MICA: Monitoring wound status using multi-parameter optical fibre sensors

Lead Research Organisation: University of Nottingham
Department Name: Faculty of Engineering

Abstract

A recent analysis of the health economic burden of wounds highlighted that ~2.2 million wounds were managed by the NHS in 2012/2013 requiring annually 18.6 million practice nurse, 10.9 million community nurse, 7.7 million GP and 3.4 million hospital outpatient visits. The annual NHS cost of managing these wounds is £4.5-5.1 billion (~4% of the entire NHS budget).
We propose to develop a wound dressing incorporating inexpensive optical fibre sensors (OFS) which will monitor whether a wound is healing, whether healing is not progressing and whether a wound is infected. The proposed sensors have been developed and validated by our team in laboratory tests thus greatly reducing project risk.
The new dressing could have a significant impact on NHS costs and patient care. It will enable clinical interventions to take place promptly but only when required, thus improving wound care and reducing the number of NHS appointments. Studies will involve clinic based evaluation followed by a community based study of patients with chronic wounds. Design, regulatory, statistics and health economics expertise will help to support development of a valuable, safe tool that is acceptable to patients and clinicians.

Technical Summary

A recent analysis of the health economic burden of wounds (Guest et al BMJ Open 2015;5:e009283) highlighted that ~2.2 million wounds were managed by the NHS in 2012/2013 requiring annually 18.6 million practice nurse, 10.9 million community nurse, 7.7 million GP and 3.4 million hospital outpatient visits. The annual NHS cost of managing these wounds is £4.5-5.1 billion (~4% of the entire NHS budget).
We propose to develop a wound dressing incorporating inexpensive optical fibre sensors (OFS) which will monitor parameters associated with wound healing. The sensors will be fabricated in thin (~100um diameter), lightweight, low cost optical fibres incorporated into a wound dressing.
The new dressing could have a significant impact on NHS costs and patient care. It will enable clinical interventions to take place promptly but only when required, thus improving wound care and reducing the number of NHS appointments. Studies will involve clinic based evaluation followed by a community based study of patients with chronic wounds. Design, regulatory, statistics and health economics expertise will help to support development of a valuable, safe tool that is acceptable to patients and clinicians.

Planned Impact

A recent analysis of the health economic burden of wounds highlighted that ~2.2 million wounds were managed by the NHS in 2012/2013 requiring annually 18.6 million practice nurse, 10.9 million community nurse, 7.7 million GP and 3.4 million hospital outpatient visits. The annual NHS cost of managing these wounds is £4.5-5.1 billion (~4% of the entire NHS budget).

Among chronic wounds, diabetic foot ulcers (DFUs) are particular group which currently accounts for almost £1 billion each year - almost 1% of the total NHS cost. The bulk of these costs are made up NHS appointments and hospital admissions for DFUs which deteriorate.

The proposed wound dressing could have a significant impact on NHS costs and patient care. Introducing remote monitoring of wound status via optical fibre sensing will notify a patient and clinician when the wound is in an adverse state, either wound healing is not progressing or the wound is infected. This will enable clinical interventions to take place promptly but only when required, thus improving wound care and reducing the number of NHS appointments. For example, if monitoring indicates that wound healing is progressing well then this will reduce the need for specialist review and can reduce the frequency of dressing changes. If the wound status deteriorates rapidly, e.g. due to infection, then this will trigger urgent specialist review. There is evidence that early expert assessment of DFUs leads to improved outcome, with reduced hospital admissions and amputations (www.digital.nhs.uk/catalogue/PUB30107).

In future the technology also has the potential to be applied as a tool to predict tissue breakdown in those with vulnerable skin (e.g. people with diabetes and older people). It could also be used as a technology for testing the performance and claims of advanced wound dressings.

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