Across the globe, about one in every 50 people suffer from wounds that take a long time to heal. And with the rapidly ageing population and a rise in chronic conditions like diabetes, healthcare providers are bracing themselves for an influx of patients with such wounds.

These chronic wounds, which typically take more than a month to heal, include diabetic foot and chronic venous leg ulcers and, if left untreated, may even lead to amputation. And caring for them isn’t exactly easy: The healing process for chronic wounds is often interrupted by infection and repeated trauma, causing patients to suffer from severe stress, pain and discomfort. Hastening the recovery requires timely care and proper treatments—but that means multiple clinical visits to the doctor for lengthy wound assessments that rely either on visual inspection or analysis from a central lab to detect specific biomarkers. All the while, the start of treatment is delayed.  

And even with recent developments in flexible wound care sensors, these can only probe a limited set of markers, such as acidity, temperature, oxygen, uric acid and impedance, to diagnose wound inflammation.

To speed up patients’ wound assessments, a research team the National University of Singapore collaborated with clinical partners from Singapore General Hospital (SGH) to develop a smart wearable sensor that can conduct real-time point-of-care assessments of chronic wounds wirelessly via a mobile application.

The researchers—led by Professor Lim Chwee Teck from the National University of Singapore’s Department of Biomedical Engineering and Institute for Health Innovation and Technology (iHealthtech)—incorporated the sensor into VeCare, a point-of-care 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.

VeCare consists of an innovative wound sensing bandage, an electronic chip and a mobile application, while the bandage itself comprises a wound contact layer, a breathable outer barrier, a microfluidic wound fluid collector and a flexible immunosensor.

With this immune-sensing bandage, a patient’s wound can be rapidly assessed through its microenvironment, inflammation and infection state by detecting multiple chronic wound-specific biomarkers from wound fluid using an electrochemical system. Meanwhile, the microfluidic wound fluid collector attached to the sensor directs and boosts wound fluid delivery to the sensor by up to 180 per cent. Regardless of the shape or size, the bandage’s design ensures reliable sensing performance.

The smart bandage enables real-time wound monitoring // Credit: National University of Singapore
 

In addition, a chip integrated with flexible electronics is connected to the sensor to transmit data wirelessly to a mobile application for convenient, real-time wound assessments and analyses onsite. The chip component, powered with a rechargeable battery, can be reused for subsequent applications.

The VeCare platform, including its mobile application, enables doctors to monitor the condition of a patient’s chronic wound remotely, reducing the need for the patient to travel to a clinic. On top of that, the bandage used complements the patient’s existing medical treatment while facilitating timely medical intervention for its wound healing process.

“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. 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,” said Lim, who is Director of iHealthtech.

Thus far, a small clinical test of VeCare, in collaboration with SGH, was conducted on patients with chronic venous leg ulcers. This test successfully demonstrated the platform’s effectiveness in assessing chronic wounds and monitoring the progress of wound healing with timely medical interventions.

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

Next, the research team plans to further develop VeCare to meet safety, regulatory and mass production considerations. They intend to explore the incorporation of other appropriate biomarkers for additional wound types and will utilise data from existing clinical workflows to improve diagnosis and treatment. The team also hopes to test VeCare on a larger prospective randomised clinical trial with different types of non-healing chronic ulcers such as diabetic foot and pressure ulcers.

Adapted by Dionne Seah from NUS researchers develop world’s first smart bandage that detects multiple biomarkers for onsite chronic wound monitoring