Periodic Reporting for period 1 - SWORD (Smart Wound monitoring Restorative Dressings)
Berichtszeitraum: 2020-01-01 bis 2022-12-31
The project is focused on developing an advanced wound dressing that will assist patients’ needs and lessen pressure on public healthcare resources.
A disruption of skin continuity is called a wound. After an injury, a wound healing processes begin that involve several key stages. Wounds that fail to proceed through these stages in timely and orderly manner that results in re-producing anatomic and functional integrity of the injured tissue are considered chronic.
It has been estimated that 1 to 2% of the population will experience a chronic wound during their lifetime. This condition alone takes up to 3% of the healthcare budgets in developed countries. It is set to rise by 30% annually, partly due to aging population but also due to advances in wound dressing materials. They result in rising costs of wound care because technological advances which can increase efficiencies in the healthcare system over the longer term often increase the short term costs.
The pace of population ageing is much faster than in the past. According to Eurostat 2019 baseline year projections, it is envisaged that by 2025 people aged 65 years and older, will account for 21.9 % of the EU-27’s population as compared with 20.2% in 2020. The predictions for 2050 estimate that people aged 65 years and older will account for 29.4% of the EU population while the total population will decrease thus rising demands on healthcare budgets even more.
Chronic wounds are strongly correlated with age. One of the reasons why elderly are more prone to this condition is that wound repair slows down as the body ages. Older people often suffer from polymorbidities (the co-occurrence of at least two chronic health conditions). These, especially diabetes, obesity, tobaccoism, coronary and vein diseases, which are typical issues for elderly, further increase the probability of complications and prevalence of chronic wounds.
The vast majority of chronic wounds fall into one of three categories: vascular (venous and arterial), diabetic and pressure ulcers (also known as ‘bed sores’). The chronic wounds in diabetic patients (diabetic foot) often lead to limb amputation or death.
Nowadays there is a tendency to discharge patients with chronic wounds from hospitals and transfer the burden of attending to their needs to community services, carers and families. Thus a lay person without medical education and experience may become responsible for therapy between doctor’s visits. This situation can lead to more frequent GP appointments (some of them unnecessary) or to underestimating patient’s complaints and more complications.
To summarize: chronic wounds are a serious medical condition that influence all society and have a growth curve which is getting steeper. The overall objective of the project is to develop a functional sample of a ‘smart’ easily readable dressing, which will have built-in specific sensors that can assess patient condition objectively, a dressing that could lead to mass production of an affordable product that will alleviate patients’ suffering, shorten the recovery time, relieve carers’ workload and lessen the strain on the healthcare expenditure associated with aging society.
A disruption of skin continuity is called a wound. After an injury, a wound healing processes begin that involve several key stages. Wounds that fail to proceed through these stages in timely and orderly manner that results in re-producing anatomic and functional integrity of the injured tissue are considered chronic.
It has been estimated that 1 to 2% of the population will experience a chronic wound during their lifetime. This condition alone takes up to 3% of the healthcare budgets in developed countries. It is set to rise by 30% annually, partly due to aging population but also due to advances in wound dressing materials. They result in rising costs of wound care because technological advances which can increase efficiencies in the healthcare system over the longer term often increase the short term costs.
The pace of population ageing is much faster than in the past. According to Eurostat 2019 baseline year projections, it is envisaged that by 2025 people aged 65 years and older, will account for 21.9 % of the EU-27’s population as compared with 20.2% in 2020. The predictions for 2050 estimate that people aged 65 years and older will account for 29.4% of the EU population while the total population will decrease thus rising demands on healthcare budgets even more.
Chronic wounds are strongly correlated with age. One of the reasons why elderly are more prone to this condition is that wound repair slows down as the body ages. Older people often suffer from polymorbidities (the co-occurrence of at least two chronic health conditions). These, especially diabetes, obesity, tobaccoism, coronary and vein diseases, which are typical issues for elderly, further increase the probability of complications and prevalence of chronic wounds.
The vast majority of chronic wounds fall into one of three categories: vascular (venous and arterial), diabetic and pressure ulcers (also known as ‘bed sores’). The chronic wounds in diabetic patients (diabetic foot) often lead to limb amputation or death.
Nowadays there is a tendency to discharge patients with chronic wounds from hospitals and transfer the burden of attending to their needs to community services, carers and families. Thus a lay person without medical education and experience may become responsible for therapy between doctor’s visits. This situation can lead to more frequent GP appointments (some of them unnecessary) or to underestimating patient’s complaints and more complications.
To summarize: chronic wounds are a serious medical condition that influence all society and have a growth curve which is getting steeper. The overall objective of the project is to develop a functional sample of a ‘smart’ easily readable dressing, which will have built-in specific sensors that can assess patient condition objectively, a dressing that could lead to mass production of an affordable product that will alleviate patients’ suffering, shorten the recovery time, relieve carers’ workload and lessen the strain on the healthcare expenditure associated with aging society.
A pH sensor was designed using chitosan-based films and the principle of photonic crystal colour changes as an indicator for pH changes in proximity of a chronic wound when an infection sets in. It was shown that a device held in a rigid frame consisting of a polystyrene-based photonic crystal deposited on a flexible rubber material with a chitosan-based film attached could provide a simple, visual indication of the presence of an infection in a wound.
The swelling process of the chitosan-based film due to pH change causes elastic deformation of the photonic crystal film that results in the stop band of the photonic crystal shifting from red to green due to an effective decrease in spacing between the polystyrene spheres and the corresponding change in effective refractive index.
