Smart bandage technologies: design and application

276 Pages·2016·31.111 MB·English

by  Cundell, Jill, Davis, James, Finlay, Dewar, McLister, Anna

SMART BANDAGE
TECHNOLOGIES
D a
esign anD pplication
To Mícheál and Caibridh
SMART BANDAGE
TECHNOLOGIES
D a
esign anD pplication
JAMES DAVIS
School of Engineering, Ulster University, Jordanstown,
Northern Ireland, United Kingdom
ANNA McLISTER
School of Engineering, Ulster University, Jordanstown,
Northern Ireland, United Kingdom
JILL CUNDELL
School Health Sciences, Ulster University/Belfast Health
and Social Care Trust, Northern Ireland, United Kingdom
DEWAR FINLAY
School of Engineering, Ulster University, Jordanstown,
Northern Ireland, United Kingdom
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CONTENTS
About the Authors ix
Preface xi
Acknowledgments xiii
List of Abbreviations xv
1. Introduction to Wound Management 1
J. Davis, A. McLister
1.1 Introduction 1
1.2 Wounds: acute and chronic 4
1.3 Wound healing 10
1.4 Wound management strategies 12
1.5 Wound treatment technologies 19
1.6 Wound infection 24
1.7 Health costs 26
1.8 Future strategies and technological solutions 28
References 30
2. Diabetic Foot Ulcers: Assessment, Treatment, and Management 37
J. Cundell
2.1 Introduction 37
2.2 Normal wound healing 39
2.3 The chronic wound 48
2.4 Growth factors—a therapeutic option for the diabetic foot 50
2.5 Infection and the diabetic foot 52
2.6 Summary 53
References 53
3. History and Evolution of Bandages, Dressings, and Plasters 63
J. Davis, A. McLister
3.1 Introduction 63
3.2 Bandage, dressing, or plaster? 64
3.3 Dressings 70
3.4 Plasters 75
3.5 Band-aid discovery and commercialization 82
3.6 Wound packing 82
v
vi Contents
3.7 Field dressing—necessity and invention 84
3.8 Winter’s revolution in wound management 85
3.9 The ideal dressing 86
3.10 Summary 89
References 90
4. Passive and Interactive Dressing Materials 93
J. Davis, A. McLister
4.1 Introduction 93
4.2 Dressing design 96
4.3 Polymeric wound dressings overview 103
4.4 DFU Dressings based on natural polymers 103
4.5 DFU Dressings based on synthetic polymers 117
4.6 Honey 124
4.7 Electrospun dressings 125
4.8 Summary 132
References 133
5. Wound Diagnostics and Diagnostic Dressings 145
J. Davis, A. McLister
5.1 Introduction 145
5.2 Ideal properties and key challenges 146
5.3 Wound fluid 147
5.4 Potential biomarkers 149
5.5 Conventional diagnostics 151
5.6 Moving toward smart dressings 158
5.7 Monitoring wound pH 158
5.8 Colorimetric pH systems 159
5.9 Electrochemical pH systems 165
5.10 Hydrogel sensors 182
5.11 Endogenous wound biomarkers 185
5.12 Summary 189
References 190
6. Sensors for Detecting and Combating Wound Infection 195
J. Davis, A. McLister
6.1 Introduction 195
6.2 Classical signs of wound infection 196
6.3 Microbial culture 197
6.4 Biofilm formation and complications 198
Contents vii
6.5 Instrumental analysis techniques 200
6.6 Real-time/point of care infection diagnostics 201
6.7 Monitoring bacterial metabolites—quorum sensing 202
6.8 Bacterial toxins—pyocyanin 205
6.9 Bacterial enzyme expression 207
6.10 Pore-forming toxins—unilamellar vesicles 209
6.11 Cephalosporin-modified dressings 210
6.12 Immune response biomarkers 210
6.13 Summary 221
References 222
7. Connected Health Approaches to Wound Monitoring 229
D. Finlay
7.1 Introduction 229
7.2 The evolution of connected health 229
7.3 Wound-monitoring technology components 231
7.4 Postprocessing stage 236
7.5 Architectures for connect health approaches to wound monitoring 237
7.6 Wound-monitoring communication architectures 239
7.7 Summary 243
References 244
Glossary 245
Subject Index 249
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ABOUT THE AUTHORS
James Davis is Professor of Biomedical Sensors at Ulster University. He is a member of
the Royal Society of Chemistry and is a Chartered Chemist. His principal interests lie
in the design and development of electrochemical sensors for a range of biomedical ap-
plications such as wound monitoring, catheter diagnostics, and ostomy management. His
research has been supported by the Engineering and Physical Sciences Research Coun-
cil, Wellcome Trust, Heart Research, United Kingdom; National Institutes of Health,
United States, Ireland; Juvenile Diabetes Research Foundation as well as numerous in-
dustrial and commercial sponsors. The team members have been involved in wound
diagnostics and the design of smart dressings over the past decade and are presently
designing systems for the early identification of infection.
Anna McLister completed her undergraduate studies in Biomedical Engineering and
is presently completing her PhD within Prof Davis’ group. She is engaged in the devel-
opment of new diagnostic devices for monitoring wound healing. The main focus of her
research has been on the design of electrochemical sensors for the decentralized/outpa-
tient monitoring of chronic wounds associated with diabetic foot disease. Her work has
involved the design of disposable screen printed sensors modified to confer selectivity
toward monitoring wound pH.
Jill Cundell is a Lecturer Practitioner at Ulster University and Belfast Health and So-
cial Care Trust. She has extensive clinical experience in the management of the High
Risk Foot, working clinically in Belfast Health and Social Care Trust. She has an MSc
in Wound Healing and Tissue Repair (2005) from Cardiff University and is currently
undertaking a PhD—Evaluation of the characteristics of leucocyte-rich platelet-rich
plasma from participants with diabetes at Ulster University. She received a SOCAP
Distinguished Member Award in 2007 and is also an FCPod Med (2011) FFPM RCPS
(Glasg) (2012) and a Chartered Scientist.
Dewar Finlay is Reader in Electronic Engineering at Ulster University. He holds a
BEng degree in Electronic Systems and a PhD in Computing. He currently teaches
courses on digital signal processing and engineering computing to students undertaking
both undergraduate and postgraduate studies in Electronic and Biomedical Engineering.
His research is focused on the application of technology in healthcare with particular
emphasis on connected health and diagnostic algorithms relating to cardiology. He cur-
rently serves as a member of the Board of Directors of Computing in Cardiology and is
a member of the Editorial Board for the Journal of Electrocardiology.
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