A multifunctional sensor for real-time monitoring and pro-healing of frostbite wounds

Polydopamine Nanoparticle-Loaded Antifreezing and Photothermal Organohydrogel Based on Pullulan for Frostbite Therapy

Rapid rewarming is the standard and most common strategy for treating frostbite. Due to freezing susceptibility and lack of thermal effects, traditional therapeutic hydrogels are not suitable for being directly applied to frostbite therapy in cold conditions. Contrastively, antifreezing and photothermal hydrogels that are not apt to freeze and capable of rewarming frostbite wounds are deemed to hold great application potential in such therapy. Nevertheless, these hydrogels have rarely been researched. Herein, using glycerol as the cryoprotectant and polydopamine nanoparticles (PDA NPs) as the photothermal agent, a novel pullulan-based antifreezing and photothermal organohydrogel (CPG-PDA organohydrogel) was successfully developed to treat frostbite for the first time. The CPG-PDA organohydrogel formed through 1-ethyl-3-(3-(dimethylamino)propyl)carbodiimide hydrochloride (EDC·HCl)-mediated esterification reactions was found to possess certain mechanical stability, shear-thinning behaviors (injectability), excellent antifreezing properties, superb in vitro and in vivo photothermal performances, and outstanding cytocompatibility and hemocompatibility. Most noticeably, the photothermal rewarming and coating therapy using the CPG-PDA organohydrogel was observed to significantly accelerate the frostbite healing of rats. The CPG-PDA organohydrogel was opined to be a promising platform for the direct treatment of frostbite in a cold environment and would open a new avenue for the design of therapeutic strategies for frostbite.

A Biomimetic One‐Stone‐Two‐Birds Hydrogel with Electroconductive, Photothermally Antibacterial and Bioadhesive Properties for Skin Tissue Regeneration and Mechanosensation Restoration

Severe skin wounds arising from burns, cancers, and accidents can damage the entire tissue structure, resulting in permanent somatosensory dysfunction in patients. Although emerging hydrogel dressings have shown clinical potential for accelerating wound repair, the use of an individual material to synchronously restore the tissue structure and sensory function of defective skin remains a challenge. Herein, a multifunctional hydrogel that combines electroconductive polydopamine‐capped graphene nanosheets (PrGOs) embedded in a dynamically crosslinked dual‐polysaccharide (xyloglucan and chitosan) matrix network is presented. The fabricated hydrogels have an adjustable modulus that can be matched to skin tissue at the wound site, owing to the dynamic Schiff‐based crosslinking as well as the facile photo‐triggered secondary crosslinking. Furthermore, the photothermal activity of PrGO can elevate the local temperature up to ≈50 °C, significantly restraining bacterial growth. These two factors jointly promote the regeneration of skin tissue. Tissue adhesion of hydrogels is also reported that offers a conformable and robust interface that can detect and quantify human movement and physiological signals to mimic the human skin somatosensory system. This hydrogel offers an effective one‐stone‐for‐two‐birds material that simultaneously achieves tissue regeneration and multi‐signal sensing, promoting the restoration and/or replacement of the structure and function of damaged skins.

Design Strategy, On-Demand Control, and Biomedical Engineering Applications of Wet Adhesion

The adhesion of tissues to external devices is fundamental to numerous critical applications in biomedical engineering, including tissue and organ repair, bioelectronic interfaces, adhesive robotics, wearable electronics, biomedical sensing and actuation, as well as medical monitoring, treatment, and healthcare. A key challenge in this context is that tissues are typically situated in aqueous and dynamic environments, which poses a bottleneck to further advancements in these fields. Wet adhesion technology (WAT) presents an effective solution to this issue. In this review, we summarize the three major design strategies and control methods of wet adhesion, comprehensively and systematically introducing the latest applications and advancements of WAT in the field of biomedical engineering. First, single adhesion mechanism under the frameworks of the three design strategies is systematically introduced. Second, control methods for adhesion are comprehensively summarized, including spatiotemporal control, detachment control, and reversible adhesion control. Third, a systematic summary and discussion of the latest applications of WAT in biomedical engineering research and education were presented, with a particular focus on innovative applications such as tissue-electronic interface devices, ingestible devices, end-effector components, in vivo medical microrobots, and medical instruments and equipment. Finally, opportunities and challenges encountered in the design and development of wet adhesives with advanced adhesive performance and application prospects are discussed.

