INTRODUCTION:

The largest organ in the body, the skin plays a critical role in protecting the body from environmental pollutants and infections, as well as in avoiding dehydration and heat stress. The injury is a component of the skin tissue that can develop as a result of physical harm from everyday activities, disease, prolonged exposure to high loads, burns, and traumatic experiences. Underlying conditions like diabetes and ischemia can alter the characteristics of the skin and make it more susceptible to physical influences. When a wound interferes with the healing processes, can't recover completely and naturally (such as pressure injuries and diabetic foot ulcers), and does not heal after 30 days, it is considered to be chronic. Persistent, uncontrolled inflammation, impaired extracellular matrix (ECM) activity, and slow or poor wound healing are all characteristics of chronic wounds.¹ Chronic wounds, such as diabetic foot ulcers, venous leg ulcers, and pressure ulcers, are primarily defined as wounds that have a 60% to 70% chance of recurring and cannot be treated for longer than three months. Furthermore, because they are readily colonized by a range of bacteria from the surrounding environment, which ultimately results in the creation of biofilms, prolonged open wounds are susceptible to infection.⁶

Chronic diseases like diabetes or immunosuppression can hinder the body's natural healing process and cause complications like infection and delayed healing. They can also raise the risk of developing a number of other diseases that are brought on by macrovascular and microvascular damage, which can negatively impact the brain, kidneys, heart, and eyes, among other organs.² Chronic wounds can afflict people of any age, although they are more common in elderly patients and those with underlying medical conditions.¹

Necrosis, sepsis, and even death may result from a microbial infection at the wound site, which can also significantly slow the healing process. Electrical stimulation may have profound impacts on the wound healing process as an alternative therapeutic approach. These effects include promoting collagen formation, fibroblast proliferation and differentiation into myofibroblasts, keratinocyte migration, angiogenesis, and drawing in macrophages.³

Skin Repair Mechanisms:

Generally speaking, wound healing occurs in four stages: hemostasis, inflammation, proliferation, and maturation. The stage of hemostasis is when the body's quick reaction to damage, in which platelets aid in the formation of a hemostatic plug to stop bleeding. When blood arteries narrow, platelets come into contact with exposed collagen and release their granules, which causes the platelets to become more active and aggregate. This causes a temporary fibrin matrix to be deposited inside the wound along with the coagulation cascade being activated. Numerous cytokines, such as transforming growth factor-β (TGF-β) and platelet-derived growth factor, are released as a result of platelet activation during hemostasis. These cytokines encourage neutrophil and macrophage chemotaxis, which initiates the inflammatory phase. Among the first cells to emerge acutely are neutrophils.⁵ Vascular permeability rises during the inflammatory stage, making it possible for immune cells, nutrients, and enzymes to get to the site of damage. Inflammatory cells that circulate clear the wound site of germs and damaged cells.⁴ These procedures aid in reducing harm, sealing the wound, getting rid of bacteria and debris, and promoting cell migration.⁷ Granulation tissue forms and the skin's integrity is restored during the proliferation stage, enabling the skin to function as a barrier once more. The stage of tissue maturation is when granulation tissue turns into scar tissue, the vascular network degenerates, and collagen and extracellular matrix undergo significant replacement and remodeling.⁴ After a few days or weeks, the tissue remodeling, proliferation, and inflammatory phase usually comes to an end.But if the inflammation lasts for months or years, chronic wounds may form and may take more than a year to close.¹ Chronic wounds can develop if any of these mechanisms are disrupted, which can cause delayed healing, frequently during the inflammatory phase.⁸

Why Smart Bandages Matter in Wound Care:

Different etiologies lead to different signs of chronic wounds. Chronic wounds can be categorized into three primary groups considering their molecular and clinical diversity: pressure ulcers (PUs), diabetic foot ulcers (DFUs), and venous leg ulcers (VLUs). Numerous dressings have been created that are recommended for particular kinds of chronic wounds depending on the wound's characteristics, such as whether it is clean or infected, dry or oozing, superficial or deep. These dressings come with a number of restrictions.⁹ The rapid development of flexible electronics has led to the emergence of smart bandages with integrated flexible electronics as a creative solution to this problem. The flexible patch with physiological sensors may fully cling to the skin in order to gather wound physiological indicators. These signs would subsequently form the basis of the treatment. Although a number of physiological indicators are linked to the condition of the wound, the majority are hard to find and only appear in trace levels.⁶

Smart Bandage Technologies

Sensors embedded into smart bandages provide real-time monitoring and wound diagnosis. Temperature, pH, moisture content, and the presence of certain bacteria or biomarkers are just a few of the variables that these bandages' sensors can measure.This information can be used by medical personnel to evaluate the wound's healing and decide whether further care is required. Smart bandages offer more accurate and unbiased information regarding the wound than conventional techniques that depend on subjective evaluations and visual inspection.¹

pH:

In order to inhibit bacterial growth, healthy human skin has a pH between 4-6, which is slightly acidic. When a wound forms, the acidic environment of the skin is disrupted. Since pH has a significant impact on wound healing, measuring a wound's pH can assist detect chronic wounds early on. Wound fluids or exudate can be used to determine the pH of the wound, and fluctuations in pH can serve as a marker of the distinct phases of wound healing. Acute wounds typically have a pH between 5 and 6, which is slightly acidic like healthy skin. However, because to bacterial growth, chronic wounds typically have a basic pH between 7 and 9.¹⁰

The pH of a wound's discharge varies with the healing process and has a significant role in the biochemical reactions that take place. Carbon quantum dots (CQDs) are a luminous nanomaterial that scientists have developed that can identify variations in the pH levels of wounds. The carboxyl or amino groups on the surface of the CQDs cause fluctuations in fluorescence intensity in response to pH changes.¹

