DFUCare: deep learning platform for diabetic foot ulcer detection, analysis, and monitoring.

Introduction: Diabetic foot ulcers (DFUs) are a severe complication among diabetic patients, often leading to amputation or even death. Early detection of infection and ischemia is essential for improving healing outcomes, but current diagnostic methods are invasive, time-consuming, and costly. There is a need for non-invasive, efficient, and affordable solutions in diabetic foot care. Methods: We developed DFUCare, a platform that leverages computer vision and deep learning (DL) algorithms to localize, classify, and analyze DFUs non-invasively. The platform combines CIELAB and YCbCr color space segmentation with a pre-trained YOLOv5s algorithm for wound localization. Additionally, deep-learning models were implemented to classify infection and ischemia in DFUs. The preliminary performance of the platform was tested on wound images acquired using a cell phone. Results: DFUCare achieved an F1-score of 0.80 and a mean Average Precision (mAP) of 0.861 for wound localization. For infection classification, we obtained a binary accuracy of 79.76%, while ischemic classification reached 94.81% on the validation set. The system successfully measured wound size and performed tissue color and textural analysis for a comparative assessment of macroscopic wound features. In clinical testing, DFUCare localized wounds and predicted infected and ischemic with an error rate of less than 10%, underscoring the strong performance of the platform. Discussion: DFUCare presents an innovative approach to wound care, offering a cost-effective, remote, and convenient healthcare solution. By enabling non-invasive and accurate analysis of wounds using mobile devices, this platform has the potential to revolutionize diabetic foot care and improve clinical outcomes through early detection of infection and ischemia.

A multifunctional electronic dressing with textile-like structure for wound pressure monitoring and treatment.

In the treatment of infected wounds in bedridden or lying chair patients with mobility problems, improper wound care can lead to wound deterioration, prolong disease pain, increase treatment and care costs, and bring heavier psychological, physical, and economic burdens to patients. In the process of wound recovery, patients with mobility problems mainly face the comprehensive problems of poor air permeability, wound pressure could not be monitored, wound infection and slow healing. Therefore, in the process of wound care for such patients, it is imperative to develop a gas permeable dressing that can monitor the patient's wound compression status in real time and promote wound healing. Here, we developed a textile-shaped gel dressing with pressure-responsive properties. Polydopamine (PDA)-silver coated calcium phosphate nanoparticles (CPNPs）and vascular endothelial growth factor (VEGF) were introduced into the gel to give the gel good antibacterial and therapeutic effects, while enhancing the pressure resistance of the gel to meet the needs of wound pressure monitoring. The textured gel morphology greatly improves the gas permeability of the gel and further improves the pressure sensitivity of the gel. This multifunctional textile-like gel dressing provides a new strategy for the development of treatment monitoring integrated dressing and has broad application prospects.

Early wound infection monitoring via headspace O2 micro-respirometry.

A luminescence based, inexpensive, 3D printed O2 indicator is incorporated into a commercial, clear, occlusive wound dressing, which allows the %O2 in the headspace above a simulated wound to be monitored. Two wound models are used to evaluate this micro-respirometry-based system for monitoring wound infection namely, a simple 'agar plug' model and a wounded porcine skin model. Inoculation of either wound model with E. coli, E. cloacae, or A. baumannii, produces the typical 'S'-shaped, τ vs incubation time, t, profiles, associated with micro-respirometry, due to the decrease in %O2 in the headspace above the wound. A threshold value for the lifetime, τTT, of 21.1 µs, is identified at which the bacterial load is equal to the critical colonization threshold, CCT, ca. 106 colony forming units, CFU/mL, above which infection is highly likely. The agar plug wound model/O2 indicator combination is used to identify when the CCT is reached for a wide range of inoculant concentrations, spanning the range 108-101 CFU/mL, for all three microbial species. The O2 indicator is also successfully evaluated using a porcine skin wound model inoculated with E. coli. The results of this work are compared to other reported, usually invasive, smart wound monitoring systems. The possible use of this new, non-invasive smart-wound dressing technology, both at the point of care and at home, are discussed briefly.

Battery-Free and Multifunctional Microfluidic Janus Wound Dressing with Biofluid Management, Multi-Indicator Monitoring, and Antibacterial Properties.

