Bioimpedance Sensor Array for Long-Term Monitoring of Wound Healing from Beneath the Primary Dressings and Controlled Formation of H2O2 Using Low-Intensity Direct Current

Controllable ion design in flexible metal organic framework film for performance regulation of electrochemical biosensing

The limitations of solvent residues, unmanageable film growth regions, and substandard performance impede the extensive utilization of metal-organic framework (MOF) films for biosensing devices. Here, we report a strategy for ion design in gas-phase synthesized flexible MOF porous film to attain universal regulation of biosensing performances. The key fabrication process involves atomic layer deposition of induced layer coupled with lithography-assisted patterning and area-selective gas-phase synthesis of MOF film within a chemical vapor deposition system. Sensing platforms are subsequently formed to achieve specific detection of H2O2, dopamine, and glucose molecules by respectively implanting Co, Fe, and Ni ions into the network structure of MOF films. Furthermore, we showcase a practical device constructed from Co ions-implanted ZIF-4 film to accomplish real-time surveillance of H2O2 concentration at mouse wound. This study specifically elucidates the electronic structure and coordination mode of ion design in MOF film, and the obtained knowledge aids in tuning the electrochemical property of MOF film for advantageous sensing devices.

Bioimpedance sensor array for monitoring chronic wounds: Validation of method feasibility

In an ageing society, the incidence of hard-to-heal wounds is rising. Chronic wound healing is a complex process, which requires specialised treatment. Clinical assessment of the wound is essential to establish care approaches but is usually based on visual evaluation and it remains challenging. Therefore, innovative quantitative methods for the assessment of chronic wounds are needed. We conducted a single-centre observational study designed to assess the feasibility of a bioimpedance measurement method conducted with a multielectrode sensor array to monitor the wound healing process in patients with chronic wounds of venous, mixed venous-arterial and diabetic aetiology. In total, 104 measurements of bioimpedance were conducted in 18 ulcers during the study. Across all 7 patients analysed, the bioimpedance of the ulcers was consistently increasing as the wound surface was decreasing. The variables had significant (p < 0.001) and strong negative correlation (r = -0.86). We validated the feasibility of the bioimpedance measurement method for the monitoring of the wound healing process on the lower legs. It may be a promising quantitative method for monitoring the status of the wounds. However, long-term measurements are needed to show the usability of the electrode dressing and bioimpedance measurement in the assessment of chronic wounds.

Comparative analysis of electrochemical and optical sensors for detection of chronic wounds biomarkers: A review

Chronic wounds (CW) present a significant healthcare challenge due to their prolonged healing time and associated complications. To effectively treat these wounds and prevent further deterioration, monitoring their healing progress is crucial. Traditional wound assessment methods relying on visual inspection and subjective evaluation are prone to inter-observer variability. Biomarkers play a critical role in objectively evaluating wound status and predicting healing outcomes, providing quantitative measures of wound healing progress, inflammation, infection, and tissue regeneration. Recent attention has been devoted to identifying and validating CW biomarkers. Various studies have investigated potential biomarkers, including growth factors, cytokines, proteases, and extracellular matrix components, shedding light on the complex molecular and cellular processes within CW. This knowledge enables a more targeted and personalized approach to wound management. Accurate and sensitive techniques are necessary for detecting CW biomarkers. Thus, this review compares and discusses the use of electrochemical and optical sensors for biomarker determination. The advantages and disadvantages of these sensors are highlighted. Differences in detection capabilities and characteristics such as non-invasiveness, portability, high sensitivity, specificity, simplicity, cost-effectiveness, compatibility with point-of-care applications, and real-time monitoring of wound biomarkers will be pointed out and compared. In summary, this work provides an overview of CW, explores the emerging field of CW biomarkers, and discusses methods for detecting these biomarkers, with a specific focus on optical and electrochemical sensors. The potential of further research and development in this field for advancing wound care and improving patient outcomes will also be noted.

Flexible wearable intelligent sensing system for wheelchair sports monitoring

The application of wearable intelligent systems toward human-computer interaction has received widespread attention. It is still desirable to conveniently promote health and monitor sports skills for disabled people. Here, a wireless intelligent sensing system (WISS) has been developed, which includes two ports of wearable flexible triboelectric nanogenerator (WF-TENG) sensing and an upper computer digital signal receiving intelligent processing. The WF-TENG sensing port is connected by the WF-TENG sensor and flexible printed circuit (FPC). Due to its flexibility, the WF-TENG sensing port can be freely adhered on the surface of human skin. The WISS can be applied to entertainment reaction training based on human-computer interaction, and to the technical judgment and analysis on wheelchair curling sport. This work provides new application opportunities for wearable devices in the fields of sports skills monitoring, sports assistive devices and health promotion for disabled people.

