Wearable Sensors and Systems for Wound Healing-Related pH and Temperature Detection

Bacterial Cellulose-Based Bandages with Integrated Antibacteria and Electrical Stimulation for Advanced Wound Management

Bandages for daily wounds are the most common medical supplies, but there are still ingrained defects in their appearance, comfort, functions, as well as environmental pollution. Here, novel bandages based on bacterial cellulose (BC) membrane for wound monitoring and advanced wound management are developed. The BC membrane is combined with silver nanowires (AgNWs) by using vacuum filtration method to achieve transparent, ultrathin (≈7 µm), breathable (389.98-547.79 g m-2  d-1 ), and sandwich-structured BC/AgNWs bandages with superior mechanical properties (108.45-202.35 MPa), antibacterial activities against Escherichia coli and Staphylococcus aureus, biocompatibility, and conductivity (9.8 × 103 -2.0 × 105  S m-1 ). Significantly, the BC/AgNWs bandage is used in the electrical stimulation (direct current, 600  microamperes for 1 h every other day) treatment of full-thickness skin defect in rats, which obviously promotes wound healing by increasing the secretion of vascular endothelial growth factor (VEGF). The BC bandage is used for monitoring wounds and achieve a high accuracy of 94.7% in classifying wound healing stages of hemostasis, inflammation, proliferation, and remodeling, by using a convolutional neural network. The outcomes of this study not only provide two BC-based bandages as multifunctional wound management, but also demonstrate a new strategy for the development of the next generation of smart bandage.

Peptidomic analysis of endogenous and bacterial protease activity in human plasma and wound fluids

Endogenous and bacterial proteases play important roles in wound healing and infection. Analysis of alterations in the low-molecular-weight peptidome by individual enzymes could therefore provide insight into proteolytic events occurring in wounds and may aid in the discovery of biomarkers. Using liquid chromatography with tandem mass spectrometry, we characterized the peptidome of plasma and acute wound fluids digested ex vivo with human (neutrophil elastase and cathepsin G) and bacterial proteases (Pseudomonas aeruginosa LasB and Staphyloccocus aureus V8). We identified over 100 protein targets for each enzyme and characterized enzyme specific peptides and cleavage patterns. Moreover, we found unique peptide regions in V8 digested samples that were also present in dressing extracts from S. aureus infected wounds. Finally, the work indicates that peptidomic analysis of qualitative differences of proteolytic activity of individual enzymes may aid in the discovery of potential diagnostic biomarkers for wound healing status.

Next-generation of smart dressings: Integrating multiplexed sensors and theranostic functions

Non-healing wounds represent a significant burden for healthcare systems and society, giving rise to severe economic and human issues. Currently, the use of dressings and visual assessment represent the primary and standard care for wounds. Conventional dressings, like cotton gauze, provide only passive physical protection. Besides, they end up paradoxically hampering the wound-healing process by producing tissue damage and pain when removed during routine check-ups. In response to these limitations, researchers, engineers, and technologists are developing innovative dressings that incorporate advanced diagnostic and therapeutic functionalities, coined as "smart dressings". Now, the maturation of smart dressing is bringing them closer to real-life applications, leading to an exciting new generation of these devices. The next generation of smart dressings is capable of monitoring in real-time multiple biomarkers while including pro-healing capabilities in a single platform. Such multiplexed and theranostic smart dressings are expected to offer a timely biomarker-directed diagnosis of non-healing wounds while enabling rapid, automated, and personalized treatments of infection and chronicity. Herein, we provide an insightful overview of these advantageous devices, delving into the diverse spectrum of possible engineering strategies. This encompasses the use of electrochemical and optical platforms with diverse multiplexing architectures, such as multi-zone sensing arrays and multi-layered devices. Open or closed-loop theranostic mechanisms using various stimuli-responsive materials that could be internally or externally controlled are also included. Finally, a critical discussion on the main challenges and future directions of smart dressings is also offered.