The sophisticated environment of chronic wounds, characterized by prolonged exudation and recurrent bacterial infections, poses significant challenges to wound recovery. Recent advancements in multifunctional wound dressings fall short of providing comprehensive, accurate, and comfortable treatment. To address these issues, a battery-free and multifunctional microfluidic Janus wound dressing (MM-JWD) capable of three functions, including exudate management, antibacterial properties, and multiple indications of wound infection detection, has been developed. During the treatment, the fully soft microfluidic Janus membrane not only demonstrated stable unidirectional fluid transport capabilities under various skin deformations for a longer period but also provided antibacterial effects through surface treatment with chitosan quaternary ammonium salts and poly(vinyl alcohol). Furthermore, integrating multiple colorimetric sensors within the Janus membrane's microchannels and a dual-layer structure enabled simultaneous monitoring of the wound's pH, uric acid, and temperature. The monitoring was facilitated by smartphone recognition of color changes in the sensors. In vivo and in vitro tests confirmed the exudate management, antibacterial, and sensing capabilities of the MM-JWD, proving its efficacy in monitoring and promoting the healing of wounds. Overall, this study provides a valuable method for the design of multifunctional wound dressings for chronic wound care.

A review of biopolymer-based hydrogels and IoT integration for enhanced diabetes diagnosis, management, and treatment.

The prevalence of diabetes has been increasing globally, necessitating innovative approaches beyond conventional blood sugar monitoring and insulin control. Diabetes is associated with complex health complications, including cardiovascular diseases. Continuous Glucose Monitoring (CGM) devices, though automated, have limitations such as irreversibility and interference with bodily fluids. Hydrogel technologies provide non-invasive alternatives to traditional methods, addressing the limitations of current approaches. This review explores hydrogels as macromolecular biopolymeric materials capable of absorbing and retaining a substantial amount of water within their structure. Due to their high-water absorption properties, these macromolecules are utilized as coating materials for wound care and diabetes management. The study emphasizes the need for early diagnosis and monitoring, especially during the COVID-19 pandemic, where heightened attention to diabetic patients is crucial. Additionally, the article examines the role of the Internet of Things (IoT) and machine learning-based systems in enhancing diabetes management effectiveness. By leveraging these technologies, there is potential to revolutionize diabetes care, providing more personalized and proactive solutions. This review explores cutting-edge hydrogel-based systems as a promising avenue for diabetes diagnosis, management, and treatment, highlighting key biopolymers and technological integrations.

pH factors in chronic wound and pH-responsive polysaccharide-based hydrogel dressings.

Chronic wounds present a significant healthcare challenge marked by complexities such as persistent bleeding, inhibited cell proliferation, dysregulated inflammation, vulnerability to infection, and compromised tissue remodeling. Conventional wound dressings often prove inadequate in addressing the intricate requirements of chronic wound healing, leading to slow healing and heightened susceptibility to infections in patients with prolonged medical conditions. Bacterial biofilms in chronic wounds pose an additional challenge due to drug resistance. Advanced wound dressings have emerged as promising tools in expediting the healing process. Among these, pH-responsive polysaccharide-based hydrogels exhibit immense prospect by adapting their functions to dynamic wound conditions. Despite their potential, the current literature lacks a thorough review of these wound dressings. This review bridges this gap by meticulously examining factors related to chronic wounds, current strategies for healing, and the mechanisms and potential applications of pH-responsive hydrogel wound dressings as an emerging therapeutic solution. Special focus is given to their remarkable antibacterial properties and significant self-healing abilities. It further explores the pH-monitoring functions of these dressings, elucidating the associated pH indicators. This synthesis of knowledge aims to guide future research and development in the field of pH-responsive wound dressings, providing valuable insights into their potential applications in wound care.

Smart wireless flexible bandage containing drug loaded polycaprolactone microparticles for real-time monitoring and treatment of chronic wounds.

The quality of life is negatively impacted by chronic wounds for more than 25 million people in the US. They are quite prone to infection, which may lead to the eventual loss of a limb. By exposing the ulcers to treatment agents at the appropriate time, the healing rate is increased. On-demand drug release in a closed-loop system will aid us in reaching our goal. In this study, we have developed a platform capable of real-time diagnosis of bacterial infection by wirelessly reading wound pH, as well as slow and on-demand local administration of antibiotics. The drug carrier microparticles, an electrical patch, a thermoresponsive hydrogel with an integrated microheater, and a flexible pH sensor comprised the closed-loop patch. Here it is reported that slow and smart release of cefazolin can be addressed by incorporation of drug encapsulated hydrophobic microparticles embedded into a thermo-responsive hydrogel. The utilization of a programmable bandage to provide antibiotic medication highlights the need of not only choosing appropriate therapeutic substances but also the controlled release of the medicine and its rate of release within the wound area. The results of our study indicate that the use of cefazolin encapsulated polycaprolactone (PCL) microparticles can effectively regulate the application of antibiotic treatment for chronic skin wounds. The results also showed a substantial gradual release of cefazolin from the thermo-responsive Pnipam hydrogel when the wound dressing was subjected to a temperature of 37°C. We believe that the developed flexible smart bandage can have a significant impact on chronic wound healing.

