慢性傷口是臨床醫療與長期照護中最具挑戰性的問題之一，特別是在高齡化社會與糖尿病人口持續增加的背景下，傷口癒合延遲與感染反覆發生，不僅嚴重影響病患的生活品質，也對醫療體系造成長期且沉重的負擔。傳統傷口照護多仰賴被動式敷料與定期換藥，臨床評估主要來自目視觀察與經驗判斷，對於傷口狀態的即時掌握與主動介入仍相當有限。

基於這樣的臨床需求，我們研究團隊近年來致力於開發一套可實際應用於傷口照護的整合式智慧系統。我們的核心思考並非單純增加感測器或治療模組，而是從系統層級出發，思考如何讓傷口在貼附狀態下，能夠被即時監測，並同步接受合適的治療介入，使整體照護流程更加連續且有效。

在這套系統中，我們首先建立了可即時反映傷口狀態的感測模組，用以連續監測與癒合進程高度相關的訊號，例如傷口阻抗與組織恢復趨勢。透過動物模型與長時間觀察，我們發現這類訊號往往能在肉眼尚未察覺明顯變化之前，即呈現出癒合進展或異常的趨勢差異，為傷口評估提供更早期且客觀的依據。

然而，我們並未將感測視為最終目的。相反地，感測是啟動治療的基礎。因此，我們進一步將電刺激治療模組整合至同一系統中，使系統能在感測的同時同步提供主動治療。根據我們的實驗觀察，適當且溫和的電刺激有助於促進細胞遷移、細胞增生與血管新生，這些皆為傷口癒合過程中的關鍵生理機制。透過這樣的整合設計，傷口照護不再只是被動等待癒合，而是能即時回應傷口需求。

在慢性傷口照護中，感染始終是影響癒合成效的關鍵因素之一。為此，我們在系統中進一步整合新穎的熱電觸媒抗菌機制。透過溫差的驅動，熱電觸媒可在傷口局部產生可控的微量過氧化氫，以有效抑制細菌生長。這種非藥物型的抗菌策略，為慢性與高風險傷口提供了新的感染控制途徑，同時也有助於降低長期使用抗生素可能帶來的抗藥性問題。

為了讓感測、電刺激與抗菌模組能在實際應用中長時間穩定運作，我們的系統採用了自驅動（self-powered）架構。透過利用人體日常活動所產生的機械能，或體溫所形成的熱能，系統可在無需外接電源的情況下持續運作。對我們而言，自驅動並非技術炫示，而是讓整合式系統真正具備可攜性與長期運作能力的關鍵設計，特別適合應用於醫療資源相對不足的地區。

整體而言，這套由我們研究團隊所開發的整合式智慧傷口照護系統，將即時感測、主動電刺激治療與熱電觸媒抗菌功能結合於同一平台中，使傷口照護得以從被動監測，邁向可即時回應與主動介入的系統化策略。我們相信，這樣的系統整合思維，能為慢性傷口管理與未來智慧醫療提供一條具體且可行的新方向。

（114年TBF吳火獅醫學獎、台大醫工系　林宗宏教授）

A New Paradigm in Smart Wound Care: Real-Time Sensing and Active Healing Enabled by a Self-Powered System

Chronic wounds represent one of the most persistent challenges in clinical medicine and long-term care. With the rapid growth of aging populations and the increasing prevalence of diabetes, delayed wound healing and recurrent infections have become major factors compromising patients’ quality of life and placing a long-term burden on healthcare systems. Conventional wound care still relies largely on passive dressings and periodic replacement, with clinical assessment based primarily on visual inspection and accumulated experience. Such approaches offer limited capability for real-time monitoring and provide few opportunities for proactive intervention.

Motivated by these unmet clinical needs, our research team has focused on developing an integrated smart wound care system that is designed for practical and sustained use. Rather than simply adding more sensors or therapeutic modules, our approach starts from a system-level perspective. We aim to enable wounds to be continuously monitored while simultaneously receiving appropriate therapeutic intervention, all within a single integrated platform that supports a more continuous and effective care process.

Within this system, we first established a sensing module capable of real-time monitoring of wound-related signals that are closely associated with healing progression, such as electrical impedance and indicators of tissue recovery. Through animal studies and long-term observations, we found that these signals often reveal differences in healing trajectories or early signs of abnormality before visible changes can be detected by the naked eye. Such early and objective information provides valuable support for wound assessment and clinical decision-making.

Importantly, in our design philosophy, sensing is not treated as an endpoint. Instead, it serves as the foundation for initiating active treatment. Accordingly, we integrated an electrical stimulation module into the same system, allowing therapeutic intervention to be delivered concurrently with sensing. Based on our experimental observations, appropriately controlled and mild electrical stimulation promotes key biological processes involved in wound repair, including cell migration, cell proliferation, and angiogenesis. With this integration, wound care is no longer limited to passive observation, but becomes an active process capable of responding to wound conditions in real time.

Infection remains one of the most critical barriers to successful healing in chronic wounds. To address this challenge, our system further incorporates a novel thermocatalyst antibacterial mechanism. Driven by temperature gradients, the thermocatalyst generates controllable, low levels of hydrogen peroxide locally at the wound site, effectively suppressing bacterial growth. This non-pharmaceutical antibacterial strategy provides an alternative pathway for infection control in chronic and high-risk wounds, while also reducing the potential risks associated with long-term antibiotic use and antimicrobial resistance.

To ensure that the sensing, electrical stimulation, and antibacterial modules can operate reliably over extended periods, we adopted a self-powered system architecture. By harvesting mechanical energy generated from daily human motion, as well as thermal energy derived from body heat, the system is capable of continuous operation without external power sources. For our team, self-powered operation is not a demonstration of technical novelty, but a key design requirement that enables true portability and long-term usability of the integrated system, particularly in settings where access to medical infrastructure is limited.

Overall, the integrated smart wound care system developed by our research team combines real-time sensing, active electrical stimulation, and thermoelectric catalytic antibacterial functionality within a single platform. This system-level integration allows wound care to transition from passive monitoring toward an approach characterized by timely response and proactive intervention. We believe that such an integrated design philosophy offers a practical and achievable pathway for improving chronic wound management and advancing the future of smart and accessible healthcare. 

(2025 TBF Wo Ho-Su Medical Award, Professor Zong-Hong Lin)