Photomedicine Massachusetts General Hospital Harvard Medical School Boston MA
| | - Haley L. Marks
- Wellman Center for Photomedicine Massachusetts General Hospital Harvard Medical School Boston MA
| | - Xiaolei Li
- Wellman Center for Photomedicine Massachusetts General Hospital Harvard Medical School Boston MA
| | - Mark Grinstaff
- Departments of Biomedical Engineering and Chemistry Boston University Boston MA
| | - Conor L. Evans
- Wellman Center for Photomedicine Massachusetts General Hospital Harvard Medical School Boston MA
| |
Collapse
|
10
|
Roussakis E, Ortines RV, Pinsker BL, Mooers CT, Evans CL, Miller LS, Calderón-Colón X. Theranostic biocomposite scaffold membrane. Biomaterials 2019; 212:17-27. [PMID: 31100480 DOI: 10.1016/j.biomaterials.2019.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/13/2019] [Accepted: 05/05/2019] [Indexed: 12/15/2022]
Abstract
Acute and chronic wounds affect millions and are associated with billions of dollars in healthcare costs. The use of healing markers, biochemical cues from biocompatible matrices and materials, and their correlation with wound healing has the potential to generate valuable diagnostic, prognostic, and therapeutic information. In this study, we developed a collagen-dextran oxygen-sensing biocomposite scaffold membrane in which a phosphorescent oxygen sensor was incorporated to monitor physiological oxygen using in vivo phosphorescence imaging in a preclinical mouse model of wound healing. The oxygen-sensing biocomposite scaffold membrane enabled the noninvasive and longitudinal monitoring of oxygenation changes in vivo in an approach compatible with commercially available preclinical in vivo imaging system instruments. This study provides a new and novel capability where a biocomposite material can serve as a biocompatible, biodegradable theranostic platform to promote and assess tissue oxygenation during wound healing.
Collapse
Affiliation(s)
- Emmanuel Roussakis
- (a)Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Roger V Ortines
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
| | - Bret L Pinsker
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
| | - Cavin T Mooers
- Research and Exploratory Development Department, The Johns Hopkins University - Applied Physics Laboratory, Laurel, MD, 20723, USA
| | - Conor L Evans
- (a)Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129, USA
| | - Lloyd S Miller
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, 21231, USA
| | - Xiomara Calderón-Colón
- Research and Exploratory Development Department, The Johns Hopkins University - Applied Physics Laboratory, Laurel, MD, 20723, USA.
| |
Collapse
|
11
|
Polacco MA, Hou H, Kuppusamy P, Chen EY. Measuring Flap Oxygen Using Electron Paramagnetic Resonance Oximetry. Laryngoscope 2019; 129:E415-E419. [PMID: 31034638 DOI: 10.1002/lary.28043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/03/2019] [Accepted: 04/15/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine if electron paramagnetic resonance (EPR) oximetry is a viable technology to aid in flap monitoring. STUDY DESIGN Prospective cohort. METHODS This was a cohort study assessing accuracy and speed of EPR oximetry in detecting ischemia of a saphenous artery-based flap in a rat model, using transcutaneous oximetry as a control. Measurements were obtained under both resting and ischemic conditions for nine Sprague Dawley rats (18 flaps), for 3 postoperative days following flap elevation. RESULTS The mean partial pressure of oxygen prior to tourniquet application was 66.9 ± 8.9 mm Hg with EPR oximetry and 64.7 ± 5.2 mm Hg with transcutaneous oximetry (P = .45). Mean partial pressures of oxygen during tourniquet application were 8.9 ± 3.2 mm Hg and 8.5 ± 2.9 mm Hg for EPR oximetry and transcutaneous oximetry, respectively (P = .48), and 67.2 ± 6.9 mm Hg and 65.3 ± 6.1 mm Hg after tourniquet release for EPR oximetry and transcutaneous oximetry, respectively (P = .44). The mean ischemia detection time of EPR oximetry was 49 ± 21 seconds. CONCLUSIONS Offering timely, accurate, and noninvasive tissue oxygen measurements, EPR oximetry is a promising adjunct in flap monitoring. LEVEL OF EVIDENCE NA Laryngoscope, 129:E415-E419, 2019.
Collapse
Affiliation(s)
- Marc A Polacco
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Huagang Hou
- Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Eunice Y Chen
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| |
Collapse
|
12
|
Lim CJ, Lee S, Kim JH, Kil HJ, Kim YC, Park JW. Wearable, Luminescent Oxygen Sensor for Transcutaneous Oxygen Monitoring. ACS APPLIED MATERIALS & INTERFACES 2018; 10:41026-41034. [PMID: 30404434 DOI: 10.1021/acsami.8b13276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We present a new concept for a wearable oxygen (O2) sensor for transcutaneous O2 pressure (tcpO2) monitoring by combining the technologies of luminescent gas sensing and wearable devices. O2 monitoring has been exhaustively studied given its central role in diagnosing various diseases. The ability to quantify the physiological distribution and real-time dynamics of O2 from the subcellular to the macroscopic level is required to fully understand mechanisms associated with both normal physiological and pathological conditions. Despite its profound biological and clinical importance, few effective methods exist for noninvasively quantifying O2 in a physiological setting. The wearable sensor developed here consists of three components: a luminescent sensing film attached onto skin by a carbon tape, an organic light-emitting diode (OLED) as a light source, and an organic photodiode (OPD) as a light detector. All the components are solution-processable and integrated on a plane in a bandage-like configuration. To verify the performance, tcpO2 variations by pressure-induced occlusion were measured in the lower arm and a thumb by the wearable sensor, and the results were comparable to those measured by a commercial instrument. In addition to its flexibility, other features of this sensor render it a potential low-cost solution for the simultaneous monitoring of tcpO2 in any part of a body.