Self-powered freestanding multifunctional microneedle-based extended gate device for personalized health monitoring

Online monitoring of prognostic biomarkers is critically important when diagnosing disorders and assessing individuals' health, especially for chronic and infectious diseases. Despite this, current diagnosis techniques are time-consuming, labor-intensive, and performed offline. In this context, developing wearable devices for continuous measurements of multiple biomarkers from body fluids has considerable advantages including availability, rapidity, convenience, and minimal invasiveness over the conventional painful and time-consuming tools. However, there is still a significant challenge in powering these devices over an extended period, especially for applications that require continuous and long-term health monitoring. Herein, a new freestanding, wearable, multifunctional microneedle-based extended gate field effect transistor biosensor is fabricated for online detection of multiple biomarkers from the interstitial fluid including sodium, calcium, potassium, and pH along with excellent electrical response, reversibility, and precision. In addition, a hybrid powering system of triboelectric nanogenerator and solar cell was developed for creating a freestanding, closed-loop platform for continuous charging of the device's battery and integrated with an Internet of Things technology to broadcast the measurements online, suggesting a stand-alone, stable multifunctional tool which paves the way for advanced practical personalized health monitoring and diagnosis.

Editorial for the Special Issue on Flexible Sensors and Actuators for Biomedicine

Flexible sensors and actuators typically rely on functional materials with low Young's moduli or ultrathin geometries [...].

Recent advances in biosensors for real time monitoring of pH, temperature, and oxygen in chronic wounds

Chronic wounds are among the major healthcare issues affecting millions of people worldwide with high rates of morbidity, losses of limbs and mortality. Microbial infection in wounds is a severe problem that can impede healing of chronic wounds. Accurate, timely and early detection of infections, and real time monitoring of various wound healing biomarkers related to infection can be significantly helpful in the treatment and care of chronic wounds. However, clinical methodologies of periodic assessment and care of wounds require physical visit to wound care clinics or hospitals and time-consuming frequent replacement of wound dressing patches, which also often adversely affect the healing process. Besides, frequent replacements of wound dressings are highly expensive, causing a huge amount of burden on the national health care systems. Smart bandages have emerged to provide in situ physiochemical surveillance in real time at the wound site. These bandages integrate smart sensors to detect the condition of wound infection based on various parameters, such as pH, temperature and oxygen level in the wound which reduces the frequency of changing the wound dressings and its associated complications. These devices can continually monitor the healing process, paving the way for tailored therapy and improved quality of patient's life. In this review, we present an overview of recent advances in biosensors for real time monitoring of pH, temperature, and oxygen in chronic wounds in order to assess infection status. We have elaborated the recent progress in quantitative monitoring of several biomarkers important for assessing wounds infection status and its detection using smart biosensors. The review shows that real-time monitoring of wound status by quantifying specific biomarkers, such as pH, temperature and tissue oxygenation to significantly aid the treatment and care of chronic infected wounds.

A 3D-printed millifluidic device for triboelectricity-driven pH sensing based on ZnO nanosheets with super-Nernstian response

This paper suggests a straightforward and rapid fabrication method applying the integration of 3D printing and triboelectric nanogenerator (TENG) technologies to realize milli/microfluidic multipurpose devices. The proposed liquid-solid TENG device is served as an energy harvester and sensor at the same time with flexibility in operation modes. Accordingly, an innovative ethylene vinyl acetate (EVA)-made millifluidic pH sensor is fabricated based on zinc oxide nanosheets as a showcase of the functional adaptability of the ubiquitous device, and its performance is analyzed and compared with contemporary electrochemical pH sensors. High crystallinity of the nanosheets with an incline to (103) orientation in parallel with high levels of oxygen vacancies provides capacity for surface charge accumulation at the nanosheet-aqueous solution interface and the ensuing ultrahigh sensitivity of the triboelectric sensor. The millichannel is optimized in terms of sensing surface area, flow rate, and hydrophobicity properties by opting for appropriate geometry, TENG operation modes, and materials. Despite the finding that quasi-single-electrode mode TENG experiences a higher response (8.12 × Nernst limit) in comparison with quasi-contact-separation configuration (4.14 × Nernst limit), the latter enjoys superior linearity, stability, repeatability, reproducibility, and reliability characteristics corresponding to R² of 98.93%, drift rate of 13 mV/h, relative standard deviation (RSD) of 1.23% in third hysteresis loop, 2.24%, and maximum standard error of ±0.2 pH units across multiple trials, respectively, in a wide pH range of 2-13. Time- and cost-effectiveness, user-friendliness, self-powering, portability, and biocompatibility of the device could be asserted as considerable advantages to open the door for feasibly realizing the new generation of real-life and point-of-care devices.