Smart theranostics for wound monitoring and therapy.

To overcome the challenges of poor wound diagnosis and limited clinical efficacy of current wound management, wound dressing materials with the aim of monitoring various biomarkers vital to the wound healing process such as temperature, pH, glucose concentration, and reactive oxygen species (ROS) and improving the therapeutic outcomes have been developed. These innovative theranostic dressings are smartly engineered using stimuli-responsive biomaterials to monitor and regulate local microenvironments and deliver cargos to the wound sites in a timely and effective manner. This review provides an overview of recent advances in novel theranostics for wound monitoring and therapy as well as giving insights into the future treatment of wounds via smart design of theranostic materials.

Injectable Hydrogels with Integrated Ph Probes and Ultrasound-Responsive Microcapsules as Smart Wound Dressings for Visual Monitoring and On-Demand Treatment of Chronic Wounds.

Hydrogel dressings capable of infection monitoring and precise treatment administration show promise for advanced wound care. Existing methods involve embedd ingorganic dyes or flexible electronics into preformed hydrogels, which raise safety issues and adaptability challenges. In this study, an injectable hydrogel based smart wound dressing is developed by integrating food-derived anthocyanidin as a visual pH probe for infection monitoring and poly(L-lactic acid) microcapsules as ultrasound-responsive delivery systems for antibiotics into a poly(ethylene glycol) hydrogel. This straightforwardly prepared hydrogel dressing maintains its favorable properties for wound repair, including porous morphology and excellent biocompatibility. In vitro experiments demonstrated that the hydrogel enabled visual assessment of pH within the range of 5 âˆ¼ 9.Meanwhile, the release of antibiotics could be triggered and controlled by ultrasound. In vivo evaluations using infected wounds and diabetic wounds revealed that the wound dressing effectively detected wound infection by monitoring pH levels and achieved antibacterial effects through ultrasound-triggered drug release. This led to significantly enhanced wound healing, as validated by histological analysis and the measurement of inflammatory cytokine levels. This injectable hydrogel-based smart wound dressing holds great potential for use in clinical settings to inform timely and precise clinical intervention and in community to improve wound care management.

Nanophotonic and hydrogel-based diagnostic system for the monitoring of chronic wounds.

Chronic wounds present a major healthcare burden, yet most wounds are only assessed superficially, and treatment is rarely based on the analysis of wound biomarkers. This lack of analysis is based on the fact that sampling of wound biomarkers is typically invasive, leading to a disruption of the wound bed while biomarker detection and quantification is performed in a remote laboratory, away from the point of care. Here, we introduce the diagnostic element of a novel theranostic system that can non-invasively sample biomarkers without disrupting the wound and that can perform biomarker quantification at the point of care, on a short timescale. The system is based on a thermally switchable hydrogel scaffold that enhances wound healing through regeneration of the wound tissue and allows the extraction of wound biomarkers non-destructively. We demonstrate the detection of two major biomarkers of wound health, i.e., IL-6 and TNF-α, in human matrix absorbed into the hydrogel dressing. Quantification of the biomarkers directly in the hydrogel is achieved using a chirped guided mode resonant biosensor and we demonstrate biomarker detection within the clinically relevant range of pg/mL to µg/mL concentrations. We also demonstrate the detection of IL-6 and TNF-α at concentration 1 ng/mL in hydrogel dressing absorbed with clinical wound exudate samples. The high sensitivity and the wide dynamic range we demonstrate are both essential for the clinical relevance of our system. Our test makes a major contribution towards the development of a wound theranostic for guided treatment and management of chronic wounds.

Progress of Hydrogel Dressings with Wound Monitoring and Treatment Functions.

