Development of a multifunctional dressing for epidermal wound monitoring and on-site drug delivery

The treatment of epidermal wounds, particularly chronic wounds, is one of the most ubiquitous medical challenges and has imposed a considerable financial burden on the global health care system. Several factors in epidermal wounds lead to severe medical conditions among which infection comprises a large number of mortalities. To tackle this issue, great efforts have been made in the last decades to incorporate antimicrobial agents into wound dressings in order to inhibit microorganism colonization. Additionally, various wound monitoring systems have been developed to detect and track infections using different indicators such as bacterial by-products. However, the integration of these infection sensors with wound dressings – most of which have benefited from electrochemical detectors – has been a major bottleneck due to the electrode failure in the wound environment and the need for electrical power supply. Other approaches have focused on the development of point-of-care devices that simplify the detection of infection. This study aims to address the aforementioned challenge by developing a multifunctional hydrogel-based wound dressing – made of alginate 1.5% (w/v) – for on-site infection monitoring via colourimetric and image processing methods. Taking advantage of wound acidity as an indicator of bacterial infection, the developed wound dressing was composed of an array of pH sensors, fabricated by 3-dimensional (3D) bioprinting. Brilliant Yellow and cabbage juice as two pH-responsive dyes were immobilized in the pH sensors to facilitate a wireless wound monitoring. In this system, Brilliant Yellow afforded a higher accuracy in image processing while cabbage juice provided a better visual observation of the wound condition. The functionality of the developed dressing in detecting bacterial infection was evaluated via an ex-vivo test on pig skin samples, infected by Pseudomonas aeruginosa, and the presence of bacteria was detected within 30 minutes after the placement of the dressings on the skin samples. Moreover, the inclusion of gentamicin-loaded components into the wound dressing facilitated the inhibition of bacterial growth, which was evaluated in vitro on the same strain of bacteria. In this experiment, 2 mg/ml of gentamicin in the hydrogel led to the eradication of P. aeruginosa. This incorporation of antibiotic delivery along with the simple colourimetric infection detection holds a great promise for managing acute and chronic wounds by inhibition of bacterial growth and monitoring infection in real-time without a need for dressing removal.