Intrinsically Nonswellable Multifunctional Hydrogel with Dynamic Nanoconfinement Networks for Robust Tissue-Adaptable Bioelectronics

Recent Progress of Soft and Bioactive Materials in Flexible Bioelectronics

Materials that establish functional, stable interfaces to targeted tissues for long-term monitoring/stimulation equipped with diagnostic/therapeutic capabilities represent breakthroughs in biomedical research and clinical medicine. A fundamental challenge is the mechanical and chemical mismatch between tissues and implants that ultimately results in device failure for corrosion by biofluids and associated foreign body response. Of particular interest is in the development of bioactive materials at the level of chemistry and mechanics for high-performance, minimally invasive function, simultaneously with tissue-like compliance and in vivo biocompatibility. This review summarizes the most recent progress for these purposes, with an emphasis on material properties such as foreign body response, on integration schemes with biological tissues, and on their use as bioelectronic platforms. The article begins with an overview of emerging classes of material platforms for bio-integration with proven utility in live animal models, as high performance and stable interfaces with different form factors. Subsequent sections review various classes of flexible, soft tissue-like materials, ranging from self-healing hydrogel/elastomer to bio-adhesive composites and to bioactive materials. Additional discussions highlight examples of active bioelectronic systems that support electrophysiological mapping, stimulation, and drug delivery as treatments of related diseases, at spatiotemporal resolutions that span from the cellular level to organ-scale dimension. Envisioned applications involve advanced implants for brain, cardiac, and other organ systems, with capabilities of bioactive materials that offer stability for human subjects and live animal models. Results will inspire continuing advancements in functions and benign interfaces to biological systems, thus yielding therapy and diagnostics for human healthcare.

Self-Maintainable Electronic Materials with Skin-Like Characteristics Enabled by Graphene-PEDOT:PSS Fillers

Conventional devices lack the adaptability and responsiveness inherent in the design of nature. Therefore, they cannot autonomously maintain themselves in natural environments. This limitation is primarily because of using rigid and fragile material components for their construction, which hinders their ability to adapt and evolve in changing environments. Moreover, they often cannot self-repair after injuries or significant damage. Even devices with self-healing, soft, and responsive properties often fail to seamlessly integrate all these attributes into a single, scalable, and cohesive platform. In this study, a significant breakthrough is introduced by utilizing graphene-poly(3,4-ethylenedioxythiophene): polystyrene sulfonate (graphene-PEDOT:PSS) fillers to transform a typically weak, insulating, and jelly-like material into a soft electronic material with properties akin to those of living organisms, such as skin tissue. The developed electronic materials exhibit a range of other capabilities attributed to the hierarchical organization originating from filler enhancement, which includes methods such as heat regulation, 3D printability, and multiplex sensing. The introduction of this new class of materials can facilitate the self-maintenance of life-like soft robots and bioelectronics that can be seamlessly integrated within dynamic environments, such as the human body, while demonstrating the ability to sense, respond, and adapt to challenging environments.

Multi-crosslinking nanoclay/oxidized cellulose hydrogel bandage with robust mechanical strength, antibacterial and adhesive properties for emergency hemostasis

Emergency bleeding presents significant challenges such as high blood flow and rapid hemorrhaging. However, many existing hemostatic bandages face limitations, including the uncontrolled release of hemostatic agents, insufficient mechanical strength, poor adhesion, and complex manufacturing processes. To address these limitations, we developed a multifunctional hydrogel bandage for emergency hemostasis using a one-pot synthesis method. The hydrogel was composed of kaolin, N-hydroxysuccinimide-grafted oxidized microcrystalline cellulose (OMCC-NHS), and polyacrylic acid (PAA). Featuring a multi-crosslinked network, it exhibited favorable elasticity (∼942 %), tensile strength (∼220 kPa), fatigue resistance, and robust tissue adhesion (∼55 kPa)-3.9 times stronger than commercial wound-closure strips, and it maintained adhesion even underwater. In addition to its mechanical properties, the hydrogel also exhibited satisfactory antibacterial activity, cytocompatibility, and histocompatibility. In vivo evaluations revealed an impressive hemostatic performance in rat models of liver bleeding, femoral artery bleeding, and tail amputation. Specifically, in the liver bleeding model, the hydrogel reduced blood loss to only 0.1 g, which is just 32 % of the blood loss seen with medical gauze. Notably, in New Zealand rabbit models with cardiac punctures and liver injuries, the hydrogel achieved rapid hemostasis and stopped the bleeding within seconds. The effective hemostatic ability of this hydrogel is primarily due to its ability to facilitate multistep hemostasis, which includes sealing the wound, rapidly absorbing blood, promoting RBC and platelets adhesion, and activating the intrinsic coagulation cascade. Therefore, this study provides a promising approach for developing gel-based hemostatic bandages, specifically tailored for emergency compressible bleeding scenarios.

