A Review of Wearable Electroceutical Devices for Chronic Wound Healing
Ali Abba Mutah, Joseph Amitrano, Mark A. Seeley, Dhruv R. Seshadri
Abstract
A chronic wound is a wound that fails to progress through the normal stages of healing within a typical time frame, often remaining open and unhealed for more than 4 to 6 weeks. The delayed healing is often associated with comorbidities, and its clinical consequences have posed great concern to patients, caregivers, and researchers. The use of electrostimulation to enhance healing in chronic wounds has received attention in the last 20 years. Innovative wearable electroceutical devices are engineered to enhance the healing of chronic wounds while prioritizing patient convenience. These devices employ controlled micro-electrostimulation to reactivate endogenous bioelectric activities needed for cellular signaling. However, these devices and their mechanisms of electrostimulation have not been fully explored. In this systematic review, three databases with articles published between 2000 and 2023 were searched and screened using strict inclusion criteria while adhering to the PRISMA checklist. We identified direct, pulsed, and alternating electric currents as the primary modalities by electroceutical devices to deliver electrical stimulation in chronic wounds. Typical chronic wounds identified include diabetic foot ulcers, pressure ulcers, and diabetic venous ulcers. Additionally, a few materials crucial for chronic wound healing were reviewed, and recent devices in research were considered in this study. Various devices, including triboelectric and piezo-nanogenerators, were identified for their potential functionalities in generating electrical stimulation relevant to chronic wound applications. The literature lacked closed-loop electroceutical platforms for treatment and concurrent monitoring of wound healing. The analysis taken from this systematic review provides opportunities at the intersection of epidermal soft bioelectronics, wound care, and remote sensing.