Stretchable and Self-Adhesive PEDOT:PSS Blend with High Sweat Tolerance as Conformal Biopotential Dry Electrodes

3D printed PEDOT:PSS-based conducting and patternable eutectogel electrodes for machine learning on textiles

The proliferation of medical wearables necessitates the development of novel electrodes for cutaneous electrophysiology. In this work, poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) is combined with a deep eutectic solvent (DES) and polyethylene glycol diacrylate (PEGDA) to develop printable and biocompatible electrodes for long-term cutaneous electrophysiology recordings. The impact of printing parameters on the conducting properties, morphological characteristics, mechanical stability and biocompatibility of the material were investigated. The optimised eutectogel formulations were fabricated in four different patterns -flat, pyramidal, striped and wavy- to explore the influence of electrode geometry on skin conformability and mechanical contact. These electrodes were employed for impedance and forearm EMG measurements. Furthermore, arrays of twenty electrodes were embedded into a textile and used to generate body surface potential maps (BSPMs) of the forearm, where different finger movements were recorded and analysed. Finally, BSPMs for three different letters (B, I, O) in sign-language were recorded and used to train a logistic regressor classifier able to reliably identify each letter. This novel cutaneous electrode fabrication approach offers new opportunities for long-term electrophysiological recordings, online sign-language translation and brain-machine interfaces.

E-Tattoos: Toward Functional but Imperceptible Interfacing with Human Skin

The human body continuously emits physiological and psychological information from head to toe. Wearable electronics capable of noninvasively and accurately digitizing this information without compromising user comfort or mobility have the potential to revolutionize telemedicine, mobile health, and both human-machine or human-metaverse interactions. However, state-of-the-art wearable electronics face limitations regarding wearability and functionality due to the mechanical incompatibility between conventional rigid, planar electronics and soft, curvy human skin surfaces. E-Tattoos, a unique type of wearable electronics, are defined by their ultrathin and skin-soft characteristics, which enable noninvasive and comfortable lamination on human skin surfaces without causing obstruction or even mechanical perception. This review article offers an exhaustive exploration of e-tattoos, accounting for their materials, structures, manufacturing processes, properties, functionalities, applications, and remaining challenges. We begin by summarizing the properties of human skin and their effects on signal transmission across the e-tattoo-skin interface. Following this is a discussion of the materials, structural designs, manufacturing, and skin attachment processes of e-tattoos. We classify e-tattoo functionalities into electrical, mechanical, optical, thermal, and chemical sensing, as well as wound healing and other treatments. After discussing energy harvesting and storage capabilities, we outline strategies for the system integration of wireless e-tattoos. In the end, we offer personal perspectives on the remaining challenges and future opportunities in the field.

Kirigami-Structured, Low-Impedance, and Skin-Conformal Electronics for Long-Term Biopotential Monitoring and Human-Machine Interfaces

Epidermal dry electrodes with high skin-compliant stretchability, low bioelectric interfacial impedance, and long-term reliability are crucial for biopotential signal recording and human-machine interaction. However, incorporating these essential characteristics into dry electrodes remains a challenge. Here, a skin-conformal dry electrode is developed by encapsulating kirigami-structured poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS)/polyvinyl alcohol (PVA)/silver nanowires (Ag NWs) film with ultrathin polyurethane (PU) tape. This Kirigami-structured PEDOT:PSS/PVA/Ag NWs/PU epidermal electrode exhibits a low sheet resistance (≈3.9 Ω sq-1 ), large skin-compliant stretchability (>100%), low interfacial impedance (≈27.41 kΩ at 100 Hz and ≈59.76 kΩ at 10 Hz), and sufficient mechanoelectrical stability. This enhanced performance is attributed to the synergistic effects of ionic/electronic current from PEDOT:PSS/Ag NWs dual conductive network, Kirigami structure, and unique encapsulation. Compared with the existing dry electrodes or standard gel electrodes, the as-prepared electrodes possess lower interfacial impedance and noise in various conditions (e.g., sweat, wet, and movement), indicating superior water/motion-interference resistance. Moreover, they can acquire high-quality biopotential signals even after water rinsing and ultrasonic cleaning. These outstanding advantages enable the Kirigami-structured PEDOT:PSS/PVA/Ag NWs/PU electrodes to effectively monitor human motions in real-time and record epidermal biopotential signals, such as electrocardiogram, electromyogram, and electrooculogram under various conditions, and control external electronics, thereby facilitating human-machine interactions.