Hydrogels are widely used in wound dressings due to their moisturizing properties and biocompatibility. However, traditional hydrogel dressings cannot monitor wounds and provide accurate treatment. Recent advancements focus on hydrogel dressings with integrated monitoring and treatment functions, using sensors or intelligent materials to detect changes in the wound microenvironment. These dressings enable responsive treatment to promote wound healing. They can carry out responsive dynamic treatment in time to effectively promote wound healing. However, there is still a lack of comprehensive reviews of hydrogel wound dressings that incorporate both wound micro-environment monitoring and treatment functions. Therefore, this review categorizes hydrogel dressings according to wound types and examines their current status, progress, challenges, and future trends. It discusses various wound types, including infected wounds, burns, and diabetic and pressure ulcers, and explores the wound healing process. The review presents hydrogel dressings that monitor wound conditions and provide tailored treatment, such as pH-sensitive, temperature-sensitive, glucose-sensitive, pressure-sensitive, and nano-composite hydrogel dressings. Challenges include developing dressings that meet the standards of excellent biocompatibility, improving monitoring accuracy and sensitivity, and overcoming obstacles to production and commercialization. Furthermore, it provides the current status, progress, challenges, and future trends in this field, aiming to give a clear view of its past, present, and future.

Diabetic Foot Ulcer Imaging: An Overview and Future Directions.

Diabetic foot ulcers (DFUs) affect one in every three people with diabetes. Imaging plays a vital role in objectively complementing the gold-standard visual yet subjective clinical assessments of DFUs during the wound treatment process. Herein, an overview of the various imaging techniques used to image DFUs is summarized. Conventional imaging modalities (e.g., computed tomography, magnetic resonance imaging, positron emission tomography, single-photon emitted computed tomography, and ultrasound) are used to diagnose infections, impact on the bones, foot deformities, and blood flow in patients with DFUs. Transcutaneous oximetry is a gold standard to assess perfusion in DFU cases with vascular issues. For a wound to heal, an adequate oxygen supply is needed to facilitate reparative processes. Several optical imaging modalities can assess tissue oxygenation changes in and around the wounds apart from perfusion measurements. These include hyperspectral imaging, multispectral imaging, diffuse reflectance spectroscopy, near-infrared (NIR) spectroscopy, laser Doppler flowmetry or imaging, and spatial frequency domain imaging. While perfusion measurements are dynamically monitored at point locations, tissue oxygenation measurements are static two-dimensional spatial maps. Recently, we developed a spatio-temporal NIR-based tissue oxygenation imaging approach to map for the extent of asynchrony in the oxygenation flow patterns in and around DFUs. Researchers also measure other parameters such as thermal maps, bacterial infections (from fluorescence maps), pH, collagen, and trans-epidermal water loss to assess DFUs. A future direction for DFU imaging would ideally be a low-cost, portable, multi-modal imaging platform that can provide a visual and physiological assessment of wounds for comprehensive wound care intervention and management.

Highly Elastic and Strain Sensing Corn Protein Electrospun Fibers for Monitoring of Wound Healing.

Due to the lack of sufficient elasticity and strain sensing capability, protein-based ultrafine fibrous tissue engineering scaffolds, though favorable for skin repair, can hardly fulfill on-spot wound monitoring during healing. Herein, we designed highly elastic corn protein ultrafine fibrous smart scaffolds with a three-layer structure for motion tracking at an unpackaged state. The densely cross-linked protein networks were efficiently established by introducing a highly reactive epoxy and provided the fiber substrates with wide-range stretchability (360% stretching range) and ultrahigh elasticity (99.91% recovery rate) at a wet state. With the assistance of the polydopamine bonding layer, a silver conductive sensing layer was built on the protein fibers and endowed the scaffolds with wide strain sensing range (264%), high sensitivity (gauge factor up to 210.55), short response time (<70 ms), reliable cycling stability, and long-lasting duration (up to 30 days). The unpackaged smart scaffolds could not only support cell growth and accelerate wound closure but also track motions on skin and in vivo and trigger alarms once excessive wound deformations occurred. These features not only confirmed the great potential of these smart scaffolds for applications in tissue reconstruction and wound monitoring but also proved the possibility of employing various plant protein ultrafine fibers as flexible bioelectronics.

Stretchable, conductive, breathable and moisture-sensitive e-skin based on CNTs/graphene/GelMA mat for wound monitoring.