Wireless, closed-loop, smart bandage with integrated sensors and stimulators for advanced wound care and accelerated healing

'Smart' bandages based on multimodal wearable devices could enable real-time physiological monitoring and active intervention to promote healing of chronic wounds. However, there has been limited development in incorporation of both sensors and stimulators for the current smart bandage technologies. Additionally, while adhesive electrodes are essential for robust signal transduction, detachment of existing adhesive dressings can lead to secondary damage to delicate wound tissues without switchable adhesion. Here we overcome these issues by developing a flexible bioelectronic system consisting of wirelessly powered, closed-loop sensing and stimulation circuits with skin-interfacing hydrogel electrodes capable of on-demand adhesion and detachment. In mice, we demonstrate that our wound care system can continuously monitor skin impedance and temperature and deliver electrical stimulation in response to the wound environment. Across preclinical wound models, the treatment group healed ~25% more rapidly and with ~50% enhancement in dermal remodeling compared with control. Further, we observed activation of proregenerative genes in monocyte and macrophage cell populations, which may enhance tissue regeneration, neovascularization and dermal recovery.

Electrical Bioimpedance Analysis for Evaluating the Effect of Pelotherapy on the Human Skin: Methodology and Experiments

BACKGROUND

Pelotherapy is the traditional procedure of applying curative muds on the skin's surface-shown to have a positive effect on the human body and cure illnesses. The effect of pelotherapy is complex, functioning through several mechanisms, and depends on the skin's functional condition. The current research objective was to develop a methodology and electrodes to assess the passage of the chemical and biologically active compounds of curative mud through human skin by performing electrical bioimpedance (EBI) analysis.

METHODS

The methodology included local area mud pack and simultaneous tap water compress application on the forearms with the comparison to the measurements of the dry skin. A custom-designed small-area gold-plated electrode on a rigid printed circuit board, in a tetrapolar configuration, was designed. A pilot study experiment with ten volunteers was performed.

RESULTS

Our results indicated the presence of an effect of pelotherapy, manifested by the varying electrical properties of the skin. Distinguishable difference in the measured real part of impedance (R) emerged, showing a very strong correlation between the dry and tap-water-treated skin (r = 0.941), while a poor correlation between the dry and mud-pack-treated skin (r = 0.166) appeared. The findings emerged exclusively in the frequency interval of 10 kHz …1 MHz and only for R.

CONCLUSIONS

EBI provides a promising tool for monitoring the variations in the electrical properties of the skin, including the skin barrier. We foresee developing smart devices for promoting the exploitation of spa therapies.

A Review of Recent Advances in Flexible Wearable Sensors for Wound Detection Based on Optical and Electrical Sensing

Chronic wounds that are difficult to heal can cause persistent physical pain and significant medical costs for millions of patients each year. However, traditional wound care methods based on passive bandages cannot accurately assess the wound and may cause secondary damage during frequent replacement. With advances in materials science and smart sensing technology, flexible wearable sensors for wound condition assessment have been developed that can accurately detect physiological markers in wounds and provide the necessary information for treatment decisions. The sensors can implement the sensing of biochemical markers and physical parameters that can reflect the infection and healing process of the wound, as well as transmit vital physiological information to the mobile device through optical or electrical signals. Most reviews focused on the applicability of flexible composites in the wound environment or drug delivery devices. This paper summarizes typical biochemical markers and physical parameters in wounds and their physiological significance, reviews recent advances in flexible wearable sensors for wound detection based on optical and electrical sensing principles in the last 5 years, and discusses the challenges faced and future development. This paper provides a comprehensive overview for researchers in the development of flexible wearable sensors for wound detection.

Multifunctional Dressing for Wound Diagnosis and Rehabilitation

A wound dressing is a sterile pad or compress that is used in direct contact with a wound to help it heal and prevent further issues or complications. Though wound healing is an intricate dynamic process that involves multiple biomolecular species, conventional wound dressings have a limited ability to provide timely information of abnormal conditions, missing the best time for early treatment. The current perspective presents and discusses the design and development of smart wound dressings that are integrated with multifunctional materials, wearable sensors and drug delivery systems as well as their application ranging from wound monitoring to timely application of therapeutics. The perspective also discusses the ongoing challenges and exciting opportunities associated with the development of wearable sensor-based smart wound dressing and provide critical insights into wound healing monitoring and management.

