The clinic-in-a-dressing paradigm: Synchronized diagnosis and treatment in chronic wounds via hydrogel-nanofiber matrices

Abstract

Chronic wounds, a critical global health challenge, necessitate advanced solutions to address limitations in current care, such as subjective assessments, uncontrolled drug delivery, and poor integration of diagnosis and treatment. This study introduces a "clinic-in-a-dressing" system that combines in situ pH monitoring with dual-responsive (pH/enzyme) drug delivery for chronic wound management. The system integrates hyaluronic acid (HA)-encapsulated vancomycin-loaded zeolitic imidazolate framework (HZV) nanoparticles and fluorescein isothiocyanate (FITC) into a nanofiber-reinforced hydrogel sponge. HZV nanoparticles enable targeted antibiotic release in response to wound environments, while FITC provides pH-sensitive fluorescence for non-invasive infection monitoring. In vitro assays demonstrated pH-dependent vancomycin release (90.01 % at pH 5.5), enhanced antibacterial efficacy against Staphylococcus aureus (99.99 % inhibition) and Escherichia coli (96.12 % inhibition) via synergistic Zn²⁺ and vancomycin action. In vivo evaluation using a diabetic rat model showed accelerated wound healing with 93.38 % closure by day 14, compared to the control group, with reduced bacterial colonization by 98.46 %, and improved collagen deposition. The dressing’s real-time pH monitoring capability, validated via smartphone-based fluorescence analysis, correlating RGB values with wound status (R² = 0.987), enables dynamic wound assessment. This multifunctional system bridges diagnostic accuracy and therapeutic efficacy, offering a transformative solution for personalized chronic wound management.

Statement of Significance

Wound dressings are widely used for chronic wound repair but face limitations like subjective assessments, uncontrolled drug delivery, and poor integration of diagnosis and treatment. Our study introduces a new dressing that combines in situ pH monitoring with dual-responsive drug delivery, balancing diagnosis and treatment. The dressing integrates hyaluronic acid (HA)-encapsulated vancomycin-loaded zeolitic imidazolate framework (HZV) nanoparticles and fluorescein isothiocyanate (FITC) into a nanofiber-reinforced hydrogel sponge. HZV nanoparticles enable targeted antibiotic release in response to wound environments, while FITC provides pH-sensitive fluorescence for non-invasive infection monitoring. These insights enable the design of next-generation "clinic-in-a-dressing", improving clinical outcomes in chronic wound diagnosis and treatments.