Bioactive Self-Adaptive Hydrogel Platform for Integrated Electrical Stimulation Therapy and Clinical Monitoring of Postoperative Wound

Postoperative wound management remains clinically challenging due to delayed healing, subcutaneous infections, and the absence of systems capable of real-time therapeutic and diagnostic integration. Addressing this need, we developed a bioactive, self-adaptive hydrogel platform that combines electrical stimulation (ES) therapy with resistance-based bioelectronic sensing for personalized postoperative wound care. The hydrogel is constructed from dynamic borate ester-cross-linked poly(vinyl alcohol) (PVA), with wool keratin for hemostasis and tissue remodeling and tannic acid for adhesion, antioxidative protection, and enhanced biocompatibility. This composition imparts excellent stretchability, self-healing ability, and conformal adaptability to irregular wound sites. Upon application, the platform delivers uniform ES to promote angiogenesis and re-epithelialization, achieving a 99.96% wound closure rate <i>in vivo</i> by day 14. Simultaneously, the system enables noninvasive clinical monitoring by capturing resistance signals that reflect healing status. Actively recovering wounds exhibited relative resistance changes of approximately 200% compared with the preoperative skin condition, while infected sites with subcutaneous abscesses showed reductions to less than 50% of the preoperative skin values. Fully healed tissues, measured 3 weeks post discharge, displayed resistance levels nearly identical to the preoperative skin condition. These findings validate the platform's dual therapeutic and sensing capabilities and demonstrate its translational potential for smart, data-driven postoperative wound care.