Wang Canran, Fan Kexin, Shirzaei Sani Ehsan, Lasalde-Ramírez José A, Heng Wenzheng, Min Jihong, Solomon Samuel A, Wang Minqiang, Li Jiahong, Han Hong, Kim Gwangmook, Shin Soyoung, Seder Alex, Shih Chia-Ding, Armstrong David G, Gao Wei
Andrew and Peggy Cherng Department of Medical Engineering, Division of Engineering and Applied Science, California Institute of Technology, Pasadena, CA 91125, USA.
Department of Materials Science and Engineering, University of Central Florida, Orlando, FL 32816, USA.
Sci Transl Med. 2025 Apr 23;17(795):eadt0882. doi: 10.1126/scitranslmed.adt0882.
Chronic wounds are a major global health challenge associated with substantial economic burden and a negative impact on patient quality of life. Real-time analysis of biomarkers like reactive oxygen and nitrogen species could guide treatment, but existing systems lack the capacity required for continuous monitoring. Wound exudate is secreted slowly and has a complex composition, making efficient fluid collection and real-time analysis challenging. To address these issues, we introduce iCares, a wearable device for wound exudate management and continuous in situ analysis of wound biomarkers. iCares contains a flexible nanoengineered sensor array that measures reactive species such as NO, HO, and O, along with pH and temperature, providing multiparameter data to inform wound status. The device features pump-free triad microfluidic modules with a superhydrophobic-superhydrophilic Janus membrane, bioinspired wedge channels, and three-dimensional graded micropillars for efficient unidirectional exudate collection, transport, and refreshing. The sensors demonstrated a consistent response and analyte selectivity in vitro and in wound exudate. iCares was designed for rapid scalable manufacturing through advanced printing and laser patterning. Wireless connectivity supported long-term continuous monitoring in wounds. The iCares system real-time monitoring was tested in a murine model of diabetic skin wound during infection and antimicrobial treatment. Clinical wound evaluation was conducted in 20 patients with chronic wounds and in two patients before and after surgery. A machine learning analysis of the multiplexed data successfully classified wounds and healing times, indicating that wound exudate analysis by iCares could offer insight into chronic wound status to aid in treatment decisions.
慢性伤口是一项重大的全球健康挑战,会带来巨大的经济负担,并对患者生活质量产生负面影响。对活性氧和氮等生物标志物进行实时分析可指导治疗,但现有系统缺乏连续监测所需的能力。伤口渗出液分泌缓慢且成分复杂,使得高效的液体收集和实时分析具有挑战性。为了解决这些问题,我们推出了iCares,这是一种用于伤口渗出液管理和伤口生物标志物连续原位分析的可穿戴设备。iCares包含一个灵活的纳米工程传感器阵列,可测量一氧化氮、羟基自由基和氧等活性物质,以及pH值和温度,提供多参数数据以了解伤口状况。该设备具有无泵三联微流体模块,配有超疏水-超亲水的Janus膜、仿生楔形通道和三维梯度微柱,用于高效单向渗出液收集、运输和更新。这些传感器在体外和伤口渗出液中表现出一致的响应和分析物选择性。iCares旨在通过先进的印刷和激光图案化实现快速可扩展制造。无线连接支持对伤口进行长期连续监测。iCares系统的实时监测在糖尿病皮肤伤口感染和抗菌治疗的小鼠模型中进行了测试。对20名慢性伤口患者以及两名手术前后的患者进行了临床伤口评估。对多路复用数据的机器学习分析成功地对伤口和愈合时间进行了分类,这表明iCares对伤口渗出液的分析可为慢性伤口状况提供见解,以帮助做出治疗决策。