HPTLC and GC-MS finger-printing of two potential multifunctional siddha tailams: Mathan and maha megarajanga tailam

The Siddha system of medicine is an ancient medical lineage that is practiced primarily in the southern part of India. Siddha system of medicine has been in practice for thousands of years with documented evidence dating back to the 6th century BCE. According to siddha system of medicine's basic fundamental principle, the human body is made up of 96 thathuvam (primary components), which encompass physical, physiological, psychological, and intellectual aspects. Medicine (marunthu) is classified as a wide range of internal and external medicines. The major components of its medical formulations include plant parts, minerals and animal products. Various methods were carried out for the purification process to eliminate the toxins. Choornam, Guligai, Tailam, Parpam, Chendooram, Kattu, Pasai and Poochu are the most common medicines used in Siddha system of medicine for the treatment of various diseases. The pathophysiological classification of diseases is elaborated in detail in the classical Siddha literature. Siddha system of medicine plays an important role in protecting people from diseases such as COVID-19 by providing immune-protecting and immune-boosting medicines in today's world. Mathan tailam and maha megarajanga tailam are the two unique preparations used widely for various skin diseases including chronic wounds and burns. Scientific validation of both medicines will help in understanding their effectiveness against a typical wound condition. In the present study physio-chemical and phytochemical, HPTLC, and GC-MS analyses were carried out and discussed in detail on the multifunctional properties exhibited in the patient communities.

Thermoresponsive nanofibers loaded with antimicrobial α-aminophosphonate-o/w emulsion supported by cellulose nanocrystals for smart wound care patches

Long-term topical application of antibiotics on wounds has led to the emergence of drug-resistant bacterial infections. Antibiotic incorporation into the wound dressing requires enormous advancement of the field to ensure that the needed dose is released when the infection arises. This study synthesized a series of antimicrobial α-aminophosphonate derivatives, and the most effective compound was incorporated into thermoresponsive wound dressing patches. Wound dressing mats were fabricated by needleless electrospinning, and the resultant nanofiber mats were coated with a thermoresponsive eicosane/cellulose nanocrystals o/w system loaded with active α-aminophosphonate derivatives. Chemical, physical, thermal, and antimicrobial properties of the wound dressings were characterized wound dressings. Using SEM analysis, Nanofibers spun with 20 % w/v solutions were selected for drug-emulsion loading since they showed lower diameters with higher surface area. Furthermore, the drug-emulsion coating on the electrospun dressings improved the hydrophilicity of the wound dressings, and the thermoresponsive behavior of the mats was proved using differential scanning calorimetry data. Finally, the drug-loaded electrospun meshes were found active against tested microorganisms, and clear inhibition zones were observed. In conclusion, this novel approach of synthesizing a new family of antimicrobial molecules and their incorporation into nanofibers from renewable sources exhibits great potential for smart and innovative dressings.

