Development of Smart Clothing to Prevent Pressure Injuries in Bedridden Persons and/or with Severely Impaired Mobility: 4NoPressure Research Protocol.

Pressure injuries (PIs) are a major public health problem and can be used as quality-of-care indicators. An incipient development in the field of medical devices takes the form of Smart Health Textiles, which can possess innovative properties such as thermoregulation, sensing, and antibacterial control. This protocol aims to describe the process for the development of a new type of smart clothing for individuals with reduced mobility and/or who are bedridden in order to prevent PIs. This paper's main purpose is to present the eight phases of the project, each consisting of tasks in specific phases: (i) product and process requirements and specifications; (ii and iii) study of the fibrous structure technology, textiles, and design; (iv and v) investigation of the sensor technology with respect to pressure, temperature, humidity, and bioactive properties; (vi and vii) production layout and adaptations in the manufacturing process; (viii) clinical trial. This project will introduce a new structural system and design for smart clothing to prevent PIs. New materials and architectures will be studied that provide better pressure relief, thermo-physiological control of the cutaneous microclimate, and personalisation of care.

End-User Assessment of an Innovative Clothing-Based Sensor Developed for Pressure Injury Prevention: A Mixed-Method Study.

This study aimed to evaluate a clothing prototype that incorporates sensors for the evaluation of pressure, temperature, and humidity for the prevention of pressure injuries, namely regarding physical and comfort requirements. A mixed-method approach was used with concurrent quantitative and qualitative data triangulation. A structured questionnaire was applied before a focus group of experts to evaluate the sensor prototypes. Data were analyzed using descriptive and inferential statistics and the discourse of the collective subject, followed by method integration and meta-inferences. Nine nurses, experts in this topic, aged 32.66 ± 6.28 years and with a time of profession of 10.88 ± 6.19 years, participated in the study. Prototype A presented low evaluation in stiffness (1.56 ± 1.01) and roughness (2.11 ± 1.17). Prototype B showed smaller values in dimension (2.77 ± 0.83) and stiffness (3.00 ± 1.22). Embroidery was assessed as inadequate in terms of stiffness (1.88 ± 1.05) and roughness (2.44 ± 1.01). The results from the questionnaires and focus groups' show low adequacy as to stiffness, roughness, and comfort. The participants highlighted the need for improvements regarding stiffness and comfort, suggesting new proposals for the development of sensors for clothing. The main conclusions are that Prototype A presented the lowest average scores relative to rigidity (1.56 ± 1.01), considered inadequate. This dimension of Prototype B was evaluated as slightly adequate (2.77 ± 0.83). The rigidity (1.88 ± 1.05) of Prototype A + B + embroidery was evaluated as inadequate. The prototype revealed clothing sensors with low adequacy regarding the physical requirements, such as stiffness or roughness. Improvements are needed regarding the stiffness and roughness for the safety and comfort characteristics of the device evaluated.

Development of Piezoresistive Sensors Based on Graphene Nanoplatelets Screen-Printed on Woven and Knitted Fabrics: Optimisation of Active Layer Formulation and Transversal/Longitudinal Textile Direction.

Although the force/pressure applied onto a textile substrate through a uniaxial compression is constant and independent of the yarn direction, it should be noted that such mechanical action causes a geometric change in the substrate, which can be identified by the reduction in its lateral thickness. Therefore, the objective of this study was to investigate the influence of the fabric orientation on both knitted and woven pressure sensors, in order to generate knowledge for a better design process during textile piezoresistive sensor development. For this purpose, these distinct textile structures were doped with different concentrations of graphene nanoplatelets (GNPs), using the screen-printing technique. The chemical and physical properties of these screen-printed fabrics were analysed using Field Emission Scanning Electron Microscopy, Ground State Diffuse Reflectance and Raman Spectroscopy. Samples were subjected to tests determining linear electrical surface resistance and piezoresistive behaviour. In the results, a higher presence of conductive material was found in woven structures. For the doped samples, the electrical resistance varied between 105 Ω and 101 Ω, for the GNPs' percentage increase. The lowest resistance value was observed for the woven fabric with 15% GNPs (3.67 ± 8.17 × 101 Ω). The samples showed different electrical behaviour according to the fabric orientation. Overall, greater sensitivity in the longitudinal direction and a lower coefficient of variation CV% of the measurement was identified in the transversal direction, coursewise for knitted and weftwise for woven fabrics. The woven fabric doped with 5% GNPs assembled in the weftwise direction was shown to be the most indicated for a piezoresistive sensor, due to its most uniform response and most accurate measure of mechanical stress.

Joule-Heating Effect of Thin Films with Carbon-Based Nanomaterials.

Smart textiles have become a promising area of research for heating applications. Coatings with nanomaterials allow the introduction of different functionalities, enabling doped textiles to be used in sensing and heating applications. These coatings were made on a piece of woven cotton fabric through screen printing, with a different number of layers. To prepare the paste, nanomaterials such as graphene nanoplatelets (GNPs) and multiwall carbon nanotubes (CNTs) were added to a polyurethane-based polymeric resin, in various concentrations. The electrical conductivity of the obtained samples was measured and the heat-dissipating capabilities assessed. The results showed that coatings have induced electrical conductivity and heating capabilities. The highest electrical conductivity of (9.39 ± 1.28 × 10-1 S/m) and (9.02 ± 6.62 × 10-2 S/m) was observed for 12% (w/v) GNPs and 5% (w/v) (CNTs + GNPs), respectively. The sample with 5% (w/v) (CNTs + GNPs) and 12% (w/v) GNPs exhibited a Joule effect when a voltage of 12 V was applied for 5 min, and a maximum temperature of 42.7 °C and 40.4 °C were achieved, respectively. It can be concluded that higher concentrations of GNPs can be replaced by adding CNTs, still achieving nearly the same performance. These coated textiles can potentially find applications in the area of heating, sensing, and biomedical applications.