Impedance sensing device for monitoring ulcer healing in human patients

A Study on Pressure Ulcer: Influencing Factors and Diagnostic Techniques

Pressure ulcer (PU) is one of the most common occurrences in bedridden subjects. Despite the standard of care, there is a huge challenge in monitoring immobile subjects in all the bodily pressure points. This increases the chance of onset of PU which in turn increases the expenditure for treating and managing the PU. Hence, we made a study on the biological and physiological factors that are responsible for the formation of PU and also on various techniques used for diagnosis. Thus, we have summarised the efficacy of various advanced diagnostic procedures with their limitations. Though there are advanced imaging techniques, risk assessment tools based on the visual inspection are widely followed in hospitals. Based on our observation, we here have identified three major areas; one being the development of mathematical modeling, the second is towards the development of non-invasive devices and finally to automate cot facility. We have also provided possible suggestions as to solutions that could be useful to researchers and for society. Thus, this review covers the present difficulty faced by bedridden subjects and respective care-takers along with the knowledge gap and a few suggestions as to future scope.

Development of an Electrical Impedance Tomography Spectroscopy for Pressure Ulcer Monitoring Tool: Preliminary study

This study developed a sensor system that measures electrical impedance with a surrounding electrode array that is located around the wound and estimates the depth and classifies the difference in tissues of small regions in the area using tomography combined with spectroscopy method. The system is designed to integrate into the dressing to reduce unnecessary removal of dressings. In the human trial, moisturizer applied area was detected using Random Forest classifier (94.4% accuracy) and differences between every 10 minutes were significant in moisturizer applied area (p<; 0.05). The study confirmed the proof of concept that the system can monitor the change in human skin without attaching the sensor to the target area and indicate the skin area that had changed.

Smart Wound Dressings for Diabetic Chronic Wounds

Given their severity and non-healing nature, diabetic chronic wounds are a significant concern to the 30.3 million Americans diagnosed with diabetes mellitus (2015). Peripheral arterial diseases, neuropathy, and infection contribute to the development of these wounds, which lead to an increased incidence of lower extremity amputations. Early recognition, debridement, offloading, and controlling infection are imperative for timely treatment. However, wound characterization and treatment are highly subjective and based largely on the experience of the treating clinician. Many wound dressings have been designed to address particular clinical presentations, but a prescriptive method is lacking for identifying the particular state of chronic, non-healing wounds. The authors suggest that recent developments in wound dressings and biosensing may allow for the quantitative, real-time representation of the wound environment, including exudate levels, pathogen concentrations, and tissue regeneration. Development of such sensing capability could enable more strategic, personalized care at the onset of ulceration and limit the infection leading to amputation. This review presents an overview of the pathophysiology of diabetic chronic wounds, a brief summary of biomaterial wound dressing treatment options, and biosensor development for biomarker sensing in the wound environment.

Long term monitoring of a pressure ulcer risk patient using thermal images

Patients in an immobile state are susceptible to pressure ulcers, which are localized injuries to the skin and/or underlying tissues due to prolonged pressure. This paper builds upon a body of work examining in-hospital older adult patients at-risk of developing pedal pressure ulcers by examining thermal images of one patient, who was reporting pain in her right foot, over 112 days of a hospital stay. Thermal images of the patient's left and right heels and malleoli were subjected to image processing to remove noise and enhance contrast, region selection and feature extraction to observe changes in temperature over time. Mean intensity within each ROI was extracted, and the difference in temperature between the left and right heels was calculated over time. The resulting temperature pattern was consistent with the physical phenomenon related to ulcer development, intervention and recovery; the right heel was similar in temperature when starting the study and at the end of the study, but was drastically warmer when experiencing erythema and drastically colder when experiencing ischaemia. These results suggest that consistent thermal imaging, in conjunction with image processing may be able to detect the formation of pressure ulcers faster than can be visually observed. Early detection of pressure ulcers is critical in the prevention of pressure ulcers, and is of great importance to any hospital or nursing home.