Smart microneedle patches for wound healing and management

The number of patients with non-healing wounds is generally increasing globally, placing a huge social and economic burden on every country. The complexity of the wound-healing process remains a major health challenge despite the numerous studies that have been reported on conventional wound dressings. Therefore, a therapeutic system that combines diagnostic and therapeutic modalities is essential to monitor wound-related biomarkers and facilitate wound healing in real time. Microneedles, as a multifunctional platform, are promising for transdermal diagnostics and drug delivery. Their advantages are mainly reflected in painless transdermal drug delivery, good biocompatibility, and ease of self-administration. In this work, we review recent advances in the use of microneedle patches for wound healing and monitoring. The paper first provides a brief overview of the skin structure and the wound healing process, and then discusses the current state of research and prospects for the development of wound-related biomarkers and their real-time monitoring based on microneedle sensors. It summarizes the current state of research based on the unique design of microneedle patches, including biomimetic, conductive, and environmentally responsive, to achieve wound healing. It further summarizes the prospects for the application of different microneedle-based drug delivery modalities and drug delivery substances for wound healing, due to their superior transdermal drug delivery advantages. It concludes with challenges and expectations for the use of smart microneedle patches for wound healing and management.

Advances in Zebrafish for Diabetes Mellitus with Wound Model

Diabetic foot ulcers cause great suffering and are costly for the healthcare system. Normal wound healing involves hemostasis, inflammation, proliferation, and remodeling. However, the negative factors associated with diabetes, such as bacterial biofilms, persistent inflammation, impaired angiogenesis, inhibited cell proliferation, and pathological scarring, greatly interfere with the smooth progress of the entire healing process. It is this impaired wound healing that leads to diabetic foot ulcers and even amputations. Therefore, drug screening is challenging due to the complexity of damaged healing mechanisms. The establishment of a scientific and reasonable animal experimental model contributes significantly to the in-depth research of diabetic wound pathology, prevention, diagnosis, and treatment. In addition to the low cost and transparency of the embryo (for imaging transgene applications), zebrafish have a discrete wound healing process for the separate study of each stage, resulting in their potential as the ideal model animal for diabetic wound healing in the future. In this review, we examine the reasons behind the delayed healing of diabetic wounds, systematically review various studies using zebrafish as a diabetic wound model by different induction methods, as well as summarize the challenges and improvement strategies which provide references for establishing a more reasonable diabetic wound zebrafish model.

Wound pH and Surface Temperature as a Predictive Biomarker of Healing in Diabetic Foot Ulcers

Aim

To monitor wound pH and surface temperature as predictors of wound healing in diabetic foot ulcers (DFU).

Methods

Prospective, observational, time-bound study of 18 months, enrolling patients aged 18 to 60 years with uninfected DFU. The wound was assessed at baseline and after that, every week for 4 weeks according to the leg ulcer measurement tool (LUMT). Concurrently, wound surface pH and temperature were measured. The data were analyzed using descriptive statistics, and a P-value < .05 was considered statistically significant.

Results

Fifty-four patients with DFU were included in the study with a mean age of 55 years and a male to female ratio of 1.57. The wound showed progressive improvement, a maximum mean LUMT score of 48.89 (± 2.81) at the initial evaluation and decreased progressively to the mean of 19.80 at week 4 (± 3.43), both of which were statistically significant ( P-value < .001). Similarly, the median wound pH progressively reduced from 7.7 at baseline to 7.20 in the fourth week, and median wound temperature decreased from 90°F (32.22 °C) at baseline to 85°F (29.44 °C) in the fourth week, both of which were statistically significant ( P-value < .001).

Conclusion

Progressive and significant change in wound pH to acidic and drop in wound surface temperature, both corresponding to improvement in the status of DFU, maximum at 4 weeks, make them valuable predictors of wound healing. However, further, more extensive studies are required to establish a concrete relationship.

Basic amino acid-mediated cationic amphiphilic surfaces for antimicrobial pH monitoring sensor with wound healing effects

BACKGROUND

The wound healing process is a complex cascade of physiological events, which are vulnerable to both our body status and external factors and whose impairment could lead to chronic wounds or wound healing impediments. Conventional wound healing materials are widely used in clinical management, however, they do not usually prevent wounds from being infected by bacteria or viruses. Therefore, simultaneous wound status monitoring and prevention of microbial infection are required to promote healing in clinical wound management.