Doping Engineering of Conductive Polymers and Their Application in Physical Sensors for Healthcare Monitoring

Physical sensors have emerged as a promising technology for real-time healthcare monitoring, which tracks various physical signals from the human body. Accurate acquisition of these physical signals from biological tissue requires excellent electrical conductivity and long-term durability of the sensors under complex mechanical deformation. Conductive polymers, combining the advantages of conventional polymers and organic conductors, are considered ideal conductive materials for healthcare physical sensors due to their intrinsic conductive network, tunable mechanical properties, and easy processing. Doping engineering has been proposed as an effective approach to enhance the sensitivity, lower the detection limit, and widen the operational range of sensors based on conductive polymers. This approach enables the introduction of dopants into conductive polymers to adjust and control the microstructure and energy levels of conductive polymers, thereby optimizing their mechanical and conductivity properties. This review article provides a comprehensive overview of doping engineering methods to improve the physical properties of conductive polymers and highlights their applications in the field of healthcare physical sensors, including temperature sensors, strain sensors, stress sensors, and electrophysiological sensing. Additionally, the challenges and opportunities associated with conductive polymer-based physical sensors in healthcare monitoring are discussed.

Cell Viability Assessment of PEDOT Conducting Polymer-Coated Microneedles for Skin Sampling

Recently, transdermal monitoring and drug delivery have gained much interest, owing to the introduction of the minimally invasive microneedle (MN) device. The advancement of electroactive MNs electrically assisted in the capture of biomarkers or the triggering of drug release. Recent works have combined conducting polymers (CPs) onto MNs owing to the soft nature of the polymers and their tunable ionic and electronic conductivity. Though CPs are reported to work safely in the body, their biocompatibility in the skin has been insufficiently investigated. Furthermore, during electrical biasing of CPs, they undergo reduction or oxidation, which in practical terms leads to release/exchange of ions, which could pose biological risks. This work investigates the viability and proliferation of skin cells upon exposure to an electrochemically biased MN pair comprising two differently doped poly(3,4-ethylenedioxy-thiophene) (PEDOT) polymers that have been designed for skin sampling use. The impact of biasing on human keratinocytes and dermal fibroblasts was determined at different initial cell seeding densities and incubation periods. Indirect testing was employed, whereby the culture media was first exposed to PEDOTs prior to the addition of this extract to cells. In all conditions, both unbiased and biased PEDOT extracts showed no cytotoxicity, but the viability and proliferation of cells cultured at a low cell seeding density were lower than those of the control after 48 h of incubation.

Stretchable surface electromyography electrode array patch for tendon location and muscle injury prevention

Surface electromyography (sEMG) can provide multiplexed information about muscle performance. If current sEMG electrodes are stretchable, arrayed, and able to be used multiple times, they would offer adequate high-quality data for continuous monitoring. The lack of these properties delays the widespread use of sEMG in clinics and in everyday life. Here, we address these constraints by design of an adhesive dry electrode using tannic acid, polyvinyl alcohol, and PEDOT:PSS (TPP). The TPP electrode offers superior stretchability (~200%) and adhesiveness (0.58 N/cm) compared to current electrodes, ensuring stable and long-term contact with the skin for recording (>20 dB; >5 days). In addition, we developed a metal-polymer electrode array patch (MEAP) comprising liquid metal (LM) circuits and TPP electrodes. The MEAP demonstrated better conformability than commercial arrays, resulting in higher signal-to-noise ratio and more stable recordings during muscle movements. Manufactured using scalable screen-printing, these MEAPs feature a completely stretchable material and array architecture, enabling real-time monitoring of muscle stress, fatigue, and tendon displacement. Their potential to reduce muscle and tendon injuries and enhance performance in daily exercise and professional sports holds great promise.

