A\nKnitted and MXenzyme-Integrated Dressing for Geriatrics\nDiagnosis and Ulcer Healing

Integrated\ndiagnostic and therapeutic dressings are desirable to\nrelieve diabetic patients who often suffer from diabetic foot ulcers\n(DFUs) and peripheral vascular diseases (PVDs). However, it is highly\ndifficult to monitor the pulse waves with fidelity under wet environments\nand connect the waveforms to diseases through a small strain sensor.\nAdditionally, immobilizing MXenzyme to regulate spatially heterogeneous\nlevels of reactive oxygen species (ROS) and applying active intervention\nto enhance ulcer healing on a single structure remain a complex task.\nTo address these issues, we designed a multiscale wearable dressing\ncomprising a knitted all-textile sensing array for quantitatively\ninvestigating the pulse wave toward PVD diagnosis. MXenzyme was loaded\nonto the dressing to provide multiple enzyme mimics for anti-inflammatory\nactivities and deliver electrical stimulation to promote wound growth.\nIn mice, we demonstrate that high and uniform expression of the vascular\nendothelial growth factor (VEGF) is observed only in the group undergoing\ndual mediation with electrical stimulation and MXenzyme. This observation\nindicates that the engineered wound dressing has the capability to\naccelerate healing in DFU. In human patient evaluations, the engineered\ndressing distinguishes vascular compliance and pulse period, enabling\nthe diagnosis of arteriosclerosis and return blockage, two typical\nPVDs. The designed and engineered multiscale dressing achieves the\npurpose of integrating diagnostic peripheral vessel health monitoring\nand ulcer healing therapeutics for satisfying the practical clinical\nrequirements of geriatric patients.