Deep skin wound needs a long wound healing process, in which external force on skin around wound can result in a sharp pain, wound re-damage and interstitial fluid flowing out, increasing the risk of deterioration and even amputation. While the conventional wound dressings cannot provide timely feedback of abnormal wound status and lose best time for wound treatment, real-time monitoring wound status is thus urgently needed for wound management. In this work, a breathable and stretchable electronic skin (i.e., e-skin) named CNTs/graphene/GelMA mat has been developed through electrospinning, ice-templating and in-situ loading method for evaluating wound status. The obtained porosity, swelling ratio and vapor transmission rate of the CNTs/graphene/GelMA mat are 55 %, 180 % and 3378.2 h-1 day-1, respectively. And owing to the good porous, nanofibrous architecture and excellent breathability of the mat, L929 cells grow and well spread on the CNTs/graphene/GelMA mat. In addition, the gauge factors of the prepared conductive CNTs/graphene/GelMA mat as a strain sensor are 15.4 and 72.9 in the strain ranges of 0-70 % and 70-85 %, respectively, matching the mechanical performance of human skin. The sensitivity coefficient of the mat for moisture sensing is 12.05, indicating its high efficiency for monitoring and warning interstitial fluid outflow from wound. Furthermore, the integration of CNTs/graphene/GelMA mat with a portable device is feasible to monitor strain and moisture on a rat model with abdominal wound. The healing process of the wounds treated with CNTs/graphene/GelMA mat is similar to that of GelMA mat, indicating that the dosage of CNTs and graphene in the CNTs/graphene/GelMA mat has negligible effect on the mat histocompatibility. The CNTs/graphene/GelMA mat demonstrates the application potential in wound management, home medical diagnosis and human-machine interactions.

Adhesive-Free, Stretchable, and Permeable Multiplex Wound Care Platform.

The wound healing process remains a poorly understood biological mechanism. The high morbidity and mortality rates associated with chronic wounds are a critical concern to the health care industry. Although assessments and treatment options exist, these strategies have primarily relied on static wound dressings that do not consider the dynamic physicochemical microenvironment and can often create additional complications through the frequent dressing changing procedure. Inspired by the need for engineering "smart" bandages, this study resulted in a multifaceted approach to developing an adhesive-free, permeable, and multiplex sensor system. The electronic-extracellular matrix (e-ECM) platform is capable of noninvasively monitoring chemical and physical changes in real-time on a flexible, stretchable, and permeable biointegrated platform. The multiplex sensors are constructed atop a soft, thin, and microfibrous substrate of silicone to yield a conformal, adhesive-free, convective, or diffusive wound exudate flow, and passive gas transfer for increased cellular epithelization and unobstructed physical and chemical sensor monitoring at the wound site. This platform emulates the native epidermal mechanics and physical extracellular matrix architecture for intimate bio-integration. The multiple biosensor array can continuously examine inflammatory biomarker such as lactate, glucose, pH, oxygen, and wound temperature that correlates to the wound healing status. Additionally, a heating element was incorporated to maintain the optimal thermal conditions at the wound bed. The e-ECM electrochemical biosensors were tested in vitro, within phosphate-buffered saline, and ex vivo, within wound exudate. The "smart" wound bandage combines biocompatible materials, treatments, and monitoring modalities on a microfibrous platform for complex wound dynamic control and analysis.

Photonic Hydrogels for Synergistic Visual Bacterial Detection and On-Site Photothermal Disinfection.

Rapid and sensitive diagnostics in the early stage of bacterial infection and immediate treatment play critical roles in the control of infectious diseases. However, it remains challenging to develop integrated systems with both rapid detection of bacterial infection and timely on-demand disinfection ability. Herein, we demonstrate a photonic hydrogel platform integrating visual diagnosis and on-site photothermal disinfection by incorporating Fe3O4@C nanoparticles into a poly(hydroxyethyl methacrylate)-co-polyacrylamide (PHEMA-co-PAAm) matrix. In vitro experiments demonstrate that such a hydrogel can respond to pH variation caused by bacterial metabolism and generate the corresponding color changes to realize naked-eye observation. Meanwhile, its excellent photothermal conversion ability enables it to effectively kill bacteria by destroying cell membranes under near-infrared irradiation. Moreover, the pigskin infection wound model also verifies the bacterial detection performance and disinfection ability of the hydrogel in vivo. Our strategy demonstrates a new approach for visual diagnosis and treatment of bacterial infections.

Wearable electronics for skin wound monitoring and healing.

