Smart bandage enables onsite chronic wound monitoring

Researchers from the National University of Singapore’s (NUS) Department of Biomedical Engineering and Institute for Health Innovation & Technology (iHealthtech) have developed a smart wearable sensor that can conduct real-time, point-of-care assessment of chronic wounds wirelessly via an app.

Claimed to be a world first, the novel sensor technology can detect temperature, pH, bacteria type and inflammatory factors specific to chronic wounds within 15 minutes, hence enabling fast and accurate wound assessment. It has been described in the journal Science Advances.

It has been estimated that about 2% of the world’s population suffer from chronic wounds, with healthcare providers now seeing more patients suffering from non-healing wounds such as diabetic foot and chronic venous leg ulcers. Timely care and proper treatment of chronic wounds are needed to speed up wound recovery; however, this requires multiple clinical visits for lengthy wound assessment and treatment, which adds to the healthcare cost.

Furthermore, current clinical assessments of wounds rely on visual inspection, or collecting and sending wound fluid to a centralised lab to detect and analyse specific biomarkers. The whole process usually takes about one to two days and may impede proper, timely and precise medical interventions. Although there are recent developments in flexible sensors designed for wound care, they can only probe a limited set of markers — such as acidity, temperature, oxygen, uric acid and impedance — to diagnose wound inflammation.

In response to these limitations, NUS researchers developed VeCare — a point-of-care wound assessment platform consisting of an innovative wound sensing bandage, an electronic chip and a mobile app. The bandage comprises a wound contact layer, a breathable outer barrier, a microfluidic wound fluid collector and a flexible immunosensor.

Professor Lim Chwee Teck and Dr Gao Yuji were the lead researchers of the NUS team that developed the VeCare platform to monitor chronic wounds.

VeCare is believed to be the first wound assessment platform that can detect bacteria type and probe inflammatory factors, in addition to measuring acidity and temperature, within a single 15-minute test. The immunosensing bandage enables rapid assessment of wound microenvironment, inflammation and infection state by detecting multiple chronic wound-specific biomarkers from wound fluid using an electrochemical system. The microfluidic wound fluid collector attached to the sensor directs and boosts wound fluid delivery to the sensor by up to 180%.

The design is said to ensure reliable sensing performance regardless of the ulcer shape or size. In addition, a chip integrated with flexible electronics is connected to the sensor to transmit data wirelessly to an app for convenient, real-time wound assessment and analysis onsite. The chip component, powered with a rechargeable battery, can be reused for subsequent applications.

The VeCare platform and mobile app enable doctors to monitor the condition of patients’ chronic wounds remotely, reducing the hassle for patients to travel to a clinic. The bandage complements the patient’s existing medical treatment while facilitating timely medical intervention for wound healing processes.

“Point-of-care devices coupled with telehealth or digital health capability can play a significant role in transforming the healthcare industry and our society, which is catalysed by the COVID-19 pandemic requirements for safe distancing,” said study co-leader Professor Lim Chwee Teck, who is Director of iHealthtech at NUS. “Our smart bandage technology is the first of its kind designed for chronic wound management to give patients the freedom to perform the test and monitor their wound conditions at home.”

In collaboration with the Singapore General Hospital, a small clinical test of VeCare was conducted on patients with chronic venous leg ulcers. They successfully demonstrated that the platform is effective in the assessment of chronic wounds and enabling monitoring of the progress of wound healing with timely medical intervention.

“The VeCare platform is easily scalable and customisable to accommodate different panels of biomarkers to monitor various types of wounds,” Prof Lim said. “The aim is to have an effective and easy-to-use diagnostic and prognostic tool for precise and data-driven clinical management of patients.”

The next step for the research team is to further develop VeCare to meet safety, regulatory and mass production considerations. The team will explore the incorporation of other appropriate biomarkers suitable for other wound types and utilise data in existing clinical workflows to improve diagnosis and treatment. They hope to test the technology on a larger prospective randomised clinical trial with different types of non-healing chronic ulcers, such as diabetic foot and pressure ulcers.

Top image caption: The VeCare platform comprises (clockwise from bottom left) a chip, wound sensor, bandage and app for real-time, point-of-care chronic wound monitoring.

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