Center for Cosmetic Surgery, General Hospital of Lanzhou Petrochemical Company (The Fourth Affiliated Hospital of Gansu University of Chinese Medicine), Lanzhou, 730060, Gansu, China.
Department of Plastic Surgery, People's Hospital of Gansu Province, Lanzhou, 730000, Gansu, China.
Cell Biochem Biophys. 2024 Sep;82(3):1965-1977. doi: 10.1007/s12013-024-01402-w. Epub 2024 Jul 5.
During chronic wound healing, the inflammatory phase can endure for extended periods, heavily impeding or halting the process. Regular inspections and dressing changes are crucial. Modern dressings like hydrogels, hydrocolloids, and foam provide protection and an optimal healing environment. However, they have limitations in offering real-time wound bed status and healing rate. Evaluation relies heavily on direct observation, and passive dressings fail to identify subtle healing differences, preventing adaptive adjustments in biological factors and drug concentrations. In recent years, the clinical field recognizes the value of integrating intelligent diagnostic tools into wound dressings. By monitoring biomarkers linked to chronic wounds' inflammatory state, real-time data can be captured, reducing medical interventions and enabling more effective treatment plans. This fosters innovation in chronic wound care. Researchers have developed smart dressings with sensing, active drug delivery, and self-adjustment capabilities. These dressings detect inflammatory markers like temperature, pH, and oxygen content, enhancing drug bioavailability on the wound surface. As wound healing technology evolves, these smart dressings hold immense potential in chronic wound care and treatment. This comprehensive review updates our understanding on the role and mechanism of action of the smart dressings in chronic refractory wounds by summarizing and discussing the latest research progresses, including the intelligent monitoring of wound oxygen content, temperature, humidity, pH, infection, and enzyme kinetics; intelligent drug delivery triggered by temperature, pH, near-infrared, and electricity; as well as the intelligent self-adjustment of pressure and shape. The review also delves into the constraints and future perspectives of smart dressings in clinical settings, thereby advancing the development of smart wound dressings for chronic wound healing and their practical application in clinical practice.
在慢性伤口愈合过程中,炎症期可能会持续很长时间,严重阻碍或停止愈合过程。定期检查和更换敷料至关重要。水凝胶、水胶体和泡沫等现代敷料为伤口提供保护和最佳的愈合环境。然而,它们在提供实时伤口床状况和愈合率方面存在局限性。评估主要依赖于直接观察,而被动敷料无法识别细微的愈合差异,无法调整生物因素和药物浓度。近年来,临床领域认识到将智能诊断工具整合到伤口敷料中的价值。通过监测与慢性伤口炎症状态相关的生物标志物,可以实时捕获数据,减少医疗干预,并制定更有效的治疗计划。这促进了慢性伤口护理的创新。研究人员已经开发出具有传感、主动药物输送和自我调节功能的智能敷料。这些敷料可以检测温度、pH 值和氧含量等炎症标志物,提高伤口表面药物的生物利用度。随着伤口愈合技术的发展,这些智能敷料在慢性伤口护理和治疗方面具有巨大的潜力。本综述通过总结和讨论最新研究进展,更新了我们对智能敷料在慢性难治性伤口中的作用和作用机制的理解,包括伤口氧含量、温度、湿度、pH 值、感染和酶动力学的智能监测;温度、pH 值、近红外和电触发的智能药物输送;以及压力和形状的智能自我调节。本综述还深入探讨了智能敷料在临床环境中的局限性和未来展望,从而推进了智能伤口敷料在慢性伤口愈合中的发展及其在临床实践中的实际应用。