Stiff and self-healing hydrogels by polymer entanglements in co-planar nanoconfinement

Many biological tissues are mechanically strong and stiff but can still heal from damage. By contrast, synthetic hydrogels have not shown comparable combinations of properties, as current stiffening approaches inevitably suppress the required chain/bond dynamics for self-healing. Here we show a stiff and self-healing hydrogel with a modulus of 50 MPa and tensile strength up to 4.2 MPa by polymer entanglements in co-planar nanoconfinement. This is realized by polymerizing a highly concentrated monomer solution within a scaffold of fully delaminated synthetic hectorite nanosheets, shear oriented into a macroscopic monodomain. The resultant physical gels show self-healing efficiency up to 100% despite the high modulus, and high adhesion shear strength on a broad range of substrates. This nanoconfinement approach allows the incorporation of novel functionalities by embedding colloidal materials such as MXenes and can be generalized to other polymers and solvents to fabricate stiff and self-healing gels for soft robotics, additive manufacturing and biomedical applications.

Robustly Repeatable, Permeable, and Multi-Axially Stretchable, Adhesive Bioelectronics With Super-adaptive Conductive Suction Cups for Continuously Deformable Biosurfaces

Skin-integrated wearable bioelectronics offer immense potential for continuous health monitoring, diagnosis, and personalized therapy. However, robustly repeatable and permeable adhesive interfaces with omnidirectional stretchability for adaptability to continuously deforming skin surface remain a critical challenge and often results in issues such as delamination, void, and signal degradation. This study presents a highly adaptable bioelectronic device with a repeatable, robust and biocompatible adhesive interfaces designed for dynamic wet skin surfaces. The device integrates a conductive softened-double-layered octopus-inspired nanocomposites adhesive and kirigami metastructure (cs-OIA_k). The cs-OIA_k achieves skin-like softness, electrical stability (ΔR/R0 < 10, under 10 000 cycles) and omnidirectional stretchability (a maximum of 200%) to accommodate skin deformation. Additionally, the hierarchical structural design of cs-OIA_k enables repeatable robust adhesion (> 10 000 cycles) and vertical alignment to ensure reversible adhesion against dynamically deforming surface (-30% to 100%, depending on skin thickness, site, and age) without skin irritation. Based on these characteristics, the highly adaptable skin-adhesive bioelectronics are demonstrated to achieve reliable electrocardiogram (ECG) and electromyogram (EMG) signal measurements even under shoulder movements with extreme skin deformation. This approach utilizing multi-axially stretchable, repeatable robust adhesives, permeable and biocompatible bioelectronics provides new insights for the development of advanced wearable systems and human-machine interfaces.

Stretchable Strain Sensors for Real-Time Bladder Volume Monitoring

Urinary incontinence (UI) is a prevalent condition that adversely affects quality of life, driving the need for innovative technologies for continuous bladder monitoring. In this study, we introduce a wrinkled metal (platinum and gold) strain sensor tailored for real-time bladder volume monitoring. This stretchable sensor is designed to provide robust and reliable performance for 5000 cycles with minimal hysteresis, and its mechanical properties match that of bladder tissue, enabling accurate monitoring during bladder filling and emptying. Our experimental results demonstrate that the sensor offers high sensitivity and stability, with a dynamic range of up to 230% strain, Young's modulus of 11.7-32 kPa, and a gauge factor (GF) of 2.9-4.7. The sensor's efficacy was validated through in vitro bladder phantom studies and ex vivo pig bladder experiments, where it consistently tracked bladder volume changes with a sensitivity of 4.60 mL-1. The results suggest that the strain sensor is a promising candidate for robust, biocompatible bladder volume monitoring in patients with urinary disorders, offering an alternative to traditional methods by being more comfortable and biocompatible.

