Review: Assessing Stress During Wound Care in Real-Time Using Wearable Sensors
Introduction: The Stress Response in Wound Care in Diabetic Foot Ulcers
Within the last decade, the rise of diabetes in the U.S. population has been matched with a rise in diabetic foot ulcers requiring amputations. Because many of these diabetic foot ulcers develop secondary to poor wound healing and susceptibility to infection after surgery, some important risk factors have been evaluated. Stress, among other factors, has been shown not only to affect the psychological state of a patient, but also biologically to impair immunity and induce an inflammatory microenvironment within patients.
Although previous studies have measured stress by using heart rate and respiration rate during a dressing change lasting three to five minutes, no studies have continuously quantified stress in patients with diabetic foot ulcers during a routine visit. This particular study attempted to examine the stress response in patients with diabetic foot ulcers by using a chest-worn sensor displaying heart rate data. The research team relied on an algorithm to estimate stress that used changes in heart rate variability, a measurement that is taken between two consecutive R waves of an electrocardiogram.
Materials and Methods: Electrocardiographic Monitoring of Wound Dressing Changes in Diabetic Foot Ulcers
Twenty patients with diabetic foot ulcers were recruited from a wound care center and were given the BioHarness3, an FDA approved body device to evaluate single-channel electrocardiogram activity, respiration rate, posture, and core body temperature. To ensure quality control, the team used a smart phone to monitor data in a real-time fashion. This smart phone and BioHarness3 system had a biomodule that was linked to the patient’s body via a biopatch and electrocardiogram electrodes.
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