CaltechAUTHORS
Published April 2025 | Version Published
Journal Article Open

A microfluidic wearable device for wound exudate management and analysis in human chronic wounds

Creators

  • 1. ROR icon California Institute of Technology
  • 2. ROR icon University of Central Florida
  • 3. ROR icon University of Southern California
  • 4. ROR icon Casa Colina Centers for Rehabilitation

Abstract

Chronic wounds are a major global health challenge associated with substantial economic burden and a negative impact on patient quality of life. Real-time analysis of biomarkers like reactive oxygen and nitrogen species could guide treatment, but existing systems lack the capacity required for continuous monitoring. Wound exudate is secreted slowly and has a complex composition, making efficient fluid collection and real-time analysis challenging. To address these issues, we introduce iCares, a wearable device for wound exudate management and continuous in situ analysis of wound biomarkers. iCares contains a flexible nanoengineered sensor array that measures reactive species such as NO, H2O2, and O2, along with pH and temperature, providing multiparameter data to inform wound status. The device features pump-free triad microfluidic modules with a superhydrophobic-superhydrophilic Janus membrane, bioinspired wedge channels, and three-dimensional graded micropillars for efficient unidirectional exudate collection, transport, and refreshing. The sensors demonstrated a consistent response and analyte selectivity in vitro and in wound exudate. iCares was designed for rapid scalable manufacturing through advanced printing and laser patterning. Wireless connectivity supported long-term continuous monitoring in wounds. The iCares system real-time monitoring was tested in a murine model of diabetic skin wound during infection and antimicrobial treatment. Clinical wound evaluation was conducted in 20 patients with chronic wounds and in two patients before and after surgery. A machine learning analysis of the multiplexed data successfully classified wounds and healing times, indicating that wound exudate analysis by iCares could offer insight into chronic wound status to aid in treatment decisions.

Copyright and License

Copyright © 2025 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Acknowledgement

We gratefully acknowledge the critical support and infrastructure provided for this work by the Kavli Nanoscience Institute at Caltech. J.M. acknowledges fellowship support from the National Institutes of Health Training grant (T32EB023858). We also acknowledge the support from the Research Institute in the Casa Colina Hospital and Centers for Healthcare in Pomona, CA. We thank the participants who contributed their time for the study. We acknowledge the support from E. R. Rosario, Director of the Research Institute at Casa Colina Hospital and Centers for Healthcare, and E. Ortega for coordinating the study.

Funding

This study was funded by the National Institutes of Health grants R01HL155815 (to W.G.), R21DK13266 (to W.G.), and R01DK124789 (to D.G.A.); National Science Foundation grants 2145802 (to W.G.) and 2052578 (to D.G.A.); American Cancer Society grant RSG-21-181-01-CTPS (to W.G.); Army Research Office grant W911NF-23-1-0041 (to W.G.); US Army Medical Research Acquisition Activity grant HT9425-24-1-0249 (to W.G.); and Heritage Medical Research Institute (to W.G.).

Conflict of Interest

W.G. is a cofounder and advisor at Persperity Health. All other authors declare that they have no competing interests.

Data Availability

All data associated with this study are present in the paper or the Supplementary Materials. All codes related to the analysis presented are available at https://doi.org/10.5281/zenodo.14773650.

Supplemental Material

  • Figs. S1 to S44, Tables S1 to S4, References (55, 56) [PDF file]
  • Data file S1 [ZIP file]
  • Movies S1 to S7 [ZIP file]
  • MDAR Reproducibility Checklist [PDF file]

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Additional details

Funding

National Institutes of Health
R01HL155815
National Institutes of Health
R21DK13266
National Institutes of Health
R01DK124789
National Science Foundation
2145802
National Science Foundation
2052578
American Cancer Society
RSG-21-181-01-CTPS
United States Army Research Office
W911NF-23-1-0041
United States Army Medical Research and Development Command
US Army Medical Research Acquisition Activity HT9425-24-1-0249

Dates

Available
2025-04-23
Published online

Caltech Custom Metadata

Caltech groups
Division of Engineering and Applied Science (EAS)
Publication Status
Published