Smart Wound Dressings for Diabetic Chronic Wounds

Abstract

Given their severity and non-healing nature, diabetic chronic wounds are a significant concern to the 30.3 million Americans diagnosed with diabetes mellitus (2015). Peripheral arterial diseases, neuropathy, and infection contribute to the development of these wounds, which lead to an increased incidence of lower extremity amputations. Early recognition, debridement, offloading, and controlling infection are imperative for timely treatment. However, wound characterization and treatment are highly subjective and based largely on the experience of the treating clinician. Many wound dressings have been designed to address particular clinical presentations, but a prescriptive method is lacking for identifying the particular state of chronic, non-healing wounds. The authors suggest that recent developments in wound dressings and biosensing may allow for the quantitative, real-time representation of the wound environment, including exudate levels, pathogen concentrations, and tissue regeneration. Development of such sensing capability could enable more strategic, personalized care at the onset of ulceration and limit the infection leading to amputation. This review presents an overview of the pathophysiology of diabetic chronic wounds, a brief summary of biomaterial wound dressing treatment options, and biosensor development for biomarker sensing in the wound environment.

The Treatment of Impaired Wound Healing in Diabetes: Looking among Old Drugs

“…They also contribute to decrease the risk of infection, accelerate wound healing, and reduce scarring. Different kinds of dressings have been developed, and all of them share the above described features: promotion of reepithelization, moisture, antimicrobial properties, prevention of further trauma, exudate wicking [35]. They can be either non-medicated or medicated, passive, bioactive, and interactive.…”

Antimicrobial and Biocompatible Polycaprolactone and Copper Oxide Nanoparticle Wound Dressings against Methicillin-Resistant Staphylococcus aureus

“…In the case of metal nanoparticles, to date, several studies have investigated their cytotoxic hazard by using a wide range of experimental approaches [ 13 ]. Thus, thanks to advances in nanotechnology, it has been possible to generate materials with improved physicochemical properties and added antimicrobial properties [ 23 ], overcoming the obstacle of current treatments for diabetic foot ulcers (DFU), such as Primapore ® , Mepora ® and cotton gauze whose purpose is limited to covering the lesion but does not protect it from infections by pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) [ 24 , 25 ]. However, many studies in the field of metal nanoparticles have only focused on their cytotoxic effects when dispersed in liquid cultures, rather than studying their biocompatibility when immobilized onto a polymeric matrix, as was done in this research.…”

A Wearable Optical Microfibrous Biomaterial with Encapsulated Nanosensors Enables Wireless Monitoring of Oxidative Stress

“…We chose polycaprolactone (PCL) as the shell material as it is an FDA-approved polymer which has been extensively studied for tissue engineering and wound healing applications. [57][58][59] Our wearable optical platform was able to wirelessly and reversibly detect peroxide in a physiologically-relevant range for wounds (1-250 µM). The ratiometric characteristic of the NIR fluorescence sensor facilitates in vivo and clinical applications as it transduces an absolute signal that is not dependent on excitation source distance nor exposure time.…”