METHODS

Basic amino acid-modified surfaces were fabricated in a water-based process via a peptide coupling reaction. Specimens were analyzed and characterized by X-ray photoelectron spectroscopy, Kelvin probe force microscopy, atomic force microscopy, contact angle, and molecular electrostatic potential via Gaussian 09. Antimicrobial and biofilm inhibition tests were conducted on Escherichia coli and Staphylococcus epidermidis. Biocompatibility was determined through cytotoxicity tests on human epithelial keratinocytes and human dermal fibroblasts. Wound healing efficacy was confirmed by mouse wound healing and cell staining tests. Workability of the pH sensor on basic amino acid-modified surfaces was evaluated on normal human skin and Staphylococcus epidermidis suspension, and in vivo conditions.

RESULTS

Basic amino acids (lysine and arginine) have pH-dependent zwitterionic functional groups. The basic amino acid-modified surfaces had antifouling and antimicrobial properties similar to those of cationic antimicrobial peptides because zwitterionic functional groups have intrinsic cationic amphiphilic characteristics. Compared with untreated polyimide and modified anionic acid (leucine), basic amino acid-modified polyimide surfaces displayed excellent bactericidal, antifouling (reduction ~ 99.6%) and biofilm inhibition performance. The basic amino acid-modified polyimide surfaces also exhibited wound healing efficacy and excellent biocompatibility, confirmed by cytotoxicity and ICR mouse wound healing tests. The basic amino acid-modified surface-based pH monitoring sensor was workable (sensitivity 20 mV pH-1) under various pH and bacterial contamination conditions.

CONCLUSION

Here, we developed a biocompatible and pH-monitorable wound healing dressing with antimicrobial activity via basic amino acid-mediated surface modification, creating cationic amphiphilic surfaces. Basic amino acid-modified polyimide is promising for monitoring wounds, protecting them from microbial infection, and promoting their healing. Our findings are expected to contribute to wound management and could be expanded to various wearable healthcare devices for clinical, biomedical, and healthcare applications.

Biodegradable Microneedle Array-Mediated Transdermal Delivery of Dimethyloxalylglycine-Functionalized Zeolitic Imidazolate Framework-8 Nanoparticles for Bacteria-Infected Wound Treatment

Bacteria-infected skin wounds caused by external injuries remain a serious challenge to the whole society. Wound healing dressings, with excellent antibacterial activities and potent regeneration capability, are increasingly needed clinically. Here, we reported a novel functional microneedle (MN) array comprising methacrylated hyaluronic acid (MeHA) embedded with pH-responsive functionalized zeolitic imidazolate framework-8 (ZIF-8) nanoparticles to treat bacteria-infected cutaneous wounds. Antibacterial activity was introduced into Zn-ZIF-8 to achieve sterilization through releasing Zn ions, as well as increased angiogenesis by dimethyloxalylglycine (DMOG) molecules that were distributed within its framework. Furthermore, biodegradable MeHA was chosen as a substrate material carrier to fabricate DMOG@ZIF-8 MN arrays. By such design, DMOG@ZIF-8 MN arrays would not only exhibit excellent antibacterial activity against pathogenic bacteria but also enhance angiogenesis within wound bed by upregulating the expression of HIF-1α, leading to a significant therapeutic efficiency on bacteria-infected cutaneous wound healing. Based on these results, we conclude that this new treatment strategy can provide a promising alternative for accelerating infected wound healing via effective antibacterial activity and ameliorative angiogenesis.