Self-Healing, Electrically Conductive, Antibacterial, and Adhesive Eutectogel Containing Polymerizable Deep Eutectic Solvent for Human Motion Sensing and Wound Healing

Flexible electronic devices such as wearable sensors are essential to advance human-machine interactions. Conductive eutectogels are promising for wearable sensors, despite their challenges in self-healing and adhesion properties. This study introduces a multifunctional eutectogel based on a novel polymerizable deep eutectic solvent (PDES) prepared by the incorporation of diallyldimethylammonium chloride (DADMAC) and glycerol in the presence of polycyclodextrin (PCD)/dopamine-grafted gelatin (Gel-DOP)/oxidized sodium alginate (OSA). The synthesized eutectogel has reversible Schiff-base bonds, hydrogen bonds, and host-guest interactions, which enable rapid self-healing upon network disruption. GPDO-15 eutectogel has significant tissue adhesion, high stretchability (419%), good ionic conductivity (0.79 mS·cm-1), and favorable antibacterial and self-healing properties. These eutectogels achieve 90% antibacterial effect, show excellent biocompatibility, and can be used as sensors to monitor human activities with strong stability and durability. The in vivo studies indicate that the eutectogels can improve the wound healing process which makes them an effective option for biological dressings.

Conductive hydrogels: intelligent dressings for monitoring and healing chronic wounds

Conductive hydrogels (CHs) represent a burgeoning class of intelligent wound dressings, providing innovative strategies for chronic wound repair and monitoring. Notably, CHs excel in promoting cell migration and proliferation, exhibit powerful antibacterial and anti-inflammatory properties, and enhance collagen deposition and angiogenesis. These capabilities, combined with real-time monitoring functions, play a pivotal role in accelerating collagen synthesis, angiogenesis and continuous wound surveillance. This review delves into the preparation, mechanisms and applications of CHs in wound management, highlighting their diverse and significant advantages. It emphasizes the effectiveness of CHs in treating various chronic wounds, such as diabetic ulcers, infected wounds, temperature-related injuries and athletic joint wounds. Additionally, it explores the diverse applications of multifunctional intelligent CHs in advanced wound care technologies, encompassing self-powered dressings, electrically-triggered drug delivery, comprehensive diagnostics and therapeutics and scar-free healing. Furthermore, the review highlights the challenges to their broader implementation, explores the future of intelligent wound dressings and discusses the transformative role of CHs in chronic wound management, particularly in the context of the anticipated integration of artificial intelligence (AI). Additionally, this review underscores the challenges hindering the widespread adoption of CHs, delves into the prospects of intelligent wound dressings and elucidates the transformative impact of CHs in managing chronic wounds, especially with the forthcoming integration of AI. This integration promises to facilitate predictive analytics and tailor personalized treatment plans, thereby further refining the healing process and elevating patient satisfaction. Addressing these challenges and harnessing emerging technologies, we postulate, will establish CHs as a cornerstone in revolutionizing chronic wound care, significantly improving patient outcomes.

3D printed multi-coupled bioinspired skin-electronic interfaces with enhanced adhesion for monitoring and treatment

Skin-electronic interfaces have broad applications in fields such as diagnostics, therapy, health monitoring, and smart wearables. However, they face various challenges in practical use. For instance, in wet environments, the cohesion of the material may be compromised, and under dynamic conditions, maintaining conformal adhesion becomes difficult, leading to reduced sensitivity and fidelity of electrical signal transmission. The key scientific issue lies in forming a stable and tight mechanical-electronic coupling at the tissue-electronic interface. Here, inspired by octopus sucker structures and snail mucus, we propose a strategy for hydrogel skin-electronic interfaces based on multi-coupled bioinspired adhesion and introduce an ultrasound (US)-mediated interfacial toughness enhancement mechanism. Ultimately, using digital light processing micro-nano additive manufacturing technology (DLP 3D), we have developed a multifunctional, diagnostic-therapeutic integrated patch (PAMS). This patch exhibits moderate water swelling properties, a maximum deformation of up to 460%, high sensitivity (GF = 4.73), and tough and controllable bioadhesion (shear strength increased by 109.29%). Apart from outstanding mechanical and electronic properties, the patch also demonstrates good biocompatibility, anti-bacterial properties, photothermal properties, and resistance to freezing at -20 °C. Experimental results show that this skin-electronic interface can sensitively monitor temperature, motion, and electrocardiogram signals. Utilizing a rat frostbite model, we have demonstrated that this skin-electronic interface can effectively accelerate the wound healing process as a wound patch. This research offers a promising strategy for improving the performance of bioelectronic devices, sensor-based educational reforms and personalized diagnostics and therapeutics in the future. STATEMENT OF SIGNIFICANCE: Establishing stable and tight mechanical-electronic coupling at the tissue-electronic interface is essential for the diverse applications of bioelectronic devices. This study aims to develop a multifunctional, diagnostic-therapeutic integrated hydrogel skin-electronic interface patch with enhanced interfacial toughness. The patch is based on a multi-coupled bioinspired adhesive-enhanced mechanism, allowing for personalized 3D printing customization. It can be used as a high-performance diagnostic-therapeutic sensor and effectively promote frostbite wound healing. We anticipate that this research will provide new insights for constructing the next generation of multifunctional integrated high-performance bioelectronic interfaces.