Collapse
Affiliation(s)
- Chang-Jin Lim
- Department of Materials Science and Engineering , Yonsei University , Seoul 03722 , Korea
| | - Soyeon Lee
- Department of Materials Science and Engineering , Yonsei University , Seoul 03722 , Korea
| | - Jin-Hoon Kim
- Department of Materials Science and Engineering , Yonsei University , Seoul 03722 , Korea
| | - Hye-Jun Kil
- Biomedical Research Institute , Korea Institute of Science and Technology , Seoul 02792 , Korea
| | - Yu-Chan Kim
- Biomedical Research Institute , Korea Institute of Science and Technology , Seoul 02792 , Korea
| | - Jin-Woo Park
- Department of Materials Science and Engineering , Yonsei University , Seoul 03722 , Korea
| |
Collapse
|
13
|
Li Z, Marks H, Evans CL, Apiou-Sbirlea G. Sensing, monitoring, and release of therapeutics: the translational journey of next generation bandages. JOURNAL OF BIOMEDICAL OPTICS 2018; 24:1-9. [PMID: 30592189 PMCID: PMC6987519 DOI: 10.1117/1.jbo.24.2.021201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/14/2018] [Indexed: 06/09/2023]
Abstract
This article aims to be a progress report on the Sensing, Monitoring And Release of Therapeutics (SMART) bandage-one of the three technologies that received the inaugural SPIE Photonics West Translational Research Symposium Award in 2015. Invented and developed by Dr. Conor L. Evans and his research team at the Wellman Center for Photomedicine, Massachusetts General Hospital, the SMART bandage is a tool aiming to provide measurements of physiological parameters in the skin alongside the administration of therapeutics on-demand. Since the project began in 2012, the chemists, physicists, and biomedical engineers in the team have worked closely with partners from academia and industry to develop oxygen-sensing SMART bandage prototypes that are now in first-in-human clinical studies. This report gives perspectives on the genesis and translational journey of the technology with an emphasis on the challenges encountered, and the solutions innovated at each stage of development.
Collapse
Affiliation(s)
- Zongxi Li
- Mass General Research Institute, Boston, Massachusetts, United States
| | - Haley Marks
- Massachusetts General Hospital, Harvard Medical School, Wellman Center for Photomedicine, Charlestown, Massachusetts, United States
| | - Conor L. Evans
- Massachusetts General Hospital, Harvard Medical School, Wellman Center for Photomedicine, Charlestown, Massachusetts, United States
| | - Gabriela Apiou-Sbirlea
- Mass General Research Institute, Boston, Massachusetts, United States
- Massachusetts General Hospital, Harvard Medical School, Wellman Center for Photomedicine, Charlestown, Massachusetts, United States
| |
Collapse
|
14
|
Papkovsky DB, Dmitriev RI. Imaging of oxygen and hypoxia in cell and tissue samples. Cell Mol Life Sci 2018; 75:2963-2980. [PMID: 29761206 PMCID: PMC11105559 DOI: 10.1007/s00018-018-2840-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/24/2018] [Accepted: 05/07/2018] [Indexed: 01/17/2023]
Abstract
Molecular oxygen (O2) is a key player in cell mitochondrial function, redox balance and oxidative stress, normal tissue function and many common disease states. Various chemical, physical and biological methods have been proposed for measurement, real-time monitoring and imaging of O2 concentration, state of decreased O2 (hypoxia) and related parameters in cells and tissue. Here, we review the established and emerging optical microscopy techniques allowing to visualize O2 levels in cells and tissue samples, mostly under in vitro and ex vivo, but also under in vivo settings. Particular examples include fluorescent hypoxia stains, fluorescent protein reporter systems, phosphorescent probes and nanosensors of different types. These techniques allow high-resolution mapping of O2 gradients in live or post-mortem tissue, in 2D or 3D, qualitatively or quantitatively. They enable control and monitoring of oxygenation conditions and their correlation with other biomarkers of cell and tissue function. Comparison of these techniques and corresponding imaging setups, their analytical capabilities and typical applications are given.
Collapse
Affiliation(s)
- Dmitri B Papkovsky
- School of Biochemistry and Cell Biology, University College Cork, Cavanagh Pharmacy Building, College Road, Cork, Ireland.
| | - Ruslan I Dmitriev
- School of Biochemistry and Cell Biology, University College Cork, Cavanagh Pharmacy Building, College Road, Cork, Ireland.
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russian Federation.
| |
Collapse
|