Wednesday, 10 May 2023
A landmark study that aims to deliver a step change in the care of chronic wounds and reduce healthcare costs for wound management has begun patient trials in people with diabetes-related foot ulcers.
Researchers at the University of Nottingham received a £902,524 grant from the Medical Research Council to develop a smart wound dressing embedded with optical fibre sensors to assess whether affected tissue is healing or infected, which is being trialled at University Hospitals of Derby and Burton NHS Foundation Trust.
Wound management costs stand at £8.3 billion1 a year, more than four per cent of the NHS budget, with diabetes related foot ulcers representing between £837 and £962 million of the cost2. These hard-to-heal wounds are at the centre of the project, as better monitoring has the potential to reduce the 7,000 plus lower limb amputations for people with diabetes in England every year.
Professor Steve Morgan, Co-Director of the Centre for Healthcare Technologies and Professor of Biomedical Engineering at the university, said: “Currently, regular wound redressing is the only way to visually assess healing rates, which can be detrimental as it can encourage infection and disrupt progress – not to mention the resulting economic burden on NHS resources.
Our smart wound dressing addresses this through the incorporation of optical fibre sensors, which can remotely monitor multiple factors associated with wound management, such as temperature, humidity and gases associated with healing and infection.
Professor Morgan continued: "This has the potential to indicate the optimum time for changing the dressing and could alert clinicians about whether an intervention is required for an infected or slow-healing wound. If successful, the impact would be a reduction in the number of healthcare appointments along with improved patient care.”
The study will see ten patients with diabetes related foot ulcers have the dressings applied and monitored on a fortnightly basis for a total of eight weeks per patient. During appointments, the wounds will be assessed, and smart dressing applied for up to one hour under observation while measurements are taken.
Professor Fran Game, Consultant Diabetologist and Clinical Director of Research and Development and the Derby Clinical Trials Support Unit at University Hospitals of Derby and Burton NHS Foundation Trust (UHDB), said: "Technologies to monitor wounds remotely and assess when things are going well or not so well, have the potential to have a significant impact on patients’ lives and health service costs.
If we knew that a wound was healing well without having to use healthcare professionals time just to visually inspect it, it would make a huge difference to the NHS.
Professor Game continued: "Equally, knowing very quickly that wound healing had stalled, or an infection had developed, would mean that we could commence appropriate treatments much more promptly which would improve outcomes.
"I’m thrilled that the first trials of this device are being conducted at UHDB and that patients with diabetes will have the opportunity to support such ground-breaking research."
Although the dressings will cost more than an average dressing up front, researchers hope to prove that this will be offset by fewer dressing changes or clinical visits and a reduced healing time.
Dr David Gomez, Assistant Professor in Optical Fibre Sensing for Healthcare and Medical Devices from the Faculty of Engineering, University of Nottingham, said: “Even a ten per cent reduction in costs associated with visits and appointments would provide significant annual savings of approximately £300 million for the NHS, but this is just one of the elements we’re looking to achieve through this research.
If we’re able to generate a better understanding of ulcer healing and monitoring, we should be able to drastically reduce the number of amputations for future patients, because intervention when a wound gets infected will be quicker and more accurate, and usher in a new approach to chronic wound care.
Dr Gomez continued: “If we’re able to generate a better understanding of ulcer healing and monitoring, we should be able to drastically reduce the number of amputations for future patients, because intervention when a wound gets infected will be quicker and more accurate, and usher in a new approach to chronic wound care.”
The project team includes clinicians at University Hospitals of Derby and Burton NHS Foundation Trust, Nottingham-based smart textiles company Footfalls and Heartbeats, and the Clinical Engineering Department at Nottingham University Hospitals NHS Trust.
Below, hear from Dr Gomez when he spoke about the project in 2019 after funding was granted.
Story credits
More information is available from Steve Morgan, Faculty of Engineering at the University Of Nottingham, at steve.morgan@nottingham.ac.uk or; Danielle Hall, Media Relations Manager at the University of Nottingham, at danielle.hall@nottingham.ac.uk or 0115 846 7156.