Mechanical and Dimensional Stability of Gelatin-Based Hydrogels Through 3D Printing-Facilitated Confined Space Assembly

Hydrogels have emerged as promising biomaterials for tissue regeneration; yet, their inherent swelling can cause deformation and reduced mechanical properties, posing challenges for practical applications in biomedical engineering. Traditional methods to reduce hydrogel swelling often involve complex synthesis procedures with limited flexibility. Inspired by nature's efficient designs, we present here the approach to improve hydrogel performance using 3D printing-assisted microstructure engineering. By utilizing polymerization-induced phase separation of hydrogel from copolymerization of gelatin methacrylate and hydroxyethyl methacrylate (poly(GelMA-co-HEMA)) in the confined space during vat photopolymerization (VPP) 3D printing, we replicate the cuttlebone-like microstructure of hydrogels with enhanced mechanical properties and swelling resistance. We demonstrate here a 4-fold increase in elastic modulus compared to bulk polymerization of poly(GelMA-co-HEMA), together with improved mechanical and dimensional stability. This method offers promising opportunities for practical biomedical and tissue engineering applications, overcoming previous limitations in the design and performance.

Monomer Trapping Synthesis Toward Dynamic Nanoconfinement Self-healing Eutectogels for Strain Sensing

The rapid advancement in attractive platforms such as biomedicine and human-machine interaction has generated urgent demands for intelligent materials with high strength, flexibility, and self-healing capabilities. However, existing self-healing ability materials are challenged by a trade-off between high strength, low elastic modulus, and healing ability due to the inherent low strength of noncovalent bonding. Here, drawing inspiration from human fibroblasts, a monomer trapping synthesis strategy is presented based on the dissociation and reconfiguration in amphiphilic ionic restrictors (7000-times volume monomer trapping) to develop a eutectogel. Benefiting from the nanoconfinement and dynamic interfacial interactions, the molecular chain backbone of the formed confined domains is mechanically reinforced while preserving soft movement capabilities. The resulting eutectogels demonstrate superior mechanical properties (1799% and 2753% higher tensile strength and toughness than pure polymerized deep eutectic solvent), excellent self-healing efficiency (>90%), low tangential modulus (0.367 MPa during the working stage), and the ability to sensitively monitor human activities. This strategy is poised to offer a new perspective for developing high strength, low modulus, and self-healing wearable electronics tailored to human body motion.

Introductory Review of Soft Implantable Bioelectronics Using Conductive and Functional Hydrogels and Hydrogel Nanocomposites

Interfaces between implantable bioelectrodes and tissues provide critical insights into the biological and pathological conditions of targeted organs, aiding diagnosis and treatment. While conventional bioelectronics, made from rigid materials like metals and silicon, have been essential for recording signals and delivering electric stimulation, they face limitations due to the mechanical mismatch between rigid devices and soft tissues. Recently, focus has shifted toward soft conductive materials, such as conductive hydrogels and hydrogel nanocomposites, known for their tissue-like softness, biocompatibility, and potential for functionalization. This review introduces these materials and provides an overview of recent advances in soft hydrogel nanocomposites for implantable electronics. It covers material strategies for conductive hydrogels, including both intrinsically conductive hydrogels and hydrogel nanocomposites, and explores key functionalization techniques like biodegradation, bioadhesiveness, injectability, and self-healing. Practical applications of these materials in implantable electronics are also highlighted, showcasing their effectiveness in real-world scenarios. Finally, we discuss emerging technologies and future needs for chronically implantable bioelectronics, offering insights into the evolving landscape of this field.

