Closed-loop theranostic hydrogel-electronics patch for chronic wound management

Chronic diabetic wounds present a significant clinical challenge due to antibiotic abuse and limited understanding of the wound microenvironment. Real-time monitoring of key biomarkers in the wound microenvironment can provide critical insights into wound status and guide therapeutic interventions. In this study, we developed an intelligent wound patch by integrating a near-infrared (NIR)-responsive photothermal antibiotic-releasing hydrogel (PPQTA) with a multichannel electrochemical biosensor array, which takes sensor monitoring-guided precise drug administration as its core. The sensing module can continuously monitor the key biomarkers in the wound in situ with high sensitivity and strong anti-interference capability within the physiological range (pH: 4–9; uric acid: 0–700 μM; glucose: 5–30 mM), providing a quantitative basis for drug release. The PPQTA hydrogel can release drugs on demand via NIR irradiation based on the sensing results, achieving 100% antibacterial efficacy against both Gram-negative and Gram-positive bacteria. Experiments in a diabetic rat wound model confirmed that this patch can monitor the dynamic changes of biomarkers in situ and guide drug administration within 7 days. After terminating drug administration on day 4, the bacteria in the wound were effectively eliminated on day 5, and the wound healing process was significantly promoted. By combining real-time diagnostics with responsive therapy, this patch offers a closed-loop strategy for personalized management of diabetic chronic wounds.