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Leonard Tender, Ph.D., a researcher in the Biological Technologies Office (BTO) at DARPA (the Defense Advanced Research Projects Agency), is working on groundbreaking advancements in wound care technology. Building on the success of the Bioelectronics for Tissue Regeneration (BETR) program, which focused on developing a “smart bandage” to monitor and accelerate wound healing, BTO is now embarking on a new initiative.
The Bioelectronics to Sense and Treat (BEST) program aims to create a closed-loop system that not only monitors wound healing in real-time but also actively treats infections. This advanced bandage will incorporate sensors to detect the presence of harmful microbes and analyze the host’s immune response, tailoring treatment accordingly.
The individualized approach is crucial, as immune responses can vary significantly depending on factors like stress, pre-existing conditions, and the battlefield environment. The program’s three-year timeline includes independent development of monitoring and treatment capabilities, culminating in the integration of a closed-loop control system.
More recently in Tender’s career, he started looking at organisms that are involved in infection, pathogenic organisms, in particular wound infection. “I wanted to really understand how those organisms can live in a wound,” he says.
Working with “some really great collaborators, in particular Professor Diane Newman from Caltech,” he says, who is an expert in these type of organisms, “We figured out how the organisms are essentially breathing, how they’re getting rid of their respired electrons. And we started wondering, well, would that have implications for wound infections, [and can] we start to sort of disrupt that process?”
“Even when we can get the injured warfighters off the battlefield into high level care within an hour, we are experiencing something like 27 percent of those people are experiencing debilitating wound infections.” The standard of care at present when a warfighter is injured on the battlefield, a high does of antibiotics is administered right away.
“There’s two problems with that,” Tender says. “The first is that we’re kind of running out of time on the antibiotics. At some point, a lot of them are just not going to be useful. Secondarily, there’s a lot of good organisms that are, if not benign, actually beneficial to the wound healing process.”
BETR takes aim at these wounds with the intent to create what is essentially a smart bandage, and asks a fundamental question: Can we monitor a wound, the healing process in real time, and then interfere with or reprogram the natural healing process to either have the wound heal faster for a simple wound or for more complicated wound have it heal better? “Say, someone has had a pretty invasive surgery, and you have a big incision on your chest,” he says. “Imagine if you could apply a [smart] bandage. It’s going to make it close off a lot faster. That would have tremendous payoffs in terms of just getting people out of the hospital a lot faster, recovering a lot faster.
“For more complicated wounds, for example, one of the wounds that soldiers, warfighters experience, is what we call volumetric muscle loss. … We have evolved naturally for those wounds to scar over. And scarring is sort of a way of sealing the wound to minimize infection.
“Imagine if you can reprogram that wound with a bandage or a dressing that is super smart so that it reprograms it not to scar, but to actually allow for functional tissue to regenerate and to replace the muscle. We actually have performers who have done both, and it’s super exciting.”
SOURCE: Information for this article was taken from an interview conducted by Stacey Wierzba, DARPA Public Affairs, with Leonard Tender, program manager, Biological Technologies Office, DARPA, and published in April 2025.