Recent Advances of Stretchable Nanomaterial-Based Hydrogels for Wearable Sensors and Electrophysiological Signals Monitoring

Electrophysiological monitoring is a commonly used medical procedure designed to capture the electrical signals generated by the body and promptly identify any abnormal health conditions. Wearable sensors are of great significance in signal acquisition for electrophysiological monitoring. Traditional electrophysiological monitoring devices are often bulky and have many complex accessories and thus, are only suitable for limited application scenarios. Hydrogels optimized based on nanomaterials are lightweight with excellent stretchable and electrical properties, solving the problem of high-quality signal acquisition for wearable sensors. Therefore, the development of hydrogels based on nanomaterials brings tremendous potential for wearable physiological signal monitoring sensors. This review first introduces the latest advancement of hydrogels made from different nanomaterials, such as nanocarbon materials, nanometal materials, and two-dimensional transition metal compounds, in physiological signal monitoring sensors. Second, the versatile properties of these stretchable composite hydrogel sensors are reviewed. Then, their applications in various electrophysiological signal monitoring, such as electrocardiogram monitoring, electromyographic signal analysis, and electroencephalogram monitoring, are discussed. Finally, the current application status and future development prospects of nanomaterial-optimized hydrogels in wearable physiological signal monitoring sensors are summarized. We hope this review will inspire future development of wearable electrophysiological signal monitoring sensors using nanomaterial-based hydrogels.

Degradable and Recyclable Hydrogels for Sustainable Bioelectronics

Hydrogel bioelectronics has been widely used in wearable sensors, electronic skin, human-machine interfaces, and implantable tissue-electrode interfaces, providing great convenience for human health, safety, and education. The generation of electronic waste from bioelectronic devices jeopardizes human health and the natural environment. The development of degradable and recyclable hydrogels is recognized as a paradigm for realizing the next generation of environmentally friendly and sustainable bioelectronics. This review first summarizes the wide range of applications for bioelectronics, including wearable and implantable devices. Then, the employment of natural and synthetic polymers in hydrogel bioelectronics is discussed in terms of degradability and recyclability. Finally, this work provides constructive thoughts and perspectives on the current challenges toward hydrogel bioelectronics, providing valuable insights and guidance for the future evolution of sustainable hydrogel bioelectronics.

Modulus-tunable multifunctional hydrogel ink with nanofillers for 3D-Printed soft electronics

Seamless integration and conformal contact of soft electronics with tissue surfaces have emerged as major challenges in realizing accurate monitoring of biological signals. However, the mechanical mismatch between the electronics and biological tissues impedes the conformal interfacing between them. Attempts have been made to utilize soft hydrogels as the bioelectronic materials to realize tissue-comfortable bioelectronics. However, hydrogels have several limitations in terms of their electrical and mechanical properties. In this study, we present the development of a 3D-printable modulus-tunable hydrogel with multiple functionalities. The hydrogel has a cross-linked double network, which greatly improves its mechanical properties. Functional fillers such as XLG or functionalized carbon nanotubes (fCNT) can be incorporated into the hydrogel to provide tunable mechanics (Young's modulus of 10-300 kPa) and electrical conductivity (electrical conductivity of ∼20 S/m). The developed hydrogel exhibits stretchability (∼1000% strain), self-healing ability (within 5 min), toughness (400-731 kJ/m3) viscoelasticity, tissue conformability, and biocompatibility. Upon examining the rheological properties in the modulated region, hydrogels can be 3D printed to customize the shape and design of the bioelectronics. These hydrogels can be fabricated into ring-shaped strain sensors for wearable sensor applications.

In Situ-Sprayed Bioinspired Adhesive Conductive Hydrogels for Cavernous Nerve Repair

Cavernous nerve injury (CNI), resulting in erectile dysfunction (ED), poses a significant threat to the quality of life for men. Strategies utilizing conductive hydrogels have demonstrated promising results for the treatment of peripheral nerves with a large diameter (>2 mm). However, integrating convenient minimally invasive operation, antiswelling and immunomodulatory conductive hydrogels for treating small-diameter injured cavernous nerves remains a great challenge. Here, a sprayable adhesive conductive hydrogel (GACM) composed of gelatin, adenine, carbon nanotubes, and mesaconate designed for cavernous nerve repair is developed. Multiple hydrogen bonds provide GACM with excellent adhesive and antiswelling properties, enabling it to establish a conformal electrical bridge with the damaged nerve and aiding in the regeneration process. Additionally, mesaconate-loaded GACM suppresses the release of inflammatory factors by macrophages and promotes the migration and proliferation of Schwann cells. In vivo tests demonstrate that the GACM hydrogel repairs the cavernous nerve and restores erectile function and fertility. Furthermore, the feasibility of sprayable GACM in minimally invasive robotic surgery in beagles is validated. Given the benefits of therapeutic effectiveness and clinical convenience, the research suggests a promising future for sprayable GACM materials as advanced solutions for minimally invasive nerve repair.