Recent Advancement of Functional Hydrogels toward Diabetic Wound Management

Wound healing is a dynamic, orchestrated process comprising partially overlapping phases of hemostasis, inflammation, proliferation, and remodeling. This programmed process, dysregulated in diabetic individuals, results in chronic diabetic wounds. The normal process of healing halts at the inflammatory stage, and this prolonged inflammatory phase is characteristic of diabetic wounds. There are a few U.S. Food & Drug Administration approved skin substitutes; dermal matrixes are commercially available to manage diabetic wounds. However, expensiveness and nonresponsiveness in a few instances are the major limitations of such modalities. To address the issues, several treatment strategies have been exploited to treat chronic wounds; among them hydrogel-based systems showed promise due to favorable properties such as excellent absorption capabilities, porous structure, tunable mechanical strength, and biocompatibility. In the past two decades, hydrogels have become one of the most acceptable systems in the field of wound dressing material, offering single functionality to multifunctionality. This review focuses on the advancement of functional hydrogels explored for diabetic wound management. The process of diabetic wound healing is discussed in the light of the normal healing process, and the role of macrophages in the process is explained. This review also discusses the different approaches to treat diabetic wounds using functional hydrogels, along with their future opportunities.

Multifunctional and Smart Wound Dressings—A Review on Recent Research Advancements in Skin Regenerative Medicine

The healing of wounds is a dynamic function that necessitates coordination among multiple cell types and an optimal extracellular milieu. Much of the research focused on finding new techniques to improve and manage dermal injuries, chronic injuries, burn injuries, and sepsis, which are frequent medical concerns. A new research strategy involves developing multifunctional dressings to aid innate healing and combat numerous issues that trouble incompletely healed injuries, such as extreme inflammation, ischemic damage, scarring, and wound infection. Natural origin-based compounds offer distinct characteristics, such as excellent biocompatibility, cost-effectiveness, and low toxicity. Researchers have developed biopolymer-based wound dressings with drugs, biomacromolecules, and cells that are cytocompatible, hemostatic, initiate skin rejuvenation and rapid healing, and possess anti-inflammatory and antimicrobial activity. The main goal would be to mimic characteristics of fetal tissue regeneration in the adult healing phase, including complete hair and glandular restoration without delay or scarring. Emerging treatments based on biomaterials, nanoparticles, and biomimetic proteases have the keys to improving wound care and will be a vital addition to the therapeutic toolkit for slow-healing wounds. This study focuses on recent discoveries of several dressings that have undergone extensive pre-clinical development or are now undergoing fundamental research.

A review of current advancements for wound healing: Biomaterial applications and medical devices

Wound healing is a complex process that is critical in restoring the skin's barrier function. This process can be interrupted by numerous diseases resulting in chronic wounds that represent a major medical burden. Such wounds fail to follow the stages of healing and are often complicated by a pro‐inflammatory milieu attributed to increased proteinases, hypoxia, and bacterial accumulation. The comprehensive treatment of chronic wounds is still regarded as a significant unmet medical need due to the complex symptoms caused by the metabolic disorder of the wound microenvironment. As a result, several advanced medical devices, such as wound dressings, wearable wound monitors, negative pressure wound therapy devices, and surgical sutures, have been developed to correct the chronic wound environment and achieve skin tissue regeneration. Most medical devices encompass a wide range of products containing natural (e.g., chitosan, keratin, casein, collagen, hyaluronic acid, alginate, and silk fibroin) and synthetic (e.g., polyvinyl alcohol, polyethylene glycol, poly[lactic‐co‐glycolic acid], polycaprolactone, polylactic acid) polymers, as well as bioactive molecules (e.g., chemical drugs, silver, growth factors, stem cells, and plant compounds). This review addresses these medical devices with a focus on biomaterials and applications, aiming to deliver a critical theoretical reference for further research on chronic wound healing.

