The TexiSense "Smart Sock" - a device for a daily prevention of pressure ulcers in the diabetic foot
Résumé
Goals.– The term « diabetic foot » refers to a set of foot pathologies essentially stemming from the neuropathy and arteriopathy of the lower limb associated with diabetes mellitus. Chronic ischemia weakens the healing potential and favors the development of wounds on a more vulnerable foot. Friction or repeated micro-traumas can lead to an ulceration (which in turn can end up in an amputation) that will remain unnoticed because of the somato-sensory deficiency. The current prevention techniques largely relying on visual inspection of the foot and enhancement of the foot/insole interface are not fully satisfying as the prevalence of plantar ulcers remains very high.
Patients and methods.– A device for the prevention of plantar ulcers–called “Smart Sock” is described. It consists of:
– a sock made of a 100% textile pressure sensing fabric developed by the TexiSense company;
– a microcontroller running a biomechanical model of the soft tissues of the foot of the diabetic person;
– a vibrating watch (and eventually a smartphone) used to warn the bearer if a pressure pattern threatens the soft tissues integrity.
Results.– Internal overpressures within the soft tissues, especially nearby bony prominences are likely to develop into deep foot ulcerations. The biomechanical model gives an estimation of their magnitude based on the external pressures measured by the sock/sensor. This modeling relies on a faithful representation of the morphology of the diabetic subject. The device sends a vibro-tactile alert in case of occasional overpressure or excessive stress dose accumulated during daytime activities.
Discussion.– The continuous use of the device, compatible with daytime activities of the diabetic person, helps compensate for the lack of attention in the prevention of pressure ulcer formation. The TexiSense “Smart Sock” can be designed so that when worn, pressure sensors fall onto sensitive anatomical areas such as the dorsal side of the toes or the posterior side of the heel, which makes it also possible to monitor regions located outside the sole of the foot.
