IEEE Systems, Man and Cybernetics Magazine - July 2020 - 41

anastomoses may herald SSI or tissue failure and
becomes apparent from five to 12 days following surgery
prompt further investigation and corrective clinical
[7], potentially leading to SSIs.
action [12], [14].
Roughly 5-10% of surgical patients develop SSIs, with
Clinicians routinely use many passive medical devices
77% of surgical mortality directly related to the condition.
and instruments that provide simple functions and enable
This costs the U.K. National Health Service approximately
access to the human body and various biosamples. Intro£1 billion [8] and the European Union up to €19.1 billion [9]
ducing sensing intelligence to
each year. Urinary-tract infections
these systems without altering
(UTIs) acquired in the United States
their deployment and basic funccost approximately US$390-450
tionality is a means of introducing
million annually, and catheter-assoObjective and
such dev ices to hea lth ca re.
ciated UTIs incur estimated mean
continuous monitoring
Examples include central venous
direct costs of US$589 each [10].
and implantable port catheters,
Similarly, in Australia, hospitalof surgical wounds
urine bags and catheters [17], and
acquired UTIs result in a four-day
through sensing
surgical drains and tools that can
increase in the expected length of
be sensorized to evaluate, in real
stay [11]. Tissue oxygenation and
technologies is
time, impor tant perioperative
vascularity are critical for healing
prudent and likely to
complications, such as infection
in CA L a nd FTT cases; thus,
be cost-effective.
and sepsis [18], increasing the
detecting ischemia is essential [12].
speed and rate of diagnosis and
Postoperative detection of ischof fer i ng va luable prog nost ic
emia and infection can be achieved
by direct (e.g., specific pathogens)
insight to in--form treatment pathor indirect markers [e.g., acidity (pH), interleukins, and
ways. These can significantly impact patient monitoring
C-reactive proteins for inflammation; pyocyanin, urate,
within hospitals and during surgery.
and uric acid; and bacteria-produced toxins and neutroSensing technologies can assist in identifying mediumphil-produced enzymes due to infection] [13]. For examand high-risk patients, monitoring behavioral changes and
ple, combining tissue measurements of ions, lactate,
facilitating long-term remote monitoring postoperatively
bioimpedance [12], [14], and oxygen saturation (StO 2) via
and during rehabilitation. Integrating sensing for early and
long-term monitoring as part of the surgical process could
near-infrared spectroscopy (NIRS) [15] may indicate tisbe a means of addressing the issues discussed previously.
sue ischemia.
For example, as illustrated in Figure 1, miniaturized wearA clinical gap exists between effective systems for
able ECG and pulse-oximetry sensors can be used across
long-term postoperative patient screening and the diagthe perioperative pathway to monitor the heart, and thonosis of subclinical SSIs [16]. There is a need to improve
racic bioimpedance imaging can track pulmonary functhe quality of care at the early postoperative stage for
tion. Microelectromechanical systems (MEMS)-based
patients with complex needs [6]. Objective and continusensors have the ability to pre- [19] and postoperatively
ous monitoring of surgical wounds through sensing tech[20] observe patient activity, rehabilitation, and lifestyle
nologies is prudent and likely to be cost-effective, since
early recognition of postdischarge SSIs may enable early
changes; NIRS and -bioimpedance and chemical sensors
intervention and therefore decrease morbidity, readmiscan peri- and postoperatively monitor tissue ischemia in
sion rates, and expenses.
the vicinity of surgical sites. Raman probes may check for
tissue infection; (bio)chemical sensors can observe important biomarkers at the point-of-care for SSIs and for generSensing to Improve Surgical Care
al homeostasis monitoring. It is clear that for idiosyncratic
Sensors that have already been used for near-real-time
applications with various needs and challenges, different
continuous blood-pressure and cardiac monitoring
embodiments are required (see Figure 2). The following
may enable ulterior processing in portable devices and
sections present key technological approaches for the realaction by the clinical team. Smart sensors that are
ization of such devices.
implanted within radiological fiducial markers in cancer patients and capable of monitoring at a cellular
Sensing Technology
level and/or continually detecting cellular proliferation
proteins may, in the future, provide a more accurate
assessment of the chemotherapeutic response, upon
Electrical and Physical Sensors
which clinicians could determine whether to switch
Temperature is one of the most important health markers
treatment regimens or expedite surgery. Technologies
and can be sensed via resistive films, silicon diodes, and
for surgical-wound monitoring include "local" sensing
bipolar transistors [2]. Temperature may be correlated with
in the wound or immediately surrounding skin areas.
physiological stress and infections across the perioperaSensors built into d ressings or in the v icin it y of
tive-care pathway, particularly in the vicinity of postoperative
	

