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Wireless, closed-loop, smart bandage with integrated sensors and stimulators for advanced wound care and accelerated healing

Nature Biotechnology volume 41, pages 652–662 (2023)Cite this article

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Abstract

‘Smart’ bandages based on multimodal wearable devices could enable real-time physiological monitoring and active intervention to promote healing of chronic wounds. However, there has been limited development in incorporation of both sensors and stimulators for the current smart bandage technologies. Additionally, while adhesive electrodes are essential for robust signal transduction, detachment of existing adhesive dressings can lead to secondary damage to delicate wound tissues without switchable adhesion. Here we overcome these issues by developing a flexible bioelectronic system consisting of wirelessly powered, closed-loop sensing and stimulation circuits with skin-interfacing hydrogel electrodes capable of on-demand adhesion and detachment. In mice, we demonstrate that our wound care system can continuously monitor skin impedance and temperature and deliver electrical stimulation in response to the wound environment. Across preclinical wound models, the treatment group healed ~25% more rapidly and with ~50% enhancement in dermal remodeling compared with control. Further, we observed activation of proregenerative genes in monocyte and macrophage cell populations, which may enhance tissue regeneration, neovascularization and dermal recovery.

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Fig. 1: Overall design of the wireless smart bandage for chronic wound management.
Fig. 2: Validation of the wireless sensing and stimulation circuits.
Fig. 3: Tough and low-impedance conductive hydrogel electrode with on-demand tissue adhesion and detachment.
Fig. 4: Wireless smart bandage can continuously monitor wound physiological conditions and accelerate tissue regeneration.
Fig. 5: Molecular mechanism involved in accelerated tissue regeneration with electrical stimulation.

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Data availability

The authors declare that all data supporting the findings of this study are available within the paper and its supplementary information.

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Acknowledgements

This work was supported by the Stanford Clinical and Translational Science Award (CTSA) to Spectrum. The CTSA program is led by the National Center for Advancing Translational Sciences at NIH. Part of this work was performed at Stanford Nano Shared Facilities, supported by the National Science Foundation under award no. ECCS-2026822. We thank Agfa for providing PEDOT:PSS. We thank T. Carlomagno and T. Vang for administrative support. We thank Y. J. Park for tissue histology support, and D. Wu at Stanford Animal Histology Services and P. Chu at the Human Research Histology Core for help with preparation of histologic specimens. We thank S. Kananian for instrument support with VNA measurements. We also thank R. Altman for his guidance with the project.

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Author notes

  1. These authors contributed equally: Yuanwen Jiang, Artem A. Trotsyuk, Simiao Niu.

Authors and Affiliations

  1. Department of Chemical Engineering, Stanford University, Stanford, CA, USA

    Yuanwen Jiang, Simiao Niu, Chien-Chung Shih, Jian-Cheng Lai, Aref Saberi, Donglai Zhong, Kefan Sun, Eric Zhao, Jing Tang, Gurupranav Gurusankar & Zhenan Bao

  2. Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA

    Artem A. Trotsyuk, Dominic Henn, Kellen Chen, Madelyn R. Larson, Alana M. Mermin-Bunnell, Smiti Mittal, Ethan Beard, Serena Jing, Sydney R. Steele, Tanish Jain, Christopher R. Neimeth, Dharshan Sivaraj, Jagannath Padmanabhan, Melanie Rodrigues, David P. Perrault, Arhana Chattopadhyay, Zeshaan N. Maan, Melissa C. Leeolou, Clark A. Bonham, Sun Hyung Kwon, Hudson C. Kussie, Katharina S. Fischer, Michael Januszyk & Geoffrey C. Gurtner

  3. Department of Biology, Stanford University, Stanford, CA, USA

    Willian G. Viana

  4. BOE Technology Center, BOE Technology Group Co., Ltd, Beijing, China

    Kui Liang & Kailiang Zhang

  5. Stanford Distinguished Careers Institute, Stanford University, Stanford, CA, USA

    Ronjon Nag

  6. Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA

    Michael P. Snyder

  7. Department of Surgery, University of Arizona College of Medicine, Tucson, AZ, USA

    Artem A. Trotsyuk, Kellen Chen, Dharshan Sivaraj, Hudson C. Kussie, Katharina S. Fischer & Geoffrey C. Gurtner

  8. Department of Materials Science and Engineering, Stanford University, Stanford, CA, USA

    Jing Tang

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  1. Yuanwen Jiang
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  40. Zhenan Bao
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Contributions

Y.J., A.A.T., S.N., G.C.G. and Z.B. designed the study. S.N. and Y.J. performed circuit design and testing. Y.J., C.-C.S., J.-C.L., D.Z. and J.T. performed material synthesis and characterizations. A.A.T., Y.J., D.H., K.C., A.M.M.-B., S.M., M.R.L., A.S., E.B., S.J., S.R.S., K.S., T.J., E.Z., C.R.N., W.G.V., D.S., J.P., M.R., D.P.P., A.C., M.C.L., C.A.B., S.H.K., K.S.F., G.G., K.L. and K.Z. performed animal and cell culture experiments and single-cell evaluations. Y.J., A.A.T., S.N., M.J., G.C.G. and Z.B. wrote the manuscript with input from all coauthors.

Corresponding authors

Correspondence to Geoffrey C. Gurtner or Zhenan Bao.

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Competing interests

Y.J., A.A.T., S.N., G.C.G. and Z.B. have filed a provisional application of patent through Stanford University with the assigned application number 63/238,017. The remaining authors declare no competing interests.

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Jiang, Y., Trotsyuk, A.A., Niu, S. et al. Wireless, closed-loop, smart bandage with integrated sensors and stimulators for advanced wound care and accelerated healing. Nat Biotechnol 41, 652–662 (2023). https://doi.org/10.1038/s41587-022-01528-3

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