A sweat-pH-enabled strongly adhesive hydrogel for self-powered e-skin applications

On-skin hydrogel electrodes are poorly conformable in sweaty scenarios due to low electrode-skin adhesion resulting from the sweat film formed on the skin surface, which seriously hinders practical applications. In this study, we fabricated a tough adhesive cellulose-nanofibril/poly(acrylic acid) (CNF/PAA) hydrogel with tight hydrogen-bond (H-bond) networks based on a common monomer and a biomass resource. Furthermore, inherent H-bonded network structures can be disrupted through judicious engineering using excess hydronium ions produced through sweating, which facilitate the transition to protonation and modulate the release of active groups (i.e., hydroxyl and carboxyl groups) accompanied by a pH drop. The lower pH enhances adhesive performance, especially on skin, with a 9.7-fold higher interfacial toughness (453.47 vs. 46.74 J m^-2), an 8.6-fold higher shear strength (600.14 vs. 69.71 kPa), and a 10.4-fold higher tensile strength (556.44 vs. 53.67 kPa) observed at pH 4.5 compared to the corresponding values at pH 7.5. Our prepared hydrogel electrode remains conformable on sweaty skin when assembled as a self-powered electronic skin (e-skin) and enables electrophysiological signals to be reliably collected with high signal-to-noise ratios when exercising. The strategy presented here promotes the design of high-performance adhesive hydrogels that may serve to record continuous electrophysiological signals under real-life conditions (beyond sweating) for various intelligent monitoring systems.

Self-Healing and Self-Adhesive Substrate-Free Tattoo Electrode

Electronic tattoos have great potential application in the biomedical field; moreover, the substrate-free electronic tattoo offers better comfortability and conformal contact. However, the substrate-free electronic tattoo is more prone to malfunction, including fall off and fracture. In this paper, a self-healing and self-adhesive substate-free tattoo based on PEDOT: PSS is studied and reported. The dry composite electrode will turn into self-healing material while it transforms into hydrogel, and a cut with a width up to 24 μm could be healed in 1 s. In terms of adhesion performance, the substrate-free electrode can hang a 28.2 g weight by a contact area of 8 mm × 8 mm. Additionally, the substate-free electrode could maintain fully conformal contact with porcine skin in 15 days by its self-adhesiveness. When applied as a substrate-free tattoo, the contact impedance and ECG signal measurement performance before and after self-healing are almost the same. At a frequency of 10 Hz, the contact impedance of the undamaged electrode, healed electrode, and Ag/AgCl gel electrode are 32.2 kΩ, 39.2 kΩ, and 62.9 kΩ, respectively. In addition, the ECG signals measured by the undamaged electrode and healed electrode are comparable to that of Ag/AgCl electrode. The self-healing and self-adhesive substrate-free tattoo electrode reported here has broad application in health monitoring.

Wireless CardioS framework for continuous ECG acquisition

A first-level textile-based electrocardiogram (ECG) monitoring system referred to as "CardioS" (cardiac sensor) for continuous health monitoring applications is proposed in this study to address the demand for resource-constrained environments. and the signal quality assessment of a wireless CardioS was studied. The CardioS consists of a Lead-I ECG signal recorded wirelessly using silver-plated nylon woven (Ag-NyW) dry textile electrodes to compare the results of wired wearable Ag-NyW textile electrode-based ECG acquisition system and CardioS. The effect of prolonged usage of Ag-NyW dry electrodes on electrode impedance was tested in the current work. In addition, electrode half-cell potential was measured to validate the range of Ag-NyW dry electrodes for ECG signal acquisition. Further, the quality of signals recorded by the proposed wireless CardioS framework was evaluated and compared with clinical disposable (Ag-AgCl Gel) electrodes. The signal quality was assessed in terms of mean magnitude coherence spectra, signal cross-correlation, signal-to-noise-band ratio (Sband/Nband), crest factor, low and high band powers and power spectral density. The experimental results showed that the impedance was increased by 2.5-54.6% after six weeks of continuous usage. This increased impedance was less than 1 MΩ/cm2, as reported in the literature. The half-cell potential of the Ag-NyW textile electrode obtained was 80 mV, sufficient to acquire the ECG signal from the human body. All the fidelity parameters measured by Ag-NyW textile electrodes were correlated with standard disposable electrodes. The cardiologists validated all the measurements and confirmed that the proposed framework exhibited good performance for ECG signal acquisition from the five healthy subjects. As a result of its low-cost architecture, the proposed CardioS framework can be used in resource-constrained environments for ECG monitoring.