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.