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.

Prevención y promoción de la salud de heridas mediante el uso ambulatorio de la termografía portátil. Estudio piloto / Prevention and promotion of wound health through the ambulatory use of portable thermography. Pilot study

Introducción y objetivo: Las heridas crónicas requieren seguimiento continuo para evaluación y prevención de complicaciones. Esta evaluación es subjetiva, sujeta a errores y consume mucho tiempo y dinero para pacientes y salud pública. Proponemos utilizar modelos tridimensionales y termográficos que complementan la evaluación de heridas. Material y método: Estudio piloto en 6 casos en donde se propone la creación de modelos tridimensionales termográficos a partir de imágenes obtenidas con dispositivos portátiles de bajo costo. Resultados: Muestran patrones de diferencias de temperaturas que parecen relacionarse con el comportamiento del área de esta herida. Conclusiones: Observamos la utilidad de una herramienta de visualización de bajo costo e indicadores objetivos cuantitativos y cualitativos de la evolución de heridas, así como la posibilidad de realizar la monitorización en zonas remotas en donde hay falta de especialistas, ya que al proveer métricas, ayudaría en su seguimiento y evaluación.(AU)

Background and objective: Chronic wounds require regular monitoring for evaluation and prevention of complications. Such assessment remains subjective, prone to error, and it is often a time-consuming and costly process for patients and public health. We propose to use three-dimensional thermographic models that can complement wound assessment. Methods: A pilot study in 6 participants where three-dimensional thermographic models were created from images obtained with low-cost portable devices. Results: The results show patterns of temperature differences that seem to be related to the behavior of the wound area. Conclusions: We observe its usefulness in providing a low-cost visualization tool and objective quantitative and qualitative indicators of the evolution of wounds, as well as the possibility of monitoring in remote areas where there is a lack of specialists, since by providing metrics, it would help in their monitoring and evaluation.(AU)

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.

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.

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.

Thin-Film Flexible Wireless Pressure Sensor for Continuous Pressure Monitoring in Medical Applications.

Physiological pressure measurement is one of the most common applications of sensors in healthcare. Particularly, continuous pressure monitoring provides key information for early diagnosis, patient-specific treatment, and preventive healthcare. This paper presents a thin-film flexible wireless pressure sensor for continuous pressure measurement in a wide range of medical applications but mainly focused on interface pressure monitoring during compression therapy to treat venous insufficiency. The sensor is based on a pressure-dependent capacitor (C) and printed inductive coil (L) that form an inductor-capacitor (LC) resonant circuit. A matched reader coil provides an excellent coupling at the fundamental resonance frequency of the sensor. Considering varying requirements of venous ulceration, two versions of the sensor, with different sizes, were finalized after design parameter optimization and fabricated using a cost-effective and simple etching method. A test setup consisting of a glass pressure chamber and a vacuum pump was developed to test and characterize the response of the sensors. Both sensors were tested for a narrow range (0-100 mmHg) and a wide range (0-300 mmHg) to cover most of the physiological pressure measurement applications. Both sensors showed good linearity with high sensitivity in the lower pressure range <100 mmHg, providing a wireless monitoring platform for compression therapy in venous ulceration.

'Smart' wound dressings for advanced wound care: a review.

Hard-to-heal wounds are a common side-effect of diabetes, obesity, pressure ulcers and age-related vascular diseases, the incidences of which are growing worldwide. The increasing financial burden of hard-to-heal wounds on global health services has provoked technological research into improving wound diagnostics and therapeutics via 'smart' dressings, within which elements such as microelectronic sensors, microprocessors and wireless communication radios are embedded. This review highlights the progress being made by research groups worldwide in producing 'smart' wound device prototypes. Significant advances have been made, for example, flexible substrates have replaced rigid circuit boards, sensors have been printed on commercial wound dressing materials and wireless communication has been demonstrated. Challenges remain, however, in the areas of power supply, disposability, low-profile components, multiparametric sensing and seamless device integration in commercial wound dressings.