Ju ly 2020

IEEE SYSTEMS, MAN, & CYBERNETICS MAGAZINE	

41



IEEE Systems, Man and Cybernetics Magazine - July 2020

Table of Contents for the Digital Edition of IEEE Systems, Man and Cybernetics Magazine - July 2020

Contents
IEEE Systems, Man and Cybernetics Magazine - July 2020 - Cover1
IEEE Systems, Man and Cybernetics Magazine - July 2020 - Cover2
IEEE Systems, Man and Cybernetics Magazine - July 2020 - Contents
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 2
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 3
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 4
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 5
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 6
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 7
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 8
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 9
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 10
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 11
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 12
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 13
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 14
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 15
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 16
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 17
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 18
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 19
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 20
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 21
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 22
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 23
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 24
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 25
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 26
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 27
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 28
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 29
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 30
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 31
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 32
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 33
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 34
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 35
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 36
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 37
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 38
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 39
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 40
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 41
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 42
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 43
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 44
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 45
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 46
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 47
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 48
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 49
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 50
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 51
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 52
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 53
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 54
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 55
IEEE Systems, Man and Cybernetics Magazine - July 2020 - 56
IEEE Systems, Man and Cybernetics Magazine - July 2020 - Cover3
IEEE Systems, Man and Cybernetics Magazine - July 2020 - Cover4
https://www.nxtbook.com/nxtbooks/ieee/smc_202110
https://www.nxtbook.com/nxtbooks/ieee/smc_202107
https://www.nxtbook.com/nxtbooks/ieee/smc_202104
https://www.nxtbook.com/nxtbooks/ieee/smc_202101
https://www.nxtbook.com/nxtbooks/ieee/smc_202010
https://www.nxtbook.com/nxtbooks/ieee/smc_202007
https://www.nxtbook.com/nxtbooks/ieee/smc_202004
https://www.nxtbook.com/nxtbooks/ieee/smc_202001
https://www.nxtbook.com/nxtbooks/ieee/smc_201910
https://www.nxtbook.com/nxtbooks/ieee/smc_201907
https://www.nxtbook.com/nxtbooks/ieee/smc_201904
https://www.nxtbook.com/nxtbooks/ieee/smc_201901
https://www.nxtbook.com/nxtbooks/ieee/smc_201810
https://www.nxtbook.com/nxtbooks/ieee/smc_201807
https://www.nxtbook.com/nxtbooks/ieee/smc_201804
https://www.nxtbook.com/nxtbooks/ieee/smc_201801
https://www.nxtbook.com/nxtbooks/ieee/systems_man_cybernetics_1017
https://www.nxtbook.com/nxtbooks/ieee/systems_man_cybernetics_0717
https://www.nxtbook.com/nxtbooks/ieee/systems_man_cybernetics_0417
https://www.nxtbook.com/nxtbooks/ieee/systems_man_cybernetics_0117
https://www.nxtbook.com/nxtbooks/ieee/systems_man_cybernetics_1016
https://www.nxtbook.com/nxtbooks/ieee/systems_man_cybernetics_0716
https://www.nxtbook.com/nxtbooks/ieee/systems_man_cybernetics_0416
https://www.nxtbook.com/nxtbooks/ieee/systems_man_cybernetics_0116
https://www.nxtbook.com/nxtbooks/ieee/systems_man_cybernetics_1015
https://www.nxtbook.com/nxtbooks/ieee/systems_man_cybernetics_0715
https://www.nxtbook.com/nxtbooks/ieee/systems_man_cybernetics_0415
https://www.nxtbook.com/nxtbooks/ieee/systems_man_cybernetics_0115
https://www.nxtbookmedia.com