Graphene quantum dot-decorated luminescent porous silicon dressing for theranostics of diabetic wounds

Diabetic wound healing is highly desirable but remains a great challenge owing to the continuous damage of excess reactive oxygen species (ROS) and degradation of therapeutic peptide drugs by over-expressed matrix metalloproteinase (MMP). Herein, we developed a stimuli-responsive smart dressing for theranostics of diabetic wounds using graphene quantum dots-decorated luminescent porous silicon (GQDs@PSi), which was further loaded with peptide and embedded in chitosan (CS) film. The confinement of GQDs in nanochannels of PSi endowed GQDs@PSi with efficient fluorescence resonance energy transfer (FRET) effect, leading to initial red fluorescence of PSi with complete quench of GQD's blue fluorescence. Furthermore, the decoration of GQDs on PSi surface significantly enhanced the loading capacity for peptide drugs including epidermal growth factor (EGF) and insulin (Ins) which can promote diabetic wounds healing. The peptides coloaded in GQDs@PSi exhibited sustained release behavior and could be protected in presence of MMP owing to size exclusion of PSi's nanochannels. As H₂O₂-triggered oxidation of PSi lead to weakened FRET effect and degradation of PSi, GQDs@PSi demonstrated H₂O₂-responsive ratiometric fluorescence change (from red PSi to blue GQDs) and drug release behavior. In combination with CS's degradation in the acidic and oxidation microenvironment, the smart dressing also showed stimuli-responsive drug release toward slightly acid and highly oxidative conditions in diabetic wounds. In vitro and in vivo results demonstrated the smart dressing enhanced the proliferation and migration of cells as well as significantly healed diabetic wounds. Real-time indicating of the exacerbation or healing of diabetic wounds was also realized using the rate of fluorescent discoloration of the dressing. STATEMENT OF SIGNIFICANCE: In this work, a dual luminescent nanomaterial was created by hosting graphene quantum dots (GQDs) in the nanochannel of porous silicon (PSi), which was further applied for theranostics of diabetic wound. The synergistic effect of the host-guest nanohybrid is significant. The GQDs can significantly improve the capacity for peptide drug loading and form a stimuli-response visual ratiometric sensor with luminescent PSi, which can also protect and sustain release of peptide drugs for effective diabetic wounds treatment. After embedded in a chitosan film, the smart dressing displayed H₂O₂-responsive visual ratiometric fluorescence change and drug release behavior. In vitro and in vivo results demonstrated the smart dressing enhanced the proliferation and migration of cells as well as significantly healed diabetic wounds.

Bioimpedance method for monitoring venous ulcers: Clinical proof-of-concept study

Evaluation of wound status is typically based on means which require the removal of dressings. These procedures are often also subjective and prone to inter-observer bias. To overcome aforementioned issues a bioimpedance measurement-based method and measurement system has been developed to evaluate the state of wound healing. The measurement system incorporated a purpose-built bioimpedance device, a measurement software and a screen-printed electrode array. The feasibility and the performance of the system and method were assessed in an open non-randomized follow-up study of seven venous ulcers. Healing of ulcers was monitored until the complete re-epithelialization was achieved. The duration of follow-up was from 19 to 106 days (mean 55.8 ± 25.2 days). A variable designated as the Wound Status Index (WSI), derived from the bioimpedance data, was used for describing the state of wound healing. The wound surface area was measured using acetate tracing for the reference. A strong correlation was found between the WSI and the acetate tracing data, r(93) = - 0.84, p < 0.001. The results indicate that the bioimpedance measurement-based method is a promising quantitative tool for the evaluation of the status of venous ulcers.

Wearable Sensors and Systems for Wound Healing-Related pH and Temperature Detection

Wound healing is a complex tissue regeneration process involving many changes in multiple physiological parameters. The pH and temperature of a wound site have long been recognized as important biomarkers for assessing wound healing status. For effective wound management, wound dressings integrated with wearable sensors and systems used for continuous monitoring of pH and temperature have received much attention in recent years. Herein, recent advances in the development of wearable pH and temperature sensors and systems based on different sensing mechanisms for wound status monitoring and treatment are comprehensively summarized. Challenges in the areas of sensing performance, infection identification threshold, large-area 3-dimensional detection, and long-term reliable monitoring in current wearable sensors/systems and emerging solutions are emphasized, providing critical insights into the development of wearable sensors and systems for wound healing monitoring and management.