Development of a textile based protein sensor for monitoring the healing progress of a wound

This article focuses on the design and fabrication of flexible textile-based protein sensors to be embedded in wound dressings. Chronic wounds require continuous monitoring to prevent further complications and to determine the best course of treatment in the case of infection. As proteins are essential for the progression of wound healing, they can be used as an indicator of wound status. Through measuring protein concentrations, the sensor can assess and monitor the wound condition continuously as a function of time. The protein sensor consists of electrodes that are directly screen printed using both silver and carbon composite inks on polyester nonwoven fabric which was deliberately selected as this is one of the common backing fabric types currently used in wound dressings. These sensors were experimentally evaluated and compared to each other by using albumin protein solution of pH 7. A comprehensive set of cyclic voltammetry measurements was used to determine the optimal sensor design the measurement of protein in solution. As a result, the best sensor design is comprised of silver conductive tracks but a carbon layer as the working and counter electrodes at the interface zone. This design prevents the formation of silver dioxide and protects the sensor from rapid decay, which allows for the recording of consecutive measurements using the same sensor. The chosen printed protein sensor was able to detect bovine serum albumin at concentrations ranging from 30 to 0.3 mg/mL with a sensitivity of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$0.0026 \mu $$\end{document}0.0026μA/M. Further testing was performed to assess the sensor’s ability to identify BSA from other interferential substances usually present in wound fluids and the results show that it can be distinguishable.

Intelligent Wearable Sensors Interconnected with Advanced Wound Dressing Bandages for Contactless Chronic Skin Monitoring: Artificial Intelligence for Predicting Tissue Regeneration

Toward the adoption of artificial intelligence-enabled wearable sensors interconnected with intelligent medical objects, this contactless multi-intelligent wearable technology provides a solution for healthcare to monitor hard-to-heal wounds and create optimal efficiencies for clinical professionals by minimizing the risk of disease infection. This article addressed a flexible artificial intelligence-guiding (FLEX-AI) wearable sensor that can be operated with a deep artificial neural network (deep ANN) algorithm for chronic wound monitoring via short-range communication toward a seamless, MXENE-attached, radio frequency-tuned, and wound dressing-integrated (SMART-WD) bandage. Based on a supervised training set of on-contact pH-responsive voltage output, the confusion matrix for healing-stage recognition from this deep ANN machine learning revealed an accuracy of 94.6% for the contactless measurement. The core analytical design of these smart bandages integrated wound dressing of poly(vinyl acrylic) gel@PANI/Cu₂O NPs for instigating pH-responsive current during the wound healing process. Effectively, a chip-free bandage tag was fabricated with a capacitive Mxene/PTFE electret and adhesive acrylic inductance to match the resonance frequency generated by the intelligent wearable antenna. Under zero-current electrochemical potential, the wound dressing attained a slope of -76 mV/pH. With the higher activation voltage applied toward the wound dressing electrodes, cuprous ions intercalated more into the hybrid PVA gel/PANI shell, resulting in an exponential increase of the two-terminal current response. The healing phase diagram was classified into regimes of fast-curing, slow-curing, and no-curing for skin disease treatment with corticosteroids. Ultimately, the near-field sensing technology offers adequate information for guiding treatment decisions as well as drug effectiveness for wound care.

Effects of Cations on HPTS Fluorescence and Quantification of Free Gadolinium Ions in Solution; Assessment of Intracellular Release of Gd3+ from Gd-Based MRI Contrast Agents

8-Hydroxypyrene-1,3,6-trisulfonate (HPTS) is a small, hydrophilic fluorescent molecule. Since the pKa of the hydroxyl group is close to neutrality and quickly responds to pH changes, it is widely used as a pH-reporter in cell biology for measurements of intracellular pH. HPTS fluorescence (both excitation and emission spectra) at variable pH was measured in pure water in the presence of NaCl solution or in the presence of different buffers (PBS or hepes in the presence or not of NaCl) and in a solution containing BSA. pKa values have been obtained from the sigmoidal curves. Herein, we investigated the effect of mono-, di-, and trivalent cations (Na+, Ca2+, La3+, Gd3+) on fluorescence changes and proposed its use for the quantification of trivalent cations (e.g., gadolinium ions) present in solution as acqua-ions. Starting from the linear regression, the LoD value of 6.32 µM for the Gd3+ detection was calculated. The effects on the emission were also analyzed in the presence of a combination of Gd3+ at two different concentrations and the previously indicated mono and di-valent ions. The study demonstrated the feasibility of a qualitative method to investigate the intracellular Gd3+ release upon the administration of Gd-based contrast agents in murine macrophages.

