What Does the Future Hold for "Smart" Wound Care?

My name's David Armstrong. I'm professor of surgery at the Keck School of Medicine at the University of Southern California, where even when it's not sunny, it's sunny. So it's a pleasure to be here. And my partner from Caltech, and teams, just published a paper very recently in Science Advances looking at new next generation smart skin, smart dressing technology that could potentially be kind of a closed loop system for detecting potentially limb threatening infection, inflammation, and other sort of analytes, as it were, even pH, while also potentially delivering something to the wound like electrical stimulation or even a drug or something that we could deliver into the wound. So it has the potential now to be a soft, stretchable material that has ultra cool new delivery technologies as well as sensor technologies. So hopefully we can keep improving the way that we measure what we manage.

There's the old adage that it's not what you put on these wounds that heals them, but what you take off. And if you debride them well, you take off what's not viable, and you offload them, you offload pressure well, well, many of these wounds are going to heal in the face of good blood flow and absent infection. That's the prequel. The problem is that most people don't do a good job offloading these wounds. We sort of talk to our patients and our patients refuse to do something, or we will then counter that by locking them into something like a total contact cast or something like that. And we've always thought that while that's my favorite method of offloading and healing patients, it may not be the nicest thing to do to a person. It wouldn't be to me or my mom or even my mother-in-law. But wouldn't it be nice if we could do something with someone and not to them?

So the bottom line is we have a new study funded by the National Institute of Health, the NIH, where we are taking a really cool looking offloading device that people might want to wear, it was actually designed by this guy, Mike DiTullo, who designed the second gen Air Jordans, and that offloads the foot really well, but then marrying that with next generation technology, like a smart watch, that could detect when someone was wearing it and when they weren't. So they could say, "Hey, Mr. Smith," or, "Hey Ms. Garcia, great job wearing that thing. You're helping heal your wound." Or, "Hey, no, not so good. It's sitting next to your la-Z-Boy or it's acting like a door stop and not on your foot healing the wound."

So that idea is a new novel study that we have going on right now, and the results have been fascinating. One of the first data that we got out of there was this technology perception. And what we're finding now, and it's fascinating, is that folks of different races, ethnicities, walks of life, socioeconomic backgrounds, are perceiving these things differently. And the thing that completely fooled us was that people of color and people of low socioeconomic status who have next to nothing very often are seizing onto this technology even more than folks of means. And so that has led us to this, I think, profound realization that maybe we could start targeting these folks that really need this problem and helping them move through the world a little bit better with the technology that they would often never get on a normal visit to clinic just because we're just dealing with so many other social determinants of health. So it's a really exciting time to be working in this area with our patients at the center of this and doing something with them and not just to them.