In brief

The dressings use surface-enhanced Raman spectroscopy to detect traces of biomarkers present in wound fluid to improve the management of chronic wounds.

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Sensor-equipped smart dressings signal when healing stalls

2 Mar 2023

Advanced biosensors integrated into dressings capture molecular information to monitor whether wounds are healing.

They say time heals all wounds, but in reality, skin healing requires more than just time. Like a finely honed symphony, a myriad of factors—immune chemicals, growth factors, skin cells and other structural elements of the skin tissue microenvironment—must converge to drive a sequence of physiological events that repair breaches to the skin barrier.

However, for some people, this process can come to a halt and stall proper healing, resulting in chronic wounds: a serious and costly health concern.

“Wound management is stretching the limits of health systems globally, challenging clinicians to evaluate the effectiveness of their treatments and deliver appropriate care to their patients,” said Jayakumar Perumal from A*STAR’s Institute of Bioengineering and Bioimaging (IBB), a Senior Scientist in the laboratory of Malini Olivo, Deputy Executive Director of IBB, a Distinguished Institute Fellow and Director of the Translational Biophotonics Laboratory (TBL) in IBB.

Perumal explained that current methods for monitoring chronic wounds are unsophisticated and inaccurate, and often rely on subjective visual inspections and manual measurements. Furthermore, these methods capture only the tip of the iceberg—they do not consider the dynamic biochemical activity happening beneath the skin’s surface, making it difficult to personalise treatment strategies.

Olivo and Perumal led a team that developed a next-generation dressing that can 'read' biomarkers to provide valuable information on a wound’s healing status. Their innovation uses cellulose fibres (CF) with silver nanoparticles to wick wound fluid from the skin and make it perceptible to surface-enhanced Raman spectroscopy (SERS).

SERS is a molecular fingerprint technique that can rapidly and simultaneously identify multiple proteins in complex biological systems. The team configured the SERS-based sensors in their dressing to pick up a panel of biomarkers known to be associated with impaired wound healing, including matrix metalloproteinase-9 (MMP-9) and interleukins (IL).

“We know that after a few weeks, non-healing wounds exhibit higher MMP-9 concentrations compared to healing wounds,” Perumal said, with IL1-α and IL-1β also displaying a similar relationship. In their proof-of-concept study, the scientists found that their CF SERS dressing was highly accurate and sensitive, detecting even trace amounts of biomarker proteins in wound fluid.

CF SERS dressings could one day be used as a cheap, comfortable, non-invasive, continuous monitoring system for chronic non-healing wounds. Efforts to commercialise the technology are already underway, and the team recently wrapped up a clinical trial to test CF SERS in a cohort of about 30 chronic wound patients.

“We are exploring the possibility of doing a large-scale clinical trial to validate biomarkers that differentiate healing from non-healing wounds,” concluded Perumal.

The researchers have filled a provisional patent for their SERS biosensing platform innovation.

The A*STAR-affiliated researchers contributing to this research are from the Institute of Bioengineering and Bioimaging (IBB).

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Perumal, J., Lim, H.Q., Attia, A.B.E., Raziq, R., Leavesley, D.I., et al. Novel cellulose fibre-based flexible plasmonic membrane for point-of-care SERS biomarker detection in chronic wound healing, International Journal of Nanomedicine 16, 5869–5878 (2021). | article

About the Researchers

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Malini Olivo

Distinguished Principal Scientist

A*STAR Skin Research Labs (A*SRL)
Malini Olivo is a Distinguished Principal Scientist at A*STAR Skin Research Labs (A*SRL) where she leads the Translational Biophotonics Laboratory. Concurrently, she is also an Adjunct Professor at the Lee Kong Chian School of Medicine, NTU; Department of Obstetrics & Gynaecology, National University Health System, NUS, Singapore; and Royal College of Surgeons Ireland, Dublin, Ireland. She obtained a PhD degree in Bio-Medical Physics in 1990 from University Malaya/University College London (UCL) and did her post-doctoral training between 1991 and 1995 at UCL, UK and both McMaster University and University of Toronto, Canada. Her current research interest is in medtech and nano-biophotonics and its applications in translational medicine. Her efforts include bridging the gap between cutting edge optical technologies and unmet clinical needs by developing in-house photonics-based devices for various industries. She has succeeded in obtaining competitive research funding of over USD 25 million to support her research in Singapore and overseas. She has published over 500 papers, three books and 20 book chapters, and filed close to 50 patents on technology platforms and devices. She is also the co- founder of three medtech companies. Furthermore, she holds many advisory international roles and is well recognised internationally for her research in biophotonics for her pioneering research contributions. She has conferred as the Fellow of Optical Society of America (OSA), Fellow of American Institute of Medical Bioengineering (AIMBE) and Fellow of Institute of Physics, UK.
Jayakumar Perumal is a Senior Scientist I at the Translational Biophotonics Laboratory at A*STAR Skin Research Labs (A*SRL). In 2010, Perumal obtained his PhD in South Korea, specialising in materials engineering and surface chemistry—in particular on polymer-based microfluidics fabrication for various bio-chemical applications. He came to Singapore in 2011 and has been working in A*STAR for more than 12 years. His research interests were mainly on optical diagnostic platform assay development similar to his work on rapid Raman/SERS based portable diagnostics and applying it on different disease biomarker detection. He is working on newer types of non-lithography based scalable plasmonic substrates for point-of-care detection of different bio-chemical analytes. Perumal has several patents and publications to his credit, and he is working towards the development of alpha prototype for early ovarian cancer diagnostics that has drawn strong interest from industries.

This article was made for A*STAR Research by Wildtype Media Group