Smart wound