Wound care: healing with technology

Wound care by nurses is directly about cleaning, sterile covering, and documentation. Medical and surgical interventions may also be necessary. In this context, wound care also offers potential for the use of technical aids that can help prevent complications.

Wound care has two facets: acute, following operations and accidents, and chronic, which becomes relevant, for example, in patients who are permanently bedridden, or in ones with diabetes, nerve diseases or circulatory disorders that favor the development of wounds. Enteral probes, permanent access points for infusions or supply lines for cardiac support systems also cause chronic wounds.

In the case of acute wounds, the question arises as to how wound healing can be promoted in such a way that, on the one hand, patients can return to their daily lives as healthy as possible and, on the other hand, no or only a few scars remain. In addition to aesthetic consequences, these can also have functional limitations, for example by restricting the mobility and elasticity of skin areas or causing persistent discomfort.

In recent years, regenerative medicine has played an increasingly important role in the treatment of acute wounds. Until now, extensive wounds have had to be covered with a skin graft from another part of the patient's body. The start-up Inventia Life Science is working on a solution to significantly accelerate the healing of wounds. The Australian company unveiled its Ligō technology platform at MEDICA 2022, which allows wound dressings made of biocompatible materials and cells to be printed directly onto the wound without contact. "This 3D bioprinting technology could be used to treat different skin defects like surgical excisions of non-malignant tumors, third degree burns, pressure ulcers and the like," as Jason Leavens explained in an interview with MEDICA-tradefair.com.

What makes Ligō special is that the printer head is guided by a robotic arm. This would theoretically make it possible to cover a wound directly in the OR. This could avoid further operations and reduce the time needed for healing. “But the ultimate goal of this platform it to reduce scarring,” says Leavens. Better tissue recovery will be achieved by applying the patient's own keratinocytes and fibroblasts, which are critical for regenerating the skin layers, to the wound along with a biocompatible hydrogel.

In healthcare, however, chronic wounds are more prominent than acute wounds. Here, wound care is time- and labor-intensive for nursing staff, resulting in high costs. Even higher, however, are the costs of suboptimal wound care, which causes complications ranging from wound infections to the development of sepsis or even the amputation of limbs. In their daily work, however, nurses often do not have enough time to provide optimal wound care.

In addition to the wound care itself, they also have to spend a lot of time on documentation, because the attending physicians need the data collected by the nurses in order to draw conclusions for further therapy. This is where the Wound Viewer from the Italian company Omnidermal Biomedics can help: "The Wound Viewer is a telemedical device that has the scope of monitoring chronic wounds through our proprietary AI algorithm. It can measure wounds and classify them in three validated clinical scales", explains Jacopo Secco in an interview with MEDICA-tradefair.com.

Nurses can use the Wound Viewer in their daily work to photograph chronic wounds. It can be linked to electronic patient records, making wound data available to the attending physician. They can then use the data to evaluate and adjust therapy. This is supported by the AI included in the Wound Viewer, which is "a pixel-by-pixel technology that really helps to understand the changes of a wound, even if they come in very, very small variations," Secco adds.

Once a wound causes complications, it is often too late: even if it eventually heals, it will leave traces. At best, these are only scars, but in the worst case, it further deteriorates the patient's health.

Solutions such as Ligō or the Wound Viewer are just two of the technical approaches that can significantly improve wound care. There are now market-ready devices that can be used to treat wounds with cold plasma – electrically charged gas. This kills pathogens in the wound and stimulates the growth of cells at the wound edges. In the future, wound dressings will also no longer be mere covers: Thanks to modern manufacturing techniques, we will soon be able to equip them with flat, flexible sensors that monitor the wound environment and indicate when an infection is occurring.

After all, only if we prevent the typical complications of wound healing can we relieve the burden on the healthcare system at this point. However, since wound healing is a lengthy process, we must resort to solutions that enable the prevention of complications rather than just the care of problems.