Mayer, Dieter

ABSTRACT The integration of Internet of Things devices in medicine has paved the way for novel diagnostic and therapeutic solutions that offer ‘smart’ capabilities, especially for at‐home wound monitoring. Such capabilities include increasing portability, diminished gaps in care through continuous analysis, and real‐time programmable manipulation of device parameters to intervene more rapidly. This scoping review explores the landscape of Internet of Things devices, including smart bandages, wearable and skin‐interfaced sensors, and mobile app‐connected devices, specifically designed for chronic wound monitoring in a remote, at‐home setting. We reviewed literature from PubMed, IEEE Xplore, Scopus, and Web of Science, using keywords related to Internet of Things and chronic wound care. The evaluation criteria focused on biomarkers analysed, Internet of Things connectivity technology, experimental models used for device validation, and unique device strengths or weaknesses. Our review identified 52 unique studies comprising 77 data entries across five biomarker categories: gas and oxygen saturation, pH, metabolic markers, biophysical parameters of the wound microenvironment, and molecular markers of inflammation or infection. These devices span a wide landscape of biomarkers analysed to predict and monitor wound recovery, with the potential to improve patient outcomes through personalised treatment and timely interventions. However, many devices were never validated clinically on humans and faced limitations in power delivery, accuracy, stability, and reliability that challenge their potential usability in humans for wound monitoring. This review provides a comprehensive understanding of the potential and limitations of Internet of Things devices in at‐home wound care, highlighting areas for future research and development.

In 2024, the Journal of Wound Care ( JWC ) published best-practice guidance on wound debridement. This introduced the concept of integral debridement, defined as the combined use of complementary debridement methods on the same wound to optimise healing outcomes. This typically involves combining less invasive approaches, such as autolytic debridement, with more active adjunctive methods, including mechanical and/or sharp debridement. In 2026, JWC convened an expert panel to explore how this concept can be effectively implemented in non-specialist settings. The panel concluded that debridement is most effective when applied repeatedly throughout the healing process and introduced the concept of continuous integral debridement (CID), a cyclical four-step approach comprising cleanse, debride, cleanse and dress (CDCD). The panel propose that, when performed regularly, this will help disrupt microbial and non-microbial barriers to healing and maintain a clean wound environment. The panel consider that CID is compatible with established frameworks, such as TIME/TIMERS and the International Wound Infection Institute wound infection continuum, and complements antibiofilm strategies, including Wound Hygiene. This document provides practical guidance for integrating CID into routine wound care across all clinical settings, including recommendations on cleansing solutions, debridement methods and dressing selection, with the aim of supporting evidence-based practice and improving patient outcomes.