The focus of advanced wound care is chronic, complex wounds, including leg ulcers, pressure ulcers, diabetic foot ulcers and dehisced surgical wounds. Although a fundamental part of everyday health care, technologies of wound care are often considered mundane and are consequently overlooked in both academic literature and medical practice. This project will bring together academic and non-academic audiences, developing cross-disciplinary engagement in an exploratory project on the interplay between histories and current practices of advanced wound care. Through three workshops the goal is to identify how an awareness and appreciation of the historical approaches and sociological discussions surrounding wound care innovation can inform current practices in a number of ways: by illuminating in more detail the manufacturer-user relationship, analysing conditions under which innovation thrive, and highlighting how particular types of product were marketed to consumers. There has been limited engagement in this field between research communities in the health sciences and humanities. In addition, the patient voice has been notably absent in discussions about research in wound care (Cullum et al, in press). The project offers a fresh interdisciplinary approach which builds on pilot work undertaken at the University of Leeds and lays the foundation for a major interdisciplinary project exploring the history and impact of advanced wound care. Whilst much research has examined the historical context of acute surgical wounds and injuries sustained on the battlefield, the case of chronic wounds has yet to be fully investigated. In the UK, most chronic wounds are managed by community nurses with referral to specialist services, including tissue viability, surgical specialties (e.g. vascular and orthopaedic surgery), podiatry and dermatology. The historical literature has tended to concentrate on hospital-based, acute clinical activity, ignoring the fact that wound care decision making, prevention and treatment is very often the preserve of nursing as well as patients themselves. Similarly, recent historical research has emphasised the importance of global conflict in driving innovations which are applicable in far broader settings; inventions emerging from warfare are appropriated and applied in many different and unexpected ways beyond the immediate field of conflict. The work of George Winter (1962), observing that wounds in young pigs healed more quickly if covered rather than being left open to the air, is the starting point for much contemporary wounds research because it established the idea that a wound dressing can influence outcomes. The theoretical context of the work will therefore bring together historical and sociological case studies of innovation and the established historical methodological approach of the 'medical marketplace', as well as recent research on the history of medical technology and everyday healthcare. This will shed new light on Rogers' (2003) influential work on diffusion of innovation and Greenhalgh et al's (2004) systematic review findings that successful innovation adoption requires analysis of the characteristics of the innovation itself, the perceptions of those individuals tasked with adopting the innovation, and the wider organisational cultures in place in the setting for adoption. The project will connect academics from a broad range of disciplines with patient and industry representatives to explore how historically-grounded accounts of advanced wound care can address current challenges in the field. To this end, major outputs will include an edited collection based on the outcomes of the workshops, an industry-facing briefing document, a public panel debate, creative visual outputs and a new network of interdisciplinary scholars which will be supported in the longer-term by digital resources.

Chronic wounds are those that fail to heal in an orderly and timely (typically three months) manner. Examples of chronic wounds include diabetic foot ulcers, pressure ulcers and venous leg ulcers. The incidence of chronic wounds is increasing as a result of lifestyle changes and the ageing population. For example, ~552 million people worldwide are estimated to have diabetes mellitus in 2030. Up to an estimated 25% of these patients will develop diabetic foot ulcers in their lifetime; half of these ulcers will be infected and 20% will undergo amputation of their lower limb. The annual economic impact of chronic wounds, which includes nursing time and dressing materials, on the global economy is estimated to be ~£20 billion by 2030. A common practise in wound management is to cover wounds with suitable dressings to facilitate the healing process. Standard dressings, however, do not provide insights into the status of the wound underneath. Thus, dressings are often changed to examine and assess the wound. This in turn hampers the process of normal wound healing and cause stress and pain to patients. The assessment process also consumes a significant amount of nursing time and dressing materials, which contributes to spiralling medical costs in wound care. In addition, current treatment methods do not use physical or chemical feedback to modify or adjust the treatment based on wound's condition, and hence have limited success. It has been proposed to embed sensors in dressings to enable clinicians and nurses to make effective diagnostic and therapeutic wound management decisions without changing wound dressings; therefore improving patient comfort. Existing sensors, however, do not satisfy the operational (e.g. sensitivity, specificity) and physical (e.g. flexibility) characteristics required for embedding them in dressings. This project will develop a sensor system to overcome these limitations. The proposed sensor system will consist of a small laser that will emit light of different colour based on the concentration of a biomarker of interest in the fluid interface at the wound surface. The change in the colour of emitted light will be measured by waving a mobile device (e.g. phone, tablet) over the dressing containing the sensor system. The captured data will be transmitted to healthcare professionals, processed, stored to keep a record of wound history, and used for diagnostics and therapeutics. The proposed project will benefit patients by effective diagnostics and treatment of chronic wounds. The information on wound condition will permit timely identification of hard to heal wounds and will also be used to create a feedback loop for fully optimised treatments tailored to individual patients. For example, the rate of release of anti-inflammatory drugs will be tailored based on wound condition. This is critical in terms of chronic wound management, where it has been shown that the longer the delay in administering appropriate treatment, the more difficult a wound is to heal.

Chronic wounds are those that fail to heal in an orderly and timely (typically three months) manner. Examples of chronic wounds include diabetic foot ulcers, pressure ulcers and venous leg ulcers. The incidence of chronic wounds is increasing as a result of lifestyle changes and the ageing population. For example, ~552 million people worldwide are estimated to have diabetes mellitus in 2030. Up to an estimated 25% of these patients will develop diabetic foot ulcers in their lifetime; half of these ulcers will be infected and 20% will undergo amputation of their lower limb. The annual economic impact of chronic wounds, which includes nursing time and dressing materials, on the global economy is estimated to be ~£20 billion by 2030. A common practise in wound management is to cover wounds with suitable dressings to facilitate the healing process. Standard dressings, however, do not provide insights into the status of the wound underneath. Thus, dressings are often changed to examine and assess the wound. This in turn hampers the process of normal wound healing and cause stress and pain to patients. The assessment process also consumes a significant amount of nursing time and dressing materials, which contributes to spiralling medical costs in wound care. In addition, current treatment methods do not use physical or chemical feedback to modify or adjust the treatment based on wound's condition, and hence have limited success. It has been proposed to embed sensors in dressings to enable clinicians and nurses to make effective diagnostic and therapeutic wound management decisions without changing wound dressings; therefore improving patient comfort. Existing sensors, however, do not satisfy the operational (e.g. sensitivity, specificity) and physical (e.g. flexibility) characteristics required for embedding them in dressings. This project will develop a sensor system to overcome these limitations. The proposed sensor system will consist of a small laser that will emit light of different colour based on the concentration of a biomarker of interest in the fluid interface at the wound surface. The change in the colour of emitted light will be measured by waving a mobile device (e.g. phone, tablet) over the dressing containing the sensor system. The captured data will be transmitted to healthcare professionals, processed, stored to keep a record of wound history, and used for diagnostics and therapeutics. The proposed project will benefit patients by effective diagnostics and treatment of chronic wounds. The information on wound condition will permit timely identification of hard to heal wounds and will also be used to create a feedback loop for fully optimised treatments tailored to individual patients. For example, the rate of release of anti-inflammatory drugs will be tailored based on wound condition. This is critical in terms of chronic wound management, where it has been shown that the longer the delay in administering appropriate treatment, the more difficult a wound is to heal.