Maansi Srinivasan

Background.  Chronic wounds represent a global health burden, affecting 1-2% of the population, including up to 40% of hospital beds in settings[1]. In the United States alone, approximately 8.5 million individuals are affected, with annual treatment costs exceeding $28 billion [1,2].  While most acute wounds follow a well-orchestrated healing process, failure to heal within approximately 6 weeks can result in chronic wound formation[2]. Chronic wounds, including diabetic foot ulcers, venous leg ulcers, arterial ulcers, and pressure injuries, are characterized by persistent inflammation, susceptibility to infection, and impaired angiogenesis. Current care, including debridement, dressings, and antimicrobials, is largely passive, lacks real-time monitoring, and is often ineffective against biofilms [2–4]. Adjunctive therapies like NPWT and advanced treatments (e.g., grafts, oxygen therapy) face limitations in cost and reliability[4–6]. Emerging bioelectronic technologies offer a shift toward active, responsive wound management through real-time sensing, targeted therapy, and adaptive feedback [2,7].

Objective.  In this review, we evaluate how bioelectronic interventions compare to standard wound care in improving healing outcomes and infection control in chronic wounds.

Search Methods.  A literature review was conducted using PubMed and Google Scholar. Search terms included “bioelectronics in wound care,” “smart wound therapy,” and “smart wound dressings.” Relevant peer-reviewed articles were selected based on their focus on bioelectronic components.

Results.  Bioelectronic systems demonstrated advantages over standard wound care across four domains: monitoring, material interactions, treatment, and feedback control, with overlap between categories. In monitoring, fluorescence imaging (FI) in the FLAAG trial (Serena et al.) improved detection of bacterial hotspots (>10⁴ CFU/g), achieving higher sensitivity than standard care (98.7% vs. 87.2%) [8]. FI has been integrated into several wearable systems e.g. patches, bandages (Dong et al.) [9]. Flexible dressings (Su et al.) have also achieved early infection detection (~6 hours) via continuous pH and temperature sensing under deformation [10]. For materials, Banerjee et al. showed that a non-antibiotic Ag-Zn electroceutical dressing disrupted P. aeruginosa biofilms via micro-electric fields and reactive oxygen species [11]. In direct treatment, Koh et al. demonstrated reduced healing time with wireless microcurrent stimulation (6 vs. 8 days) [12]. Finally, a smart bandage (Jiang et al.) integrated sensing with adaptive stimulation/feedback, achieving ~25% faster wound closure and enhanced tissue regeneration[13].

Conclusions.  Bioelectronics show potential to improve healing outcomes through real-time, adaptive therapy. However, challenges remain in large-scale, clinical validation. Future work should focus on AI-driven, personalized closed-loop systems and expanded clinical trials.

Work Cited

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