Three‐dimensional shape‐conformation performances of wound dressings tested in a robotic sacral pressure ulcer phantom

Abstract

Effective exudate retention by dressings requires close and intimate dressing‐wound contact, immediately and continuously after the dressing application. Any dressing‐wound spaces may allow for build‐up of non‐retained fluids, causing exudate pooling which forms a favourable environment for pathogen growth. Maceration may follow if the pooled exudates spread to peri‐wound skin. Dressings with a claimed 3D‐shape‐conformation technology are commercially available; however, their effectiveness in minimising dressing‐wound gaps has never been scientifically investigated. We present a novel bioengineering methodology for testing the effectiveness of such 3D‐shape‐conformation dressings, using our recently reported robotic phantom system of a sacral pressure ulcer. By means of 3D laser scanning and bespoke software, we reconstructed dressing shapes after simulated use and calculated the goodness‐of‐fit between each dressing (swelled to near‐saturation) and the corresponding wound geometry. Two dressing sizes (10 × 10 cm and 12.5 × 12.5 cm) and two wound depths (2.5 or 2 cm) were considered. All the tested dressings were far from reaching good contact with the (simulated) wounds: Approximately one‐third of the wound volume and nearly half of the wound surface were not in contact with the swelled dressings. Our present findings question whether 3D‐shape‐conformation dressings are effective, by revealing their swelling behaviour which was previously unknown.

How Should Clinical Wound Care and Management Translate to Effective Engineering Standard Testing Requirements from Foam Dressings? Mapping the Existing Gaps and Needs

“…There are a few examples for academic research and companies reporting the use of protein containing test liquids 75,76 and more viscous test fluids. 21,[77][78][79][80] However, since these test solutions are not included in the EN 13726-1 22 standard, the tests are often not eligible for consideration in hospital formularies. Bioengineering studies in the area of dressing efficacy research are therefore essential to advance this field, for example, by measuring the ranges of exudate viscosities for different wound etiologies and stages of healing towards establishing standards for test fluids.…”

“…Ultimately, the industry would need to develop a range of exudate substitute fluids capable of representing the existing diversity of native biological exudates, to enable clinically-relevant laboratory testing and the formulation of new testing standards for wound dressings. This work is ongoing in the first author's (AG) research group 21,74,80 .…”

Fluid management and strength postsimulated use of primary and secondary dressings for treating diabetic foot ulcers: Robotic phantom studies

“…The further use of secondary bordered dressings provides an additional reservoir for fluid absorption and retention for exudate delivered from the primary dressing through gravity‐driven flow or capillary motion (sorptivity), depending on the body posture and activity (Figure 2). 24,36 Combining a primary and secondary dressing reduces the likelihood of either pooling of exudate in the wound cavity or leakage and spread of exudate to the peri‐wound area, provided that each dressing of the pair is clinically effective and that the dressings function synergistically.…”

“…It is further essential that all bioengineering laboratory measurements of these product specifications are made clinically relevant and reflect the pathophysiology of the patient and wound and the appropriate clinical practice of treatment. Our recent approach of using robotic phantoms of wounds 24,36 has proven to be extremely effective for this purpose and should therefore be used in newly developed testing standards for wound dressings.…”

Microstructure and Biological Properties of Electrospun In Situ Polymerization of Polycaprolactone-Graft-Polyacrylic Acid Nanofibers and Its Composite Nanofiber Dressings

“…Chronic skin wounds impose considerable medical burden, especially to individuals suffering from burns [ 1 ] and chronic skin ulcers [ 2 , 3 , 4 ]. A good skin wound dressing needs to satisfy the following requirements [ 5 ]: good tissue compatibility, which prevents toxicity or inflammation [ 6 , 7 ]; good moisture retention, which maintains the moist environment of the wound and promotes cell hydration [ 8 ]; and sufficient physical and mechanical durability, which ensures its integrity and prevents external bacterial infection due to material damage [ 9 ]. Polycaprolactone (PCL) is a polymer material widely used in biomedical applications, including wound healing, drug delivery [ 10 ], and bone regeneration [ 11 ].…”