Caltech engineers have advanced their flexible “lab-on-skin” smart bandage from animal testing to human trials, demonstrating its potential to revolutionize chronic wound care. In a recent study published in Science Translational Medicine (DOI: 10.1126/scitranslmed.adt0882), the device was tested on 20 patients with slow-healing wounds such as diabetic foot ulcers, poor-circulation sores, and post-surgical injuries. The bandage successfully collected and analyzed fresh wound fluid, identified early signs of inflammation and infection, and wirelessly transmitted data to smartphones up to three days before visible symptoms appeared.
This marks a critical milestone in translating laboratory technology into clinical practice. The device aims to reduce the burden on healthcare providers, give earlier warning of complications, and improve outcomes for millions of patients with chronic wounds.
The smart bandage, called iCare, was developed by Caltech’s Wei Gao in collaboration with the Keck School of Medicine at the University of Southern California. It consists of a disposable patch made from a flexible, biocompatible polymer and built using low-cost, 3D-printable methods. A reusable circuit board snaps onto the patch to power its electronics and transmit data in real time.
At the heart of the system is a nano-engineered sensor array that targets two inflammation-related molecules: nitric oxide (NO) and hydrogen peroxide (H₂O₂). These molecules are known to spike in the early stages of infection. The device uses a layered microfluidic system to ensure only the freshest wound fluid reaches the sensors, avoiding contamination from older fluid.
In the clinical study, the iCare bandage consistently detected chemical changes in the wound environment before external symptoms like redness, swelling, or odor became visible. These early alerts provide clinicians with a valuable head start in managing infections and adjusting treatment strategies.
Beyond monitoring, the bandage incorporates machine-learning algorithms that analyze incoming data to predict how quickly a wound is healing. These predictions were shown to match the assessments of experienced clinicians, helping to guide decisions on debridement, antibiotic use, and care planning.
The current prototype focuses on sensing, but future versions are intended to deliver medication or electrical stimulation directly to the wound site. This would create a closed-loop system capable of detecting problems and initiating treatment autonomously, significantly reducing the need for constant clinical oversight.
Traditional wound care relies heavily on visual inspections and intermittent measurements. The iCare system replaces this episodic monitoring with continuous biochemical tracking, providing a more detailed and timely picture of wound health.
Despite its capabilities, the iCare bandage uses a straightforward design. Rather than relying on costly optical components, it employs electrochemical sensors that measure tiny currents generated when NO or H₂O₂ reacts with coated electrodes. This approach keeps the device affordable, compact, and comfortable enough to wear under clothing or inside footwear.
The machine-learning system personalizes data interpretation for each patient, recognizing meaningful changes while minimizing false alarms. This individualization enhances both accuracy and clinical relevance.
The pilot study was conducted under physician supervision, with participants continuing to receive standard care while wearing the bandage. Data was streamed via Bluetooth to a clinical dashboard, where doctors reviewed it alongside their own observations.
USC surgeon David G. Armstrong, a co-author of the study, helped integrate the technology into clinical workflows and assess its practicality in real-world settings. The team plans larger trials to evaluate outcomes such as wound closure time and hospital readmissions, essential steps for regulatory approval and widespread adoption.
Funding for the project came from a diverse group of supporters, including the National Institutes of Health, the National Science Foundation, the American Cancer Society, the Army Research Office, and the Heritage Medical Research Institute. Caltech’s Kavli Nanoscience Institute provided fabrication space for the microfluidic components.
Chronic wounds cost healthcare systems billions annually and can result in severe complications, including amputation and systemic infections. Tools like the iCare smart bandage, which detect biochemical shifts before physical symptoms appear, offer a new layer of precision in wound care. Unlike telehealth cameras or consumer wearables, this device operates at the molecular level, giving healthcare providers the insights needed to intervene earlier and more effectively.
With its combination of real-time monitoring, predictive analytics, and potential for integrated treatment, the iCare smart bandage represents a significant step forward in personalized, proactive wound management.
By Impact Lab
