• Dr. Timothy Smith

Article: Smart Bandages—A Game Changer for Chronic Wounds

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Cuts, scrapes, punctures, and burns--we've all had them to a greater or lesser degree in our lives. Anyone who has had such an injury knows that healing involves both pain and patience. The biology of wound healing reveals what needs to happen for successful healing to occur and the types of treatment required for the serious issue of chronic wounds.

Wound healing involves four events that need to happen one after the other—hemostasis, inflammation, proliferation, and remodeling. Hemostasis, or blood clotting, occurs first to stop blood loss, followed by inflammation. Inflammation involves a variety of immune cells such as natural killer cells and leukocytes that migrate to the wound to battle microbes that will, if unchecked, cause an infection. Next, the body will regrow or regenerate blood vessels, skin, and collagen to seal the wound. Finally, remodeling occurs when collagen and blood vessels get paired back to normal, completing the healing process. Any disruption of the healing process can lead to chronic and potentially life-threatening wounds.

According to Singer and Clark in an article in the New England Journal of Medicine titled "Cutaneous Wound Healing," 1.25 million people in the US suffer burns, and 6.5 million live with chronic skin ulcers due to pressure, poor circulation, or diabetes. (nejm.org) A wound that has not shown any sign of healing after eight weeks gets labeled as chronic. Poor circulation and a weakened immune system often contribute to chronic skin ulcers, which need special treatment. Treatment will depend on the wound's size, depth, and location.

The wound treatment regimen involves cleaning and dressing the wound and additional applications such as antibiotics or gels to promote healing. A book called InformedHealth described dealing with injuries in a chapter titled, "What are the treatment options for chronic wounds?" The authors summarized, "At first, chronic wounds are regularly cleaned and covered using wound dressings and bandages. If a wound still hasn't healed after a long time despite this wound care, special treatments such as vacuum-assisted closure or skin grafts are used." (nih.gov) To eliminate places for microbes to grow, doctors need to keep the wound clean, which involves removing dead skin with washing and, in some cases, scraping the area.

A growing number of artificial intelligence-driven applications have emerged recently to provide guidance in wound treatment as well as new smart bandages that do more than cover and protect the wound. Unfortunately, not all medical personnel have equal expertise in wound treatment. To address this inequality, new applications that use smartphone cameras employ artificial intelligence to analyze wound pictures to classify wound location, size, depth, and severity to provide treatment guidance. Moreover, in "Smart Bandages: The Future of Wound Care," the authors detail new high technology bandages. These bandages contain micro sensors to monitor wound healing and drug delivery mechanisms built into the fabric to supply antibiotics and growth factors to promote wound healing. For example, keeping a wound at the proper acidity or pH helps promote healing. New bandages contain sensors that report the pH of the wound using tiny electrodes woven right into the dressing. Additionally, some new smart bandages contain medicine encapsulated in little packages that get released into the wound under computer control of heated fibers woven into the bandages. The most advanced bandages under development combine sensing and drug delivery all in one.

Scrapes, cuts, and burns happen to everyone, and for the mild cases, our bodies perform remarkable repairs. The repair process for wounds follows four biological steps: clotting to stop blood loss, an immune response to protect against infection, a round of regeneration to close the wound, and remodeling to return typical structures like skin and the supporting vasculature. Any disruption of the healing process, such as lack of blood flow, infection, or pressure, can prevent proper healing and lead to chronic skin ulcers. Chronic skin ulcers affect millions of people worldwide, leading to great suffering. Advances in medical research have developed new treatments such as antibiotics, wound cleaning solutions, and tissue growth factors. However, not all medical professionals have expertise in wound care. Artificial intelligence-driven applications can now analyze pictures of wounds for size, depth, and location to make treatment recommendations remotely.

Additionally, new smart bandages have remarkable technology woven right into the fabric. Such bandages can sense the state of the wound and even provide medication and growth stimulators right from the dressing. The future of wound healing looks to technology to help ease the suffering from chronic skin ulcers.

Dr. Smith’s career in scientific and information research spans the areas of bioinformatics, artificial intelligence, toxicology, and chemistry. He has published a number of peer-reviewed scientific papers. He has worked over the past seventeen years developing advanced analytics, machine learning, and knowledge management tools to enable research and support high-level decision making. Tim completed his Ph.D. in Toxicology at Cornell University and a Bachelor of Science in chemistry from the University of Washington.

You can buy his book on Amazon in paperback and in kindle format here.