A flexible and low power telemetric sensing and monitoring system for chronic wound diagnostics.

BACKGROUND: Non-healing chronic wounds, such as venous leg ulcers, can be monitored non-invasively by using modern sensing devices and wireless technologies. The development of such a wireless diagnostic tool may improve chronic wound management by providing evidence on efficacy of treatments being provided. This paper presents a low-power portable telemetric system for wound condition sensing and monitoring. The system aims at measuring and transmitting real-time information of wound-site temperature, sub-bandage pressure and moisture level from within the wound dressing. METHODS: Commercially available non-invasive temperature, moisture, and pressure sensors are interfaced with a telemetry device on a flexible 0.15 mm thick printed circuit material to construct a light-weight, non-invasive, biocompatible, and low-power sensing device. The real-time data obtained is transmitted wirelessly to a portable receiver which displays the measured values. The performance of the whole telemetric sensing system is validated on a mannequin leg using commercial compression bandages and dressings. A number of trials on a healthy human volunteer are performed where treatment conditions were emulated using various compression bandage configurations. RESULTS: A reliable and repeatable performance of the system is achieved under compression bandage and with minimal discomfort to the volunteer. The system is capable of reporting instantaneous changes in bandage pressure, moisture level and local temperature at wound site with average measurement resolutions of 0.5 mmHg, 3.0% RH, and 0.2°C respectively. Effective range of data transmission is 4-5 m in an open environment. CONCLUSIONS: A flexible and non-invasive sensing system is developed to acquire and wirelessly transmit wound parameters from within a compression bandage and wound dressing worn on a human limb. Pre-clinical results on a healthy human subject suggest its clinical usability and value to health practitioners. However, further performance evaluations of the device on a wider population of healthy human subjects and on patients with chronic wounds are required to confirm its medial usefulness and to quantify its real impact on chronic wound management.

An improved flexible telemetry system to autonomously monitor sub-bandage pressure and wound moisture.

This paper presents the development of an improved mobile-based telemetric dual mode sensing system to monitor pressure and moisture levels in compression bandages and dressings used for chronic wound management. The system is fabricated on a 0.2 mm thick flexible printed circuit material, and is capable of sensing pressure and moisture at two locations simultaneously within a compression bandage and wound dressing. The sensors are calibrated to sense both parameters accurately, and the data are then transmitted wirelessly to a receiver connected to a mobile device. An error-correction algorithm is developed to compensate the degradation in measurement quality due to battery power drop over time. An Android application is also implemented to automatically receive, process, and display the sensed wound parameters. The performance of the sensing system is first validated on a mannequin limb using a compression bandage and wound dressings, and then tested on a healthy volunteer to acquire real-time performance parameters. The results obtained here suggest that this dual mode sensor can perform reliably when placed on a human limb.

Design and Fabrication of Glucose Biosensors Based on Immobilization of Glucose Oxidase on Titanium Oxide Nanotube Arrays.

An electrochemical biosensor for the detection of glucose is realized by immobilizing glucose oxidase (GOx) enzyme onto titanium dioxide nanotube arrays by a coupling encapsulation process. We present details of a robust fabrication technique that results in a durable and reproducible sensor characteristics. The TiO2 nanotube arrays are grown directly on a titanium substrate by a potentiostatic anodization process in a water and ethylene-glycol mixture solution, which contains ammonium fluoride. An electropolymerization process was also performed to enhance interfacial adhesion between GOx and TiO2 nanotubes. Detection of glucose concentrations was achieved with a linear response in the range of 0.01 to 0.2 mM. Investigation of enhanced sensitivity by increasing the count, the length, and the cross-section of the nanotubes was also carried out. Surface morphologies of Ti substrate were examined by scanning electron microscopy to optimize the anodization process and thus the TiO2/Ti nanotube dimensions. We utilized a time-based amperometric response for the quantitative determination of hydrogen peroxide concentration through electro-reduction reaction with a bare TiO2/Ti nanotube-array electrodes, thus providing a reference for the determination of glucose levels with a GOx-coated TiO2/Ti nanotube array electrodes. Detection levels down to 5.2 µM were recorded.

Applications of modern sensors and wireless technology in effective wound management.

The management of chronic wounds has emerged as a major health care challenge during the 21st century consuming, significant portions of health care budgets. Chronic wounds such as diabetic foot ulcers, leg ulcers, and pressure sores have a significant negative impact on the quality of life of affected individuals. Covering wounds with suitable dressings facilitates the healing process and is common practice in wound management plans. However, standard dressings do not provide insights into the status of the wound underneath. Parameters such as moisture, pressure, temperature and pH inside the dressings are indicative of the healing rate, infection, and wound healing phase. But owing to the lack of information available from within the dressings, these are often changed to inspect the wound, disturbing the normal healing process of wounds in addition to causing pain to the patient. Sensors embedded in the dressing would provide clinicians and nurses with important information that would aid in wound care decision making, improve patient comfort, and reduce the frequency of dressing changes. The potential benefits of this enabling technology would be seen in terms of a reduction in hospitalization time and health care cost. Modern sensing technology along with wireless radio frequency communication technology is poised to make significant advances in wound management. This review discusses issues related to the design and implementation of sensor technology and telemetry systems both incorporated in wound dressings to devise an automated wound monitoring technology, and also surveys the literature available on current sensor and wireless telemetry systems.