The pH of wound fluid is recognized as a significant biomarker of wound condition and is known to impact wound healing.¹⁴

Fig 1: A smart bandage that can wirelessly send data to a smartphone to track wound healing by detecting pH changes at the wound site is shown in this illustration ¹²

Temperature :

Like pH sensors, electrochemical temperature sensors and flexible colorimetric sensors have found extensive use in biomedical applications.⁹ Temperature measurements at the wound site can reveal details about local blood flow, wound infection, and the healing process. A persistent rise in temperature of at least 1.11 °C can also be a sign of bacterial infection and alterations in metabolic activity, while elevated temperature is linked to the inflammatory stage. A drop in temperature at the wound site may be a sign of partial ischemia, which could impede the healing process.¹⁰

Fig 2: Schematic of a smart bandage with integrated pH sensors, heater/thermometer, and thermally activated drug-releasing microbeads for real-time monitoring and targeted treatment.¹³

Oxygen:

Collagen deposition, epithelialization, fibroplasia, angiogenesis, infection resistance, and other processes all depend on it. Tissue hypoxia, which results from a lack of oxygen, prolongs the healing process of wounds. During extended inflammation, the partial pressure of oxygen in non-healing/chronic wound exudate ranges from 5 to 20 mmHg, while in healthy tissues, it is approximately 30 to 50 mmHg.¹⁰

The primary function of oxygen is to take part in aerobic respiration, which oxidizes nutrients to produce ATP, which is needed for a number of physiological functions, including transmembrane transport, signal transduction, and cell survival, proliferation, migration, and differentiation. Tissue cells will undergo metabolic reprogramming, also referred to as the "Warburg Effect," when oxygen levels are low. This alters the anaerobic respiration mode, leading to ineffective nutrition utilization and metabolic acidosis from lactic acid buildup. Furthermore, cells will immediately experience necrosis, apoptosis, or autophagy in the event of severe and prolonged hypoxia.¹¹

Moisture:

The healing process is slowed down by a dry or extremely moist wound. Cell growth is not possible in dry wounds. To promote wound healing, cells require a suitable wet environment in which to grow, divide, and move. As a result, dry wounds heal more slowly and reach the remodeling stage. Excessive wetness may raise the risk of bacterial infection, but it also hinders wound healing since certain bacterial species thrive in moist environments.¹⁰

Table 1. Advantages and Disadvantages of the Main Bandages on the Market.¹⁶

Bandage Type	Advantages	Disadvantages	Highlights for Manufacturing
Gauzes	· Highly absorbent · Surface compatibility · Economical	· Fiber and particulate loss · Bacteria contamination · Discomfort in dry-state removal	Excellent for holding sensors in place at any interface of the body. The fluid that is absorbed or evaporated from the bandage may alter its structure. Widely used and very economical
Hydro-conductive	· No removal discomfort · Rapid removal of exudate and impurities	· High frequency of replacement	Excellent absorption for biochemical sensors. It is a costly solution for mass production due to the frequency of replacement.
Foam	• Highly absorbent • If the surface is clean, it can be used for extended periods of time. • Allows gas exchange • Thermal management through insulating	• High frequency of replacement for infected wounds • Tendency to swell and create air pockets between wound bed and bandage • Wound maceration	Excellent for both biophysical and biochemical sensors. Absorption causes little to no structural changes (depending on foam density). Needs a sticky layer to remove motion-related artifacts.
Hydrogel	• No removal discomfort • Allows gas exchange • Keeps a moist environment • Thermal management through cooling	• Not a good barrier for external impurities • High frequency of replacement for infected wounds • Secondary dressing required	Not very economical due to secondary dressings and manufacturing costs. It is a great foundation for biochemical sensors because of its excellent absorption and lack of drastic structural alterations.
Hydrocolloid	• Highly absorbent • The barrier to external impurities • Keeps a moist environment	• Not suitable for infected wounds • Discomfort and possible trauma during removal	Excellent absorption but with extreme structural transformations as a result.
Transparent Film	• No removal discomfort • The barrier to external impurities • Keeps a moist environment • Easy application • Allows gas exchange	• Not suitable for infected wounds • Not absorbent	Good structural consistency for biophysical sensors. Excellent conformity to the epidermis layer. Proven mass production process with a clear scale-up process.

FURTHER PERSPECTIVES:

The lack of conventional wound care techniques has prompted the creation of next-generation smart wound dressings, which can assist medical professionals in making prompt and precise treatment decisions to impede tissue repair by better understanding the true state of the wound during the healing process. In order to accomplish remote real-time monitoring, early wound status diagnosis, and prompt on-demand drug treatment, wearable sensors that track wound-related biomarkers, wireless transmission techniques, and sophisticated drug delivery systems can all be integrated into a single wound dressing.¹⁵

CONCLUSION:

Chronic wound care is still a difficult clinical problem. With their integrated sensors and sophisticated delivery systems, smart bandages are revolutionizing wound care by facilitating real-time, continuous, non-invasive monitoring of vital physiological indicators. They lessen reliance on traditional frequent dressing changes, enable individualized treatment, and offer early diagnosis of problems. Smart bandages have the potential to enhance overall patient outcomes, reduce infections, and speed up healing by addressing the drawbacks of conventional wound care. To guarantee wider clinical use and improved accessibility of these cutting-edge wound treatment systems, future research should concentrate on enhancing sensor sensitivity, biocompatibility, and cost-effectiveness.

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Received on 09.01.2026 Revised on 27.02.2026

Accepted on 10.04.2026 Published on 24.06.2026

Available online from June 30, 2026

International Journal of Technology. 2026; 16(1):73-77.

DOI: 10.52711/2231-3915.2026.00009

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.