慢性傷口一般被定義為超過4週而未能痊癒且處於發炎期的傷口，當患者本身身體狀態欠佳則有更大的可能會發生，不良的健康狀態容易造成癒合機制的延遲並成為微生物感染的溫床，基於現代社會慢性疾病(如糖尿病、高血壓等)、生活型態的改變(缺乏運動、久坐、高油飲食)，慢性傷口儼然成為一不可忽視的重要議題，而慢性傷口的特殊性又會導致患者疏於發現及及時就醫，故發展重點照護(point-of-care)傷口檢測試片將能有效提升醫療照護品質，而在過去慢性傷口檢測上沒有一個好的策略，無法有效的監視傷口癒合進程，或者需要較長的時間及繁瑣的實驗室設備及技術人員，使得患者無法及時獲得妥善的治療，往往就醫時傷口已惡化至一定程度。
　　故本研究著重於開發一款新式的慢性傷口檢測試片，具有便宜、快速、簡單使用等特點，我們選擇嗜中性白血球彈性蛋白酶(HNE)作為此試片的檢測生物標記，並基於傳統試片只能做到定性無法做到定量，因此試圖以試片的檢測變色率加以分析，開發試片用的色彩分析輔助系統，系統主體為以手機相機計算試片的RGB值，經過校正環境誤差後將RGB轉換成灰階值以統一量值，再將其灰階值轉換為相應的檢體HNE含量，以便於臨床診斷及居家照護上有更好的判斷依據。

Chronic wounds are generally defined as wounds that have not healed for more than 30 days and are in an inflammatory period. When the patient’s body condition is not good, it is more likely to occur. Poor health can easily cause delays in healing mechanisms and become a hotbed for microbial infections. Based on chronic diseases (such as diabetes, high blood pressure, etc.) and changes in lifestyles (lack of exercise, sedentary, high-fat diet) that are likely to cause chronic wounds in modern society, chronic wounds have become an important issue that cannot be ignored, and the particularity of chronic wounds will causing patients to neglect detection and timely medical treatment. Therefore, the development of point-of-care wound test strips will effectively improve the quality of medical care. In the past, there was no good strategy for chronic wound detection, which could not effectively monitor the progress of wound healing, or it would take a long time and require laboratory equipment and technical personnel to make it impossible for patients to obtain proper treatment in time, and often the wound has deteriorated to a certain extent when seeking medical treatment.
　　This study focuses on the development of a new type of chronic wound detection test strip, which is cheap, fast, and easy to use. We chose human neutrophil elastase (HNE) as the detection biomarker of this test strip, and because the traditional test strip can only be qualitative but not quantitative, so we try to analyze the color change rate of the test strip to quantify it and develop a color analysis auxiliary system for the test strip. The main function of the system is to calculate the RGB value of the test strip with the mobile phone camera. After correcting the environmental deviation, convert the RGB value into a grayscale value to unify the value. Then, the grayscale value is converted into the corresponding content of HNE in the specimen to provide a better basis for judgment in clinical diagnosis and home care.

摘要 I
Abstract II
目錄 IV
圖目錄 VIII
表目錄 X
第一章、緒論 1
　 1.1重點照護檢測 1
1.1.1重點照護檢測之材料 1
　　1.2慢性傷口定義 2
　　　1.2.1壓瘡(Pressure ulcer) 3
　　　1.2.2糖尿病足(diabetic foot) 3
　　　1.2.3動脈潰瘍(arterial ulcer) 4
　　　1.2.4靜脈潰瘍(venous ulcer) 4
1.3生物膜(biofilm) 6
　　 1.3.1生物膜定義 6
　　　1.3.2生物膜結構 6
　　　1.3.3慢性傷口生物膜感染及負面影響 8
　　1.4嗜中性白血球彈性蛋白酶 9
　　1.5酵素結合免疫吸附分析法 10
1.6色彩校正 12
1.6.1 RGB色彩模型 12
1.6.2 CMYK色彩模型 13
1.6.3 HSI色彩模型 13
　　1.7研究動機 15
第二章、實驗材料及方法 17
　　2.1實驗材料 17
　　2.2.1蛋白萃取檢體處理程序(舊) 19
2.2.2棉棒採集檢體處理程序(新) 19
　　2.3 PMN (Neutrophil) Elastase Human ELISA Kit 20
　　2.4試片製作 22
第三章、試片開發與檢測過程 24
　　3.1慢性傷口生物膜檢測試片 24
　　　3.1.1 生物膜染色程序 24
　　 3.1.2 染色結果及預後分析 25
　　3.2急性和慢性傷口HNE值含量及關係確立 27
　　　3.2.1舊檢體採集方式ELISA 27
　　　3.2.2新檢體採集方式ELISA 28
3.3試片之製造及功能性優化 29
3.3.1最佳濃度建立 29
3.3.2試片製作 32
第四章、手機輔助APP開發 35
　　4.1 搭配細菌檢測試片之APP開發 35
　　 4.1.1 MTT-PMS細菌檢測試片 36
　　 4.1.2 RGB變色率及細菌檢測試片濃度分析 37
　　 4.1.3色彩分析及濃度換算APP 39
4.1.4 成果 42
4.2 搭配HNE試片之APP建構及使用 43
第五章、結論與未來展望 48
第六章、參考文獻 50

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