3D Printing of Self-Healing Materials

This review article presents a comprehensive overview of the latest advances in the field of 3D printable structures with self-healing properties. Three-dimensional printing (3DP) is a versatile technology that enables the rapid manufacturing of complex geometric structures with precision and functionality not previously attainable. However, the application of 3DP technology is still limited by the availability of materials with customizable properties specifically designed for additive manufacturing. The addition of self-healing properties within 3D printed objects is of high interest as it can improve the performance and lifespan of structural components, and even enable the mimicking of living tissues for biomedical applications, such as organs printing. The review will discuss and analyze the most relevant results reported in recent years in the development of self-healing polymeric materials that can be processed via 3D printing. After introducing the chemical and physical self-healing mechanism that can be exploited, the literature review here reported will focus in particular on printability and repairing performances. At last, actual perspective and possible development field will be critically discussed.

Electrochemical and Electrical Biosensors for Wearable and Implantable Electronics Based on Conducting Polymers and Carbon-Based Materials

Bioelectronic devices are designed to translate biological information into electrical signals and vice versa, thereby bridging the gap between the living biological world and electronic systems. Among different types of bioelectronics devices, wearable and implantable biosensors are particularly important as they offer access to the physiological and biochemical activities of tissues and organs, which is significant in diagnosing and researching various medical conditions. Organic conducting and semiconducting materials, including conducting polymers (CPs) and graphene and carbon nanotubes (CNTs), are some of the most promising candidates for wearable and implantable biosensors. Their unique electrical, electrochemical, and mechanical properties bring new possibilities to bioelectronics that could not be realized by utilizing metals- or silicon-based analogues. The use of organic- and carbon-based conductors in the development of wearable and implantable biosensors has emerged as a rapidly growing research field, with remarkable progress being made in recent years. The use of such materials addresses the issue of mismatched properties between biological tissues and electronic devices, as well as the improvement in the accuracy and fidelity of the transferred information. In this review, we highlight the most recent advances in this field and provide insights into organic and carbon-based (semi)conducting materials' properties and relate these to their applications in wearable/implantable biosensors. We also provide a perspective on the promising potential and exciting future developments of wearable/implantable biosensors.

Biocompatible, Antibacterial, and Stable Deep Eutectic Solvent-Based Ionic Gel Multimodal Sensors for Healthcare Applications

In this study, we investigated a novel approach to fabricate multifunctional ionic gel sensors by using deep eutectic solvents (DESs) as replacements for water. When two distinct DESs were combined, customizable mechanical and conductive properties were created, resulting in improved performance compared with traditional hydrogel-based strain sensors. DES ionic gels possess superior mechanical properties, transparency, biocompatibility, and antimicrobial properties, making them suitable for a wide range of applications such as flexible electronics, soft robotics, and healthcare. We conducted a comprehensive evaluation of the DES ionic gels, evaluating their performance under extreme temperature conditions (-70 to 80 °C), impressive optical transparency (94%), and biocompatibility. Furthermore, a series of tests were conducted to evaluate the antibacterial performance (Escherichia coli) of the DES ionic gels. Their wide strain (1-400%) and temperature (15-50 °C)-sensing ranges demonstrate the versatility and adaptability of DES ionic gels for diverse sensing requirements. The resulting DES ionic gels were successfully applied in human activity and vital sign monitoring, demonstrating their potential for biointegrated sensing devices and healthcare applications. This study offers valuable insights into the development and optimization of hydrogel sensors, particularly for applications that require environmental stability, biocompatibility, and antibacterial performance, thereby paving the way for future advancements in this field.