A mobile app for postoperative wound care after arthroplasty: Ease of use and perceived usefulness.

BACKGROUND: Early postoperative discharge after joint arthroplasty may lead to decreased wound monitoring. A mobile woundcare app with an integrated algorithm to detect complications may lead to improved monitoring and earlier treatment of complications. In this study, the ease of use and perceived usefulness of such a mobile app was investigated. OBJECTIVE: Primary objective was to investigate the ease of use and perceived usefulness of using a woundcare app. Secondary objectives were the number of alerts created, the amount of days the app was actually used and patient-reported wound infection. METHODS: Patients that received a joint arthroplasty were enrolled in a prospective cohort study. During 30 postoperative days, patients scored their surgical wound by daily answering of questions in the app. An inbuilt algorithm advised patients to contact their treating physician if needed. On day 15 and day 30, additional questionnaires in the app investigated ease of use and perceived usefulness. RESULTS: Sixty-nine patients were included. Median age was 68 years. Forty-one patients (59.4%) used the app until day 30. Mean grade for ease of use (on a Likert-scale of 1-5) were 4.2 on day 15 and 4.2 on day 30; grades for perceived usefulness were 4.1 on day 15 and 4.0 on day 30. Out of 1317 days of app use, an alert was sent to patients on 29 days (2.2%). Concordance between patient-reported outcome and physician-reported outcome was 80%. CONCLUSIONS: Introduction of a woundcare app with an alert communication on possible wound problems resulted in a high perceived usefulness and ease of use. Future studies will focus on validation of the algorithm and the association between postoperative wound leakage and the incidence of prosthetic joint infection.

Perspective review of optical imaging in welfare assessment in animal-based research.

To refine animal research, vital signs, activity, stress, and pain must be monitored. In chronic studies, some measures can be assessed using telemetry sensors. Although this methodology provides high-precision data, an initial surgery for device implantation is necessary, potentially leading to stress, wound infections, and restriction of motion. Recently, camera systems have been adapted for animal research. We give an overview of parameters that can be assessed using imaging in the visible, near-infrared, and thermal spectrum of light. It focuses on heart activity, respiration, oxygen saturation, and motion, as well as on wound analysis. For each parameter, we offer recommendations on the minimum technical requirements of appropriate systems, regions of interest, and light conditions, among others. In general, these systems demonstrate great performance. For heart and respiratory rate, the error was <4 beats / min and 5 breaths/min. Furthermore, the systems are capable of tracking animals during different behavioral tasks. Finally, studies indicate that inhomogeneous temperature distribution around wounds might be an indicator of (pending) infections. In sum, camera-based techniques have several applications in animal research. As vital parameters are currently only assessed in sedated animals, the next step should be the integration of these modalities in home-cage monitoring.

Bioimpedance Sensor Array for Long-Term Monitoring of Wound Healing from Beneath the Primary Dressings and Controlled Formation of H2O2 Using Low-Intensity Direct Current.

Chronic wounds impose a significant financial burden for the healthcare system. Currently, assessment and monitoring of hard-to-heal wounds are often based on visual means and measuring the size of the wound. The primary wound dressings must be removed before assessment can be done. We have developed a quasi-monopolar bioimpedance-measurement-based method and a measurement system to determine the status of wound healing. The objective of this study was to demonstrate that with an appropriate setup, long-term monitoring of wound healing from beneath the primary dressings is feasible. The developed multielectrode sensor array was applied on the wound area and left under the primary dressings for 142 h. The impedance of the wounds and the surrounding intact skin area was measured regularly during the study at 150 Hz, 300 Hz, 1 kHz, and 5 kHz frequencies. At the end of the follow-up period, the wound impedance had reached the impedance of the intact skin at the higher frequencies and increased significantly at the lowest frequencies. The measurement frequency affected the measurement sensitivity in wound monitoring. The skin impedance remained stable over the measurement period. The sensor array also enabled the administration of periodical low-intensity direct current (LIDC) stimulation in order to create an antimicrobial environment across the wound area via the controlled formation of hydrogen peroxide (H2O2).