Key Takeaways & Executive Findings
- •• • CMC-PDBI dressing exhibits pH-triggered color change from orange (pH 6.0) to green (pH 6.5–7.5) to blue (pH 8.0), with no visible dye leaching, enabling visual infection detection. • • In a murine model, the dressing turned green within 24 h post-infection, preceding symptom manifestation and rise in CBC inflammatory markers, allowing early intervention. • • Early antimicrobial therapy guided by CMC-PDBI significantly accelerated wound closure and suppressed inflammation, demonstrating clinical utility. • • The smartphone app InfectSense provides a clear assessment of wound infection risk, lowering the diagnostic threshold for clinicians and home caregivers.
Abstract
Cutaneous wound infections affect millions of patients annually worldwide, and early diagnosis is critical for timely anti-infection treatment. Bacterial infections alter wound pH, offering a promising diagnostic approach. Here, a diagnostic smart dressing (CMC-PDBI) is developed by ultraviolet-initiated crosslinking of a pH-responsive indicator coating, incorporating modified bromothymol blue, onto a carboxymethyl cellulose substrate. The dressing exhibits superior pH-triggered color-changing performance in both phosphate buffer solution and bacterial cultures across the pH range associated with wound infection (orange at pH 6.0, green from pH 6.5 to 7.5, blue at pH 8.0). In a murine wound infection model, CMC-PDBI indicates infection two days before symptomatic manifestation. Early therapy guided by the dressing accelerates wound healing and reduces inflammation. A smartphone application (InfectSense) assists in identifying infection risk. This work presents a novel early-warning platform for qualitative visual diagnosis of wound infections before clinical symptom onset, with high potential for clinical and home care settings.
1. Introduction
Wound infections impose a substantial burden on healthcare systems, with diabetic foot ulcers experiencing infection in 60% of cases and burn-related fatalities 75% attributable to infections. Current diagnosis relies on subjective clinical signs (swelling, erythema, purulent discharge) or swab cultures requiring 3–5 days, delaying intervention. There is an urgent need for simple, early detection methods, especially for home care settings.
This work addresses the bottleneck by developing a pH-responsive smart dressing (CMC-PDBI) that provides a visible color change in response to bacterial-induced pH alterations. The dressing enables pre-symptomatic detection of infection, guiding timely therapy and improving wound outcomes. Its integration with a smartphone app (InfectSense) offers a user-friendly platform for both clinical and home care, potentially transforming wound management.
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Shanshan Yu, Zhaoyang Chen, Xiangmei Sun, Haitao Pan, Zihao Yang, Kefeng Ren, Xiaoliang Shi, Jian Ji (2026). pH-Triggered Visible Indicator Dressing for Early Diagnosis of Bacterial Wound Infection. SCIENCE CHINA Materials. https://doi.org/10.1007/s40843-025-4052-0
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Frequently Asked Questions
What is the exact pH range for color transition and how does it correlate with wound infection?
The dressing changes from orange at pH 6.0 to green between pH 6.5 and 7.5, and blue at pH 8.0. This range aligns with the pH shift observed in infected wounds, enabling visual detection.
How early can the dressing detect infection compared to conventional methods?
In a murine model, the dressing turned green within 24 hours post-infection, two days before symptomatic manifestation, whereas conventional swab cultures require 3–5 days.
What is the clinical utility of early detection in terms of wound healing outcomes?
Early antimicrobial therapy guided by the dressing significantly accelerated wound closure and reduced inflammation, as demonstrated in a subsequent murine wound healing model.
Is there any dye leaching that could compromise safety or performance?
No visible dye leaching occurred during color transitions, indicating stable immobilization of the pH indicator on the carboxymethyl cellulose substrate.
How does the smartphone app InfectSense integrate with the dressing for infection risk assessment?
The app analyzes color changes of the dressing to provide a clear assessment of wound infection risk, facilitating decision-making for both clinicians and home caregivers.
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