Notch-insensitive, tough and self-healing conductive bacterial cellulose nanocomposite hydrogel for flexible wearable strain sensor

To date, conductive hydrogels as an alternative to traditional rigid metallic conductors have attracted much attention in the field of flexible wearable electronic devices due to their inherent characteristics. Herein, a conductive bacterial cellulose (BC) nanocomposite hydrophobic-association (HA) hydrogel with highly stretchable, strong, self-healing, and notch-insensitive was fabricated by introducing the hydrophobic association. The obtained BCNC HA hydrogel shows excellent mechanical properties (∼ 2400 % of stress and ∼ 0.35 MPa of mechanical strength), superior notch-insensitive property with a fracture energy of ∼38 KJ.m-2, and good self-healing property (healing efficiency of ∼97 %). In addition, the hydrogel exhibits excellent ionic conductivity of ∼1.90 S.m-1 and high sensing sensitivity toward tensile deformation. The wearable strain sensor based on this material is assembled can detect both large-scale motions and subtle body motions in real time, which show excellent durability (1000 cycles with the strain of 30 %). Thus, the BCNC HA hydrogels have promising potential in various wearable flexible electronic devices for artificial intelligence and human-machine interface applications in the future.

Carbon Quantum Dot-Functionalized Dermis-Derived Transparent Electronic Skin for Multimodal Human Motion Signal Monitoring and Construction of Self-Powered Triboelectric Nanogenerator

Electronic skin (e-skin) is considered as a highly promising interface for human-computer interaction systems and wearable electronic devices. Through elaborate design and assembly of various materials, it possesses multiple characteristics similar to human skin, including remarkable flexibility, stretchability, sensitivity to temperature and humidity, biocompatibility, and efficient interfacial ion/electron transport capabilities. Here, we innovatively integrate multifunctional carbon quantum dots (CQDs), which exhibit conductivity, antibacterial properties, ultraviolet absorption, and fluorescence emission, with poly(acrylic acid) and glycerin (Gly) into a three-dimensional network structure of natural goatskin collagen fibers. Through a top-down design strategy enhanced by hydrogen bond reconstruction, we successfully fabricated a novel transparent e-skin (PAC-eSkin). This e-skin exhibited significant tensile properties (4.94 MPa of tensile strength and 263.42% of a maximum breaking elongation), while also possessing Young's modulus similar to human skin (2.32 MPa). It is noteworthy that the functionalized CQDs used was derived from discarded goat hair, and the addition of Gly gave PAC-eSkin excellent antifreezing and moisturizing properties. Due to the presence of ultrasmall CQDs, which creates efficient ion/electron transport channels within PAC-eSkin, it could rapidly sense human motion and physiological signals (with a gauge factor (GF) of 1.88). Furthermore, PAC-eSkin had the potential to replace traditional electrode patches for real-time monitoring of electrocardiogram, electromyogram, and electrooculogram signals, with a higher SNR (signal-to-noise ratio) of 25.1 dB. Additionally, the customizable size and shape of PAC-eSkin offer vast possibilities for the construction of single-electrode triboelectric nanogenerator systems. We have reason to believe that the design and development of this transparent e-skin based on CQDs-functionalized dermal collagen matrices can pave a new way for innovations in human-computer interaction interfaces and their sensing application in diverse scenarios.

