Fluorinated Methacrylamide Chitosan Hydrogel Dressings Improve Regenerated Wound Tissue Quality in Diabetic Wound Healing.

Objective: Oxygen therapy has shown promising results for treating diabetic wounds. However, clinically used oxygen therapies are cumbersome and expensive. Thus, there is a need to develop a localized oxygenating treatment that is easy to use and inexpensive. Approach: In this study, we tested a previously developed hydrogel sheet wound dressing based on fluorinated methacrylamide chitosan (MACF) for enhanced oxygenation and compared it with a commercial sheet hydrogel dressing, AquaDerm™, and no treatment controls in a splinted transgenic diabetic mouse wound model. Results: AquaDerm exhibited poor wound closure response compared with the MACF oxygenating hydrogel sheet dressing (MACF+O2) and no treatment. Histological analysis revealed enhanced collagen synthesis and neovascularization upon MACF+O2 treatment as indicated by higher collagen content and number of blood vessels/capillaries compared with AquaDerm and no treatment. MACF+O2 also improved wound collagen fiber alignment, thus demonstrating improved skin tissue maturation. Nuclear magnetic resonance spectroscopy-based biodistribution analysis revealed that the degradation products of the MACF-based dressing did not accumulate in lung, liver, and kidney tissues of the treated animals after 14 days of treatment. Innovation: This study presents the first application of a unique oxygenating biomaterial (MACF) made into a moist hydrogel wound dressing for treating diabetic wounds. Conclusion: The results of this study confirm the benefits of this novel biomaterial approach for improving regenerated tissue structure in diabetic wound healing.

Regulation of FES-induced grasp force based on cutaneous nerve signals: experiments and modelling.

We investigated the control of electrically induced hand grasp by natural sensors located in the skin of the index finger. A tetraplegic volunteer was implanted with an eight-channel muscle stimulator, providing hand grasp, and a nerve signal recording cuff electrode placed on a branch of the palmar digital nerve deriving from the median nerve and innervating the radial aspect of the index finger. The recorded nerve signal contained information that could be used to detect slips and further to increase the stimulation intensity to stop a slip. A mathematical model of the experiments was employed to understand the behaviour of the hand grasp system, to extrapolate data obtained in experiments, to test parameter influence on the length of a slip, and to refine the control algorithm. The model considered the mechanical conditions causing a slip, the major properties of the musculo-skeletal system of the hand in lateral grasp, and the relation between the processed nerve signal and the slip velocity. The objective of this study was to investigate the control algorithm in both experiment and simulation. We tested reactions on a slip with different fixed increases in stimulator command and an algorithm with adaptive increase in stimulator command based on the amplitude of the processed nerve signal. Further, the application of a number of maximum stimulator commands with double the instantaneous stimulation frequency as an initial reaction to a slip was investigated. We tested three different surfaces of the held object, representing different frictional conditions of the skin-object contact. A discussion of the slip-based controller concludes the paper.

Functional evaluation of natural sensory feedback incorporated in a hand grasp neuroprosthesis.

We investigated whether automatic control of a hand grasp neuroprosthesis by means of signals from natural sensors in the skin of the index finger can mimic the natural control of grasp force in an important task of daily living, namely eating. We designed a simulated eating task with the same ratio of rest and activity as was found on average in a video analysis of three meals consumed in a social environment. An instrumented fork measured grasp force as well as the force in the long axis and perpendicular to the long axis at the tip of the fork. The simulated eating task was performed by a tetraplegic volunteer using a hand grasp neuroprosthesis both with and without use of feedback from the natural sensors. Further, 10 able-bodied volunteers performed the task with the same (lateral) grasp as the tetraplegic volunteer to obtain measures for improving the control strategy of the hand grasp neuroprosthesis. We have shown that a hand grasp neuroprosthesis incorporating natural sensory feedback can to some extent mimic the natural application of grasp force on a fork during simulated eating. The mean grasp force during active phases was higher than the mean grasp force during inactive phases. The mean grasp force applied during a simulated eating task was reduced by using the system with sensory feedback compared to using the system without sensory feedback.

Implementation of natural sensory feedback in a portable control system for a hand grasp neuroprosthesis.

This paper presents the design and implementation of the first generation of a portable system for a hand grasp neuroprosthesis that is controlled by means of signals from natural sensors in the skin of the index finger. To reduce development time and costs, we based our design on readily available, standardised modules such as a 486DX100 compatible CPU, a data acquisition board, a flash disk storage unit, and a high-efficiency DC/DC switch-mode power supply. Additionally, we designed and built a telemeter to supply an implanted muscle stimulator with power and control data. The signal from the natural sensors was recorded with a cuff electrode implanted around the palmar digital nerve innervating the radial aspect of the index finger. For amplification of the recorded nerve signal, we added an external low-noise nerve signal amplifier. For pre-processing of the recorded nerve signal, an optimised band-pass filter was used. A data-recording unit allowed storage and off-line analysis of the stimulator command and the recorded nerve signal. The portable system was used by a tetraplegic volunteer to test the feasibility of including natural sensors in a hand grasp neuroprosthesis for activities of daily living. The flexibility of the presented system allows rapid prototyping of experimental FES hand grasp systems intended for portable use.

Biopotentials as command and feedback signals in functional electrical stimulation systems.

Today Functional Electrical Stimulation (FES) is available as a clinical tool in muscle activation used for picking up objects, for standing and walking, for controlling bladder emptying, and for breathing. Despite substantial progress in development and new knowledge, many challenges remain to be resolved to provide a more efficient functionality of FES systems. The most important task of these challenges is to improve control of the activated muscles through open loop or feedback systems. Command and feedback signals can be extracted from biopotentials recorded from muscles (Electromyogram, EMG), nerves (Electroneurogram, ENG), and the brain (Electroencephalogram (EEG) or individual cells). This paper reviews work in which EMG, ENG, and EEG signals in humans have been used as command and feedback signals in systems using electrical stimulation of motor nerves to restore movements after an injury to the Central Nervous System (CNS). It is concluded that the technology is ready to push for more substantial clinical FES investigations in applying muscle and nerve signals. Brain-computer interface systems hold great prospects, but require further development of faster and clinically more acceptable technologies.