The measured response of the device is in the form of an evident colour change while the structure requires no external power supply or electronic sensors to operate.
Chitosan-based fibres were prepared by electrospinning and their suitability to be used as dressings for wound healing was investigated. The fibers were prepared using poly(ethylene glycol) as agent in chitosan electrospinning, which was then removed selectively by washing with water. This procedure produced mesoporous chitosan fibers having the ability to absorb large amounts of liquid, similar to commercial dressings for highly exudated wounds. The modification of fibers by imination with bioactive aldehydes via reversible imination endowed the fibers with “on demand” antimicrobial activity controlled by the consumption of the bioactive aldehyde in the inhibitions process of pathogens. The fibers proved good biocompatibility to fibroblasts and biodegraded completely in media with pH 5.5 characteristic for normal healthy skin. This would make it possible to use these fibers in biodegradable dressings and avoid traumatic wound debridement routinely used nowadays during the dressing change.
New chitosan based hydrogels were also synthesised and characterised, and their ability to encapsulate drugs and to deliver them in a controlled manner was studied. To this aim, chitosan hydrogelation was performed with naturally occurring aldehydes, taking advantage of imination reversibility which favours the supramolecular organisation of the newly formed imine units into clusters with the role of crosslinking nodes. The in situ encapsulation of drugs during the hydrogelation process proved to be an excellent method favouring a fine dispersion of large amounts of drug into hydrogels, and further their release in a prolonged manner. The formulations were biocompatible, biodegradable and capable to absorb large amounts of liquid.
The study has been extended to other polymers, such as (i) polyalcohol boric acid (PVAB) and (ii) polyethylene glycol (PEG). The measurements indicate that PVAB is a potential candidate for wound dressings.
The swelling process of the chitosan-based film due to pH change causes elastic deformation of the photonic crystal film that results in the stop band of the photonic crystal shifting from red to green due to an effective decrease in spacing between the polystyrene spheres and the corresponding change in effective refractive index.
The measured response of the device is in the form of an evident colour change while the structure requires no external power supply or electronic sensors to operate.
Chitosan-based fibres were prepared by electrospinning and their suitability to be used as dressings for wound healing was investigated. The fibers were prepared using poly(ethylene glycol) as agent in chitosan electrospinning, which was then removed selectively by washing with water. This procedure produced mesoporous chitosan fibers having the ability to absorb large amounts of liquid, similar to commercial dressings for highly exudated wounds. The modification of fibers by imination with bioactive aldehydes via reversible imination endowed the fibers with “on demand” antimicrobial activity controlled by the consumption of the bioactive aldehyde in the inhibitions process of pathogens. The fibers proved good biocompatibility to fibroblasts and biodegraded completely in media with pH 5.5 characteristic for normal healthy skin. This would make it possible to use these fibers in biodegradable dressings and avoid traumatic wound debridement routinely used nowadays during the dressing change.
New chitosan based hydrogels were also synthesised and characterised, and their ability to encapsulate drugs and to deliver them in a controlled manner was studied. To this aim, chitosan hydrogelation was performed with naturally occurring aldehydes, taking advantage of imination reversibility which favours the supramolecular organisation of the newly formed imine units into clusters with the role of crosslinking nodes. The in situ encapsulation of drugs during the hydrogelation process proved to be an excellent method favouring a fine dispersion of large amounts of drug into hydrogels, and further their release in a prolonged manner. The formulations were biocompatible, biodegradable and capable to absorb large amounts of liquid.
The study has been extended to other polymers, such as (i) polyalcohol boric acid (PVAB) and (ii) polyethylene glycol (PEG). The measurements indicate that PVAB is a potential candidate for wound dressings.
We achieved proof of concept pH sensor using the principle of photonic crystal colour changes as an indicator for pH changes in proximity of wound.
We developed
- a method to produce mesoporous chitosan fibers with ability to absorb high amounts of liquid that is necessary for dressings in the case of highly exudating chronic wounds,
- a method to prepare “smart” dressings capable to release antimicrobial agents “on demand” as a result of their utilization during the bacteria inhibition process,
- a route to prepare dressings encapsulating high amount of drugs anchored into a chitosan based matrix by in situ hydrogelation of chitosan with monoaldehydes of natural origin.
We aim to continue planned research works and create a pilot of a novel wound dressing that could be further developed into a marketable product with a backing of an industrial partner.
We plan to produce samples of three more sensors in order to enable assessing patient’s condition more precisely. We will also work on advancement of properties of highly absorbing non-woven dressing materials with the aim to develop a pilot of a novel wound dressing with market potential that would also save public funds and, as much as possible alleviate sufferings that patients with chronic wounds experience and reduce excessive workload falling on the carers and community nurses.
We developed
- a method to produce mesoporous chitosan fibers with ability to absorb high amounts of liquid that is necessary for dressings in the case of highly exudating chronic wounds,
- a method to prepare “smart” dressings capable to release antimicrobial agents “on demand” as a result of their utilization during the bacteria inhibition process,
- a route to prepare dressings encapsulating high amount of drugs anchored into a chitosan based matrix by in situ hydrogelation of chitosan with monoaldehydes of natural origin.
We aim to continue planned research works and create a pilot of a novel wound dressing that could be further developed into a marketable product with a backing of an industrial partner.
We plan to produce samples of three more sensors in order to enable assessing patient’s condition more precisely. We will also work on advancement of properties of highly absorbing non-woven dressing materials with the aim to develop a pilot of a novel wound dressing with market potential that would also save public funds and, as much as possible alleviate sufferings that patients with chronic wounds experience and reduce excessive workload falling on the carers and community nurses.