Wound healing is one of the most complex processes in the human body, supported by many cellular events that are tightly coordinated to repair the wound efficiently. Chronic wounds have potentially life-threatening consequences. Traditional wound dressings come in direct contact with wounds to help them heal and avoid further complications. However, traditional wound dressings have some limitations. These dressings do not provide real-time information on wound conditions, leading clinicians to miss the best time for adjusting treatment. Moreover, the current diagnosis of wounds is relatively subjective. Wearable electronics have become a unique platform to potentially monitor wound conditions in a continuous manner accurately and even to serve as accelerated healing vehicles. In this review, we briefly discuss the wound status with some objective parameters/biomarkers influencing wound healing, followed by the presentation of various novel wearable devices used for monitoring wounds and accelerating wound healing. We further summarize the associated device working principles. This review concludes by highlighting some major challenges in wearable devices toward wound healing that need to be addressed by the research community.

Conductive Biomaterials as Bioactive Wound Dressing for Wound Healing and Skin Tissue Engineering.

Conductive biomaterials based on conductive polymers, carbon nanomaterials, or conductive inorganic nanomaterials demonstrate great potential in wound healing and skin tissue engineering, owing to the similar conductivity to human skin, good antioxidant and antibacterial activities, electrically controlled drug delivery, and photothermal effect. However, a review highlights the design and application of conductive biomaterials for wound healing and skin tissue engineering is lacking. In this review, the design and fabrication methods of conductive biomaterials with various structural forms including film, nanofiber, membrane, hydrogel, sponge, foam, and acellular dermal matrix for applications in wound healing and skin tissue engineering and the corresponding mechanism in promoting the healing process were summarized. The approaches that conductive biomaterials realize their great value in healing wounds via three main strategies (electrotherapy, wound dressing, and wound assessment) were reviewed. The application of conductive biomaterials as wound dressing when facing different wounds including acute wound and chronic wound (infected wound and diabetic wound) and for wound monitoring is discussed in detail. The challenges and perspectives in designing and developing multifunctional conductive biomaterials are proposed as well.

Integrated Multiplex Sensing Bandage for In Situ Monitoring of Early Infected Wounds.

Infection, the most common complication of chronic wounds, has placed tremendous burden on patients and society. Existing care strategies could hardly reflect in situ wound status, resulting in overly aggressive or conservative therapeutic options. Multiplexed tracking of wound markers to obtain diagnostic information in a more accurate way is highly promising and in great demand for the emerging development of personalized medicine. Here, an integrated multiplex sensing bandage (MSB) system, including a multiplex sensor array (MSA), a corresponding flexible circuit, and a mobile application, was developed for real-time monitoring of sodium, potassium, calcium, pH, uric acid, and temperature indicators in the wound site to provide a quantitative diagnostic basis. The MSB was optimized for wound-oriented management applications, which exhibits a broad linear response, excellent selectivity, temporal stability, mechanical stability, reproducibility, and reliable signal transmission performance on the aforementioned physiological indicators. The results of in vivo experiments demonstrate that the MSA is capable of real-time monitoring of actual wounds as well as early prediction of infection. The results ultimately point to the potential clinical applicability of the MSB, which might benefit the quantifications of the complexity and diversity of the wound healing process. This work provides a unique strategy that holds promise for broad application in optimizing wound management and even coping with other diseases.

An Integrated Smart Sensor Dressing for Real-Time Wound Microenvironment Monitoring and Promoting Angiogenesis and Wound Healing.

Prolonged chronic wound healing not only places great stress on patients but also increase the health care burden. Fortunately, the emergence of tissue-engineered dressings has provided a potential solution for these patients. Recently, the relationship between the wound microenvironment and wound healing has been gradually clarified. Therefore, the state of wounds can be roughly ascertained by monitoring the microenvironment in real time. Here, we designed a three-layer integrated smart dressing, including a biomimetic nanofibre membrane, microenvironment sensor and ß-cyclodextrin-containing gelatine methacryloyl (GelMA + ß-cd) UV-crosslinked hydrogel. The hydrogel helped increase the expression of vascular endothelial growth factor (VEGF) through hypoxia-inducible factor-1α (HIF-1α) to promote neovascularization and wound healing. The microenvironment sensor, combined with the biological dressings, exhibited satisfactory measurement accuracy, stability, durability and biocompatibility. A BLE4.0 antenna was used to receive, display and upload wound microenvironment data in real time. Such integrated smart dressings can not only achieve biological functions but also monitor changes in the wound microenvironment in real time. These dressings can overcome the challenge of not knowing the state of the wound during the healing process and provide support for clinical work.