A Mechanically Resilient and Tissue-Conformable Hydrogel with Hemostatic and Antibacterial Capabilities for Wound Care

Hydrogels are used in wound dressings because of their tissue-like softness and biocompatibility. However, the clinical translation of hydrogels remains challenging because of their long-term stability, water swellability, and poor tissue adhesiveness. Here, tannic acid (TA) is introduced into a double network (DN) hydrogel consisting of poly(vinyl alcohol) (PVA) and poly(acrylic acid) (PAA) to realize a tough, self-healable, nonswellable, conformally tissue-adhesive, hemostatic, and antibacterial hydrogel. The TA within the DN hydrogel forms a dynamic network, enabling rapid self-healing (within 5 min) and offering effective energy dissipation for toughness and viscoelasticity. Furthermore, the hydrophobic moieties of TA provide a water-shielding effect, rendering the hydrogel nonswellable. A simple chemical modification to the hydrogel further strengthens its interfacial adhesion with tissues (shear strength of ≈31 kPa). Interestingly, the TA also can serve as an effective hemostatic (blood-clotting index of 58.40 ± 1.5) and antibacterial component, which are required for a successful wound dressing. The antibacterial effects of the hydrogel are tested against Escherichia coli and Staphylococcus aureus. Finally, the hydrogel is prepared in patch form and applied to a mouse model to test in vivo biocompatibility and hemostatic performances.

Tailoring the Swelling-Shrinkable Behavior of Hydrogels for Biomedical Applications

Hydrogels with tailor-made swelling-shrinkable properties have aroused considerable interest in numerous biomedical domains. For example, as swelling is a key issue for blood and wound extrudates absorption, the transference of nutrients and metabolites, as well as drug diffusion and release, hydrogels with high swelling capacity have been widely applicated in full-thickness skin wound healing and tissue regeneration, and drug delivery. Nevertheless, in the fields of tissue adhesives and internal soft-tissue wound healing, and bioelectronics, non-swelling hydrogels play very important functions owing to their stable macroscopic dimension and physical performance in physiological environment. Moreover, the negative swelling behavior (i.e., shrinkage) of hydrogels can be exploited to drive noninvasive wound closure, and achieve resolution enhancement of hydrogel scaffolds. In addition, it can help push out the entrapped drugs, thus promote drug release. However, there still has not been a general review of the constructions and biomedical applications of hydrogels from the viewpoint of swelling-shrinkable properties. Therefore, this review summarizes the tactics employed so far in tailoring the swelling-shrinkable properties of hydrogels and their biomedical applications. And a relatively comprehensive understanding of the current progress and future challenge of the hydrogels with different swelling-shrinkable features is provided for potential clinical translations.

3D printing of mechanically tough and self-healing hydrogels with carbon nanotube fillers

Hydrogels have the potential to play a crucial role in bioelectronics, as they share many properties with human tissues. However, to effectively bridge the gap between electronics and biological systems, hydrogels must possess multiple functionalities, including toughness, stretchability, self-healing ability, three-dimensional (3D) printability, and electrical conductivity. Fabricating such tough and self-healing materials has been reported, but it still remains a challenge to fulfill all of those features, and in particular, 3D printing of hydrogel is in the early stage of the research. In this paper, we present a 3D printable, tough, and self-healing multi-functional hydrogel in one platform made from a blend of poly(vinyl alcohol) (PVA), tannic acid (TA), and poly(acrylic acid) (PAA) hydrogel ink (PVA/TA/PAA hydrogel ink). Based on a reversible hydrogen-bond (H-bond)-based double network, the developed 3D printable hydrogel ink showed excellent printability via shear-thinning behavior, allowing high printing resolution (~100 μm) and successful fabrication of 3D-printed structure by layer-by-layer printing. Moreover, the PVA/TA/PAA hydrogel ink exhibited high toughness (tensile loading of up to ~45.6 kPa), stretchability (elongation of approximately 650%), tissue-like Young's modulus (~15 kPa), and self-healing ability within 5 min. Furthermore, carbon nanotube (CNT) fillers were successfully added to enhance the electrical conductivity of the hydrogel. We confirmed the practicality of the hydrogel inks for bioelectronics by demonstrating biocompatibility, tissue adhesiveness, and strain sensing ability through PVA/TA/PAA/CNT hydrogel ink.