The Penicillin of Pressure Injuries: Researchers Develop New Sensor System to Prevent a Common Hospital Complication

Newswise — Hospital stays can be long and arduous; they can also cause serious complications. When a person lies in one position too long and begins to sweat, painful sores called pressure injuries (PIs) can form on the body, leading to infection or even death. A patient can develop a PI in a few days — or even a few hours. And once present, a PI is hard to treat.

Previously known as pressure ulcers, PIs affect 2.5 million patients and result in 60,000 deaths a year, from veterans in wheelchairs to premature babies requiring life-support devices in the Neonatal Intensive Care Unit. Even physicians wearing respirator masks for hours can be prone to PIs.

Another complication of PIs is that no one knows exactly how long it takes for them to form. Currently, the only way medical staff can prevent PIs is by manually turning bedridden or critically ill patients every few hours.

One missed turn can lead to more medical complications. The U.S. spends nearly $27 billion annually on PI medical care. Given the country’s ongoing nursing shortage, a more automated PI monitoring method needs to be implemented. This could ensure that patients leave the hospital better than when they arrived.

To address this issue, researchers at Georgia Tech have developed a new, flexible, sensor-filled fabric to monitor areas at risk of PIs and alert hospital staff when a patient needs to be turned.

“I call this technology a paradigm shift,” said Sundaresan Jayaraman, a professor in the School of Materials Science and Engineering (MSE). “We’re using a fabric that acts like a bedsheet under the patient. It collects pressure and moisture data unobtrusively — whether you’re lying in bed or sitting in a wheelchair. From this, we can predict when a PI is likely to occur and, more importantly, understand how long it takes to form.”

This technology is currently being piloted on four cribs in the Children’s Healthcare of Atlanta Arthur M. Blank Hospital Pediatric Intensive Care Unit (PICU), with the eventual goal of deploying it in 50 beds. The researchers hope their device becomes universal across healthcare systems, making PIs a thing of the past.

“I call this technology a paradigm shift. We’re using a fabric that acts like a bedsheet under the patient. It collects pressure and moisture data unobtrusively — whether you’re lying in bed or sitting in a wheelchair. From this, we can predict when a PI is likely to occur and, more importantly, understand how long it takes to form.” —Sundaresan Jayaraman

Sensor Scope

Jayaraman and collaborator Sungmee Park, a principal research scientist in MSE, have been working on this project since 2017, which culminated in the successful proof-of-concept testing of the first version at Children’s in 2019. Their next breakthrough managed PIs for individuals in wheelchairs with spinal cord injuries, such as veterans. The researchers collaborated with doctors at Children’s to deploy the enhanced system in a clinical setting to help PICU patients. The research for this priority issue is funded by the Pediatric Technology Center (PTC) – a joint partnership between Children’s Healthcare of Atlanta and Georgia Tech, including funds from the Imlay Foundation’s Imlay Innovation Fund.

“In the PICU, we have many kids who are critically ill or injured, sedated, lying in bed with lots of devices on them, and all these things lead to a higher incidence of PI,” said Jana Stockwell, M.D., a pediatric critical care physician at Children’s. Stockwell collaborates with the researchers.

“PI occurs in about 10% of kids in PICUs, and it’s even higher in the neonatal intensive care units,” she explained. “Even something as minor as a folded sheet or misplaced IV tubing can lead to a pressure injury in a child.”

Creating a flexible, washable sensor was a challenge. But making sure it wasn’t intrusive —especially for tiny, medically fragile, premature babies — was even harder.

“We needed to make sure all the sensor data was streaming correctly and integrated into the bed, so the sensors don’t disturb either the physicians’ treatment or the baby’s movement,” Park said.

While earlier prototypes had dozens of connecting cables that increased how long it took to deploy the system on the crib, the current device uses just one cable. This simplicity makes the sensor fabric easier for medical staff to implement and feels more natural for the patient and less like a “device” for family members and caregivers.

“The idea that these sensors even exist, let alone be in fabric that isn’t as hard as a board under a patient, is pretty incredible,” Stockwell said.

“In the PICU, we have many kids who are critically ill or injured, sedated, lying in bed with lots of devices on them, and all these things lead to a higher incidence of PI. Even something as minor as a folded sheet or misplaced IV tubing can lead to a pressure injury in a child.” –Jana Stockwell 

Machine Learning Medicine

Machine learning is key to the device’s next evolution. Researchers are using predictive analytics to study data patterns and automate care recommendations.

“The beauty of this system is that it adapts to the patient’s weight and condition,” Jayaraman said. “We are monitoring how long the pressure has not changed and how much moisture is there, so we can customize the response to it.”

Healthcare workers will be able to use an app connected to the device that will tell them when to move a patient. In the future, this data will also be automatically integrated into electronic medical records, turning a once laborious manual treatment into something efficient and digitized.

Marketing a Medical Marvel

The researchers are collaborating with Children’s to test and enhance the technology to create the right product. They’re also working with Georgia Tech’s Georgia Manufacturing Extension Partnership to understand the regulatory requirements. Widespread adoption of this sensor fabric could be game-changing for hospitals.

“Penicillin revolutionized how we treat infections, and we want our technology to be similarly revolutionary. Just like penicillin made certain infections obsolete, we hope our sensors can make PIs a preventable relic of the past,” Jayaraman said. “That’s why we believe commercialization is very, very critical.”

If successful, this sensor could transform patient care — and actually make pressure injuries a preventable relic of the past.