1 Guest JF, Fuller GW, Vowden P. Cohort study evaluating the burden of wounds to the UK's National Health Service in 2017/2018: update from 2012/2013. BMJ Open. 2020 Dec 22;10(12):e045253. doi: 10.1136/bmjopen-2020-045253. PMID: 33371051; PMCID: PMC7757484.
2 Kerr M, Barron E, Chadwick P, Evans T, Kong WM, Rayman G, Sutton-Smith M, Todd G, Young B, Jeffcoate WJ. The cost of diabetic foot ulcers and amputations to the National Health Service in England. Diabet Med. 2019 Aug;36(8):995-1002. doi: 10.1111/dme.13973. Epub 2019 Jun 5. PMID: 31004370.
About the Faculty of Engineering:
Made up of six departments – Architecture and Built Environment, Chemical and Environmental Engineering, Civil Engineering, Electrical and Electronic Engineering, Mechanical, Materials and Manufacturing Engineering and Foundation Engineering and Physical Sciences – the university’s Faculty of Engineering is home to more than 5,600 students and 800 staff.
The faculty, which has educated engineers and architects for more than 140 years, was the first in the country to be accredited with an Athena SWAN Gold Award for excellence in advancing gender equality across higher education and research and is home to multiple state-of-the-art facilities, including the recently opened £40m Power Electronics and Machines Centre (PEMC).
With research at its heart, 21 research groups are undertaking pioneering projects for a sustainable future across several themes – including net zero transport, sustainable energies and the built environment, advanced manufacturing, and healthcare technologies – and has delivered a positive impact in more than 20 countries. Within those countries, the faculty’s research has supported 500 companies and three governments – that have changed their strategies as a result of its research – and has also directly created jobs for around 3,000 people across the world.
About University Hospitals of Derby and Burton NHS Foundation Trust (UHDB)
University Hospitals of Derby and Burton NHS Foundation Trust (UHDB) is one of the largest NHS Foundation Trusts in the country, with five hospitals that provide care to more than one million patients each year. It houses one of the biggest trauma and orthopaedics specialties in the country, one of the largest elective care centres with the third highest number of operations, and one of the biggest diabetic foot services. With more than 14,000 staff, it is one of the largest employers in the region with around a £1bn turnover.
As a university hospitals Trust, research is pivotal and is key to providing exceptional care. The research department hosts research funded by external organisations including the National Institute for Health Research (NIHR), Association of Medical Research Charities (AMRC) and the life sciences industry. The team also works with collaborators across the region and beyond to design and deliver innovative research and sponsor high quality research of clear value to the NHS.
An embedded, UKCRC CTU-fully registered clinical trials support unit enables a leading role in high profile research and provides a bespoke service to researchers, sponsors and industry partners through the design, delivery, analysis and reporting of high-quality clinical research.
Notes to editors:
About the University of Nottingham
Ranked 32 in Europe and 16th in the UK by the QS World University Rankings: Europe 2024, the University of Nottingham is a founding member of the Russell Group of research-intensive universities. Studying at the University of Nottingham is a life-changing experience, and we pride ourselves on unlocking the potential of our students. We have a pioneering spirit, expressed in the vision of our founder Sir Jesse Boot, which has seen us lead the way in establishing campuses in China and Malaysia - part of a globally connected network of education, research and industrial engagement.
Nottingham was crowned Sports University of the Year by The Times and Sunday Times Good University Guide 2024 – the third time it has been given the honour since 2018 – and by the Daily Mail University Guide 2024.
The university is among the best universities in the UK for the strength of our research, positioned seventh for research power in the UK according to REF 2021. The birthplace of discoveries such as MRI and ibuprofen, our innovations transform lives and tackle global problems such as sustainable food supplies, ending modern slavery, developing greener transport, and reducing reliance on fossil fuels.
The university is a major employer and industry partner - locally and globally - and our graduates are the second most targeted by the UK's top employers, according to The Graduate Market in 2022 report by High Fliers Research.
We lead the Universities for Nottingham initiative, in partnership with Nottingham Trent University, a pioneering collaboration between the city’s two world-class institutions to improve levels of prosperity, opportunity, sustainability, health and wellbeing for residents in the city and region we are proud to call home.
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