Smart Dressings and Their Applications in Chronic Wound Management

During chronic wound healing, the inflammatory phase can endure for extended periods, heavily impeding or halting the process. Regular inspections and dressing changes are crucial. Modern dressings like hydrogels, hydrocolloids, and foam provide protection and an optimal healing environment. However, they have limitations in offering real-time wound bed status and healing rate. Evaluation relies heavily on direct observation, and passive dressings fail to identify subtle healing differences, preventing adaptive adjustments in biological factors and drug concentrations. In recent years, the clinical field recognizes the value of integrating intelligent diagnostic tools into wound dressings. By monitoring biomarkers linked to chronic wounds' inflammatory state, real-time data can be captured, reducing medical interventions and enabling more effective treatment plans. This fosters innovation in chronic wound care. Researchers have developed smart dressings with sensing, active drug delivery, and self-adjustment capabilities. These dressings detect inflammatory markers like temperature, pH, and oxygen content, enhancing drug bioavailability on the wound surface. As wound healing technology evolves, these smart dressings hold immense potential in chronic wound care and treatment. This comprehensive review updates our understanding on the role and mechanism of action of the smart dressings in chronic refractory wounds by summarizing and discussing the latest research progresses, including the intelligent monitoring of wound oxygen content, temperature, humidity, pH, infection, and enzyme kinetics; intelligent drug delivery triggered by temperature, pH, near-infrared, and electricity; as well as the intelligent self-adjustment of pressure and shape. The review also delves into the constraints and future perspectives of smart dressings in clinical settings, thereby advancing the development of smart wound dressings for chronic wound healing and their practical application in clinical practice.

Electronic Skin for Health Monitoring Systems: Properties, Functions, and Applications

Electronic skin (e-skin), a skin-like wearable electronic device, holds great promise in the fields of telemedicine and personalized healthcare because of its good flexibility, biocompatibility, skin conformability, and sensing performance. E-skin can monitor various health indicators of the human body in real time and over the long term, including physical indicators (exercise, respiration, blood pressure, etc.) and chemical indicators (saliva, sweat, urine, etc.). In recent years, the development of various materials, analysis, and manufacturing technologies has promoted significant development of e-skin, laying the foundation for the application of next-generation wearable medical technologies and devices. Herein, the properties required for e-skin health monitoring devices to achieve long-term and precise monitoring and summarize several detectable indicators in the health monitoring field are discussed. Subsequently, the applications of integrated e-skin health monitoring systems are reviewed. Finally, current challenges and future development directions in this field are discussed. This review is expected to generate great interest and inspiration for the development and improvement of e-skin and health monitoring systems.

Preparation of pH-sensitive porous polylactic acid-based medical dressing with self-pumping function

Excessive exudation from the wound site and the difficulty of determining the state of wound healing can make medical management more difficult and, in extreme cases, lead to wound deterioration. In this study, we fabricated a pH-sensitive colorimetric chronic wound dressing with self-pumping function using electrostatic spinning technology. It consisted of three layers: a polylactic acid-curcumin (PCPLLA) hydrophobic layer, a hydrolyzed polyacrylonitrile (HPAN) transfer layer, and a polyacrylonitrile-purple kale anthocyanin (PAN-PCA) hydrophilic layer. The results showed that the preparation of porous PLLA fiber membrane loaded with 0.2 % Cur was achieved by adjusting the spinning-related parameters, which could ensure that the composite dressing had sufficient anti-inflammatory, antibacterial and antioxidant properties. The HPAN membrane treated with alkali for 30 min had significantly enhanced liquid wetting ability, and the unidirectional transport of liquid could be achieved by simple combination with the 20 um PCPLLA fiber membrane. In addition, the 4 % loaded PCA showed more obvious color difference than the colorimetric membrane. In vivo and ex vivo experiments have demonstrated the potential of multifunctional dressings for the treatment of chronic wounds.

Progress of Research on Conductive Hydrogels in Flexible Wearable Sensors

Conductive hydrogels, characterized by their excellent conductivity and flexibility, have attracted widespread attention and research in the field of flexible wearable sensors. This paper reviews the application progress, related challenges, and future prospects of conductive hydrogels in flexible wearable sensors. Initially, the basic properties and classifications of conductive hydrogels are introduced. Subsequently, this paper discusses in detail the specific applications of conductive hydrogels in different sensor applications, such as motion detection, medical diagnostics, electronic skin, and human-computer interactions. Finally, the application prospects and challenges are summarized. Overall, the exceptional performance and multifunctionality of conductive hydrogels make them one of the most important materials for future wearable technologies. However, further research and innovation are needed to overcome the challenges faced and to realize the wider application of conductive hydrogels in flexible sensors.