Metal-Oxide Based Nanomaterials: Synthesis, Characterization and Their Applications in Electrical and Electrochemical Sensors

Pure, mixed and doped metal oxides (MOX) have attracted great interest for the development of electrical and electrochemical sensors since they are cheaper, faster, easier to operate and capable of online analysis and real-time identification. This review focuses on highly sensitive chemoresistive type sensors based on doped-SnO₂, RhO, ZnO-Ca, Sm_x-CoFe_2−xO₄ semiconductors used to detect toxic gases (H₂, CO, NO₂) and volatile organic compounds (VOCs) (e.g., acetone, ethanol) in monitoring of gaseous markers in the breath of patients with specific pathologies and for environmental pollution control. Interesting results about the monitoring of biochemical substances as dopamine, epinephrine, serotonin and glucose have been also reported using electrochemical sensors based on hybrid MOX nanocomposite modified glassy carbon and screen-printed carbon electrodes. The fundamental sensing mechanisms and commercial limitations of the MOX-based electrical and electrochemical sensors are discussed providing research directions to bridge the existing gap between new sensing concepts and real-world analytical applications.

Conductive Materials for Healing Wounds: Their Incorporation in Electroactive Wound Dressings, Characterization, and Perspectives

The use of conductive materials to promote the activity of electrically responsive cells is an effective means of accelerating wound healing. This article focuses on recent advancements in conductive materials, with emphasis on overviewing their incorporation with non-conducting polymers to fabricate electroactive wound dressings. The characteristics of these electroactive dressings are deliberated, and the mechanisms on how they accelerate the wound healing process are discussed. Potential directions for the future development of electroactive wound dressings and their potential in monitoring the course of wound healing in vivo concomitantly are also proposed.

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.

Heuristic Analysis for In-Plane Non-Contact Calibration of Rulers Using Mask R-CNN

Determining an object measurement is a challenging task without having a well-defined reference. When a ruler is placed in the same plane of an object being measured it can serve as metric reference, thus a measurement system can be defined and calibrated to correlate actual dimensions with pixels contained in an image. This paper describes a system for non-contact object measurement by sensing and assessing the distinct spatial frequency of the graduations on a ruler. The approach presented leverages Deep Learning methods, specifically Mask Region proposal based Convolutional Neural Networks (R-CNN), for rulers’ recognition and segmentation, as well as several other computer vision (CV) methods such as adaptive thresholding and template matching. We developed a heuristic analytical method for calibrating an image by applying several filters to extract the spatial frequencies corresponding to the ticks on a given ruler. We propose an automated in-plane optical scaling calibration system for non-contact measurement.

Novel Enzyme-Free Multifunctional Bentonite/Polypyrrole/Silver Nanocomposite Sensor for Hydrogen Peroxide Detection over a Wide pH Range

Precise designs of low-cost and efficient catalysts for the detection of hydrogen peroxide (H₂O₂) over wide ranges of pH are important in various environmental applications. Herein, a versatile and ecofriendly approach is presented for the rational design of ternary bentonite-silylpropyl-polypyrrole/silver nanoarchitectures (denoted as BP-PS-PPy/Ag) via the in-situ photo polymerization of pyrrole with salinized bentonite (BP-PS) in the presence of silver nitrate. The Pyrrolyl-functionalized silane (PS) is used as a coupling agent for tailoring the formation of highly exfoliated BP-PS-PPy sheet-like nanostructures ornamented with monodispersed Ag nanoparticles (NPs). Taking advantage of the combination between the unique physicochemical properties of BP-PS-PPy and the outstanding catalytic merits of Ag nanoparticles (NPs), the as-synthesized BP-PS-PPy/Ag shows a superior electrocatalytic reduction and high-detection activity towards H₂O₂ under different pH conditions (from 3 to 10). Intriguingly, the UV-light irradiation significantly enhances the electroreduction activity of H₂O₂ substantially, compared with the dark conditions, due to the high photoelectric response properties of Ag NPs. Moreover, BP-PS-PPy/Ag achived a quick current response with a detection limit at 1 μM within only 1 s. Our present approach is green, facile, scalable and renewable.

The Self-Calibration Method for the Vertex Distance of the Elliptical Paraboloid Array

The elliptical paraboloid array plays an important role in precision measurement, astronomical telescopes, and communication systems. The calibration of the vertex distance of elliptical paraboloids is of great significance to precise 2D displacement measurement. However, there are some difficulties in determining the vertex position with contact measurement. In this study, an elliptical paraboloid array and an optical slope sensor for displacement measurement were designed and analyzed. Meanwhile, considering the geometrical relationship and relative angle between elliptical paraboloids, a non-contact self-calibration method for the vertex distance of the elliptical paraboloid array was proposed. The proposed self-calibration method was verified by a series of experiments with a high repeatability, within 3   μ m in the X direction and within 1   μ m in the Y direction. Through calibration, the displacement measurement system error was reduced from 100   μ m to 3   μ m . The self-calibration method of the elliptical paraboloid array has great potential in the displacement measurement field, with a simple principle and high precision.