Wound Dressing: From Nanomaterials to Diagnostic Dressings and Healing Evaluations

Wound dressings based on nanomaterials play a crucial role in wound treatment and are widely used in a whole range of medical settings, from minor to life-threatening tissue injuries. This article presents an educational review on the accumulating knowledge in this multidisciplinary area to lay out the challenges and opportunities that lie ahead and ignite the further and faster development of clinically valuable technologies. The review analyzes the functional advantages of nanomaterial-based gauzes and hydrogels as well as hybrid structures thereof. On this basis, the review presents state-of-the-art advances to transfer the (semi)blind approaches to the evaluation of a wound state to smart wound dressings that enable real-time monitoring and diagnostic functions that could help in wound evaluation during healing. This review explores the translation of nanomaterial-based wound dressings and related medical aspects into real-world use. The ongoing challenges and future opportunities associated with nanomaterial-based wound dressings and related clinical decisions are presented and reviewed.

Highly Efficient Self-Healing Multifunctional Dressing with Antibacterial Activity for Sutureless Wound Closure and Infected Wound Monitoring

Wound healing represents a major clinical and public healthcare problem that is frequently challenged by infection risks, detrimental consequences on the surrounding tissues, and difficulties to monitor the healing process. Here we report on a novel self-healing, antibacterial, and multifunctional wound dressing for sutureless wound closure and real-time monitoring of the healing parameters. The self-healing elastomer contains cetyltrimethylammonium bromide (CTAB) and has high mechanical toughness (35 MJ m^-3 ), biocompatibility, and outstanding antibacterial activity (bactericidal rate is ≈90% in 12 h), enabling the wound dressing to effectively inhibit bacterial growth and accelerate infected wound healing. In vivo tests based on full-thickness skin incision model shows that the multifunctional wound dressing can help in contracting wound edges and facilitate wound closure and healing, as could be evidenced by notably dense and well-organized collagen deposition. The test provides an evidence that the integrated sensor array within the multifunctional wound dressing can monitor temperature, pH, and glucose level of the wound area in real-time, providing reliable and timely information of the condition of the wound. Ultimately, the reported multifunctional dressing would be of high value in managing the burden associated with wound healing via personalised monitoring and treatment approaches, digital and other people-centred solutions for health care.

Bioinspired Triboelectric Nanosensors for Self-Powered Wearable Applications

The sustainable operation of wearable sensors plays an important role in continuous and longtime health monitoring. Conventional batteries, which are bulky and rigid, do not satisfy these requirements and, rather, cause additional economic burdens and environmental problems by regular replacement of power sources. This article provides a review on an alternative solution in the form of self-powered devices that can harvest energy from the surrounding environment to support the operation of the wearable sensor. The Review starts with an introduction of the self-powered triboelectric nanosensors (TENSs) and its two independent modules: the energy harvester and the sensing module. The Review continues with the TENS-related bioinspired designs for wearable applications, while providing a bird's-eye view of their characteristics and applications. The ongoing challenges and prospects for providing personal healthcare with self-powered TENS are presented and discussed.

Multifunctional Dressing for Wound Diagnosis and Rehabilitation

A wound dressing is a sterile pad or compress that is used in direct contact with a wound to help it heal and prevent further issues or complications. Though wound healing is an intricate dynamic process that involves multiple biomolecular species, conventional wound dressings have a limited ability to provide timely information of abnormal conditions, missing the best time for early treatment. The current perspective presents and discusses the design and development of smart wound dressings that are integrated with multifunctional materials, wearable sensors and drug delivery systems as well as their application ranging from wound monitoring to timely application of therapeutics. The perspective also discusses the ongoing challenges and exciting opportunities associated with the development of wearable sensor-based smart wound dressing and provide critical insights into wound healing monitoring and management.