The Impact of Digital Technologies on Wound Care

Wound care depends on severity and its stage of healing. Frost & Sullivan has identified important digital tools that are gaining prominence among clinicians to help them monitor the progress of healing and offer the appropriate course of action.

Wounds affect millions of people each day. They may be as simple as a paper cut or a complex result of another condition, such as a diabetic foot ulcer. Wounds are not classified merely on how much pain they cause, how big of an area they affect or even how much it costs to treat them, but rather how much time it takes for the wound to heal. There are two categories of wounds: acute and chronic. Regardless of its cause, physical appearance or level of pain, an acute wound follows a predictable healing path that involves four distinct but overlapping stages: blood-clotting (hemostasis), inflammation, tissue growth (proliferation) and tissue remodeling (maturation). This process is both complex and fragile; any number of factors can delay one or more of these stages, prolonging the healing process and transforming it into a chronic wound—one that remains unhealed for more than three months.

Care depends on a wound’s severity and its stage of healing. Frost & Sullivan has identified important digital tools that are gaining prominence among clinicians to help them monitor the progress of healing and offer the appropriate course of action. A brief description of these technologies and the innovators is provided below.

inSight® from eKare, Inc. (Fairfax, Va.)

eKare’s wound assessment system uses the Apple iPad and an attachable optical imaging probe. The sensor probe, which has low-energy infrared imaging capabilities in addition to standard white light imaging, is attached to the back of the iPad, effectively improving the tablet’s imaging abilities. As the probe scans the wound site, it obtains a high-resolution image that is then subjected to advanced computer vision and artificial intelligence-based algorithms. This analysis provides a 3-D volumetric picture of the wound and information about the tissue composition—making the tool a valuable addition to ambulatory and post-acute care in hospitals.

Mobile wound management from WoundMatrix (Chadds Ford, Pa.)

WoundMatrix has developed a cloud-based telehealth solution for wound management that instantly documents a wound with images and patient details. The program performs image analytics and provides information such as moisture and exudate content in the wound site and the amount of granulation of tissues, and quantifies the healing process. Physicians can know the amount (in percentage terms and in actual area) of necrotic, healthy and sloughed tissues, which are indicators of the efficacy of the prescribed course of action. The enterprise solution easily integrates with electronic health records so doctors can continuously track the healing process and change treatments accordingly.

Silhouette imaging from ARANZ Medical (Christchurch, New Zealand)

ARANZ Medical’s Silhouette® imaging system documents wounds at the point of care. This system is built on a handheld camera, called the SilhouetteStar, which uses LED and laser light to accurately map the contours of the wound site in 3-D. As the physician moves the camera over the site, the laser light is adjusted to obtain the best possible focus. This non-contact image capture traces undulations and precisely measures wound area, depth and volume. As with the other products, the algorithm gleans information from the image using advanced analytics.

WoundVision Scout from WoundVision, LLC (Indianapolis, Ind.)

The WoundVision Scout™ device is the first visual and infrared imaging technology for non-invasive wound image capture, measurement and evaluation. This device goes beyond optical image capture by enabling clinicians to identify changes in metabolic activity, temperature and blood flow around the wound area through its advanced infrared assessment. Its design is similar to that of a speed gun or a barcode reader; its portability is useful in emergency departments that may receive hundreds of traumatic injuries every day. 

Mobile wound solutions from Tissue Analytics, Inc. (Baltimore, Md.)

Tissue Analytics has developed an app for smartphones and tablets that captures wound images and corrects brightness and angles. This eliminates erroneous effects of light that could result in a misdiagnosis, especially during a remote consultation. Image processing is supplemented by an algorithm that meticulously calculates wound dimensions and other parameters. Tissue Analytics’ core technology was developed at the Johns Hopkins Center for Bioengineering and Design, being spun-out as a separate company in 2014. Since then, Johns Hopkins has worked closely with the start-up, most recently running its feasibility study through the Johns Hopkins Home Care Group.

The Road Ahead

The future of digital technologies in wound care depends on whether today’s solutions prove their efficacy and cost-effectiveness. Although several innovative products have entered the market in the last five years, their adoption in clinical practice has been limited. Cost is an important consideration, as is the lack of proven clinical benefits.

Frost & Sullivan envisions wearable devices and implantable sensors playing an important role in wound care. Implantable biosensors already are undergoing experiments to develop the first generation of smart wound care. In the near future, bandages may be able to measure dissolved oxygen in the tissues, local temperature, and moisture, and identify biomarkers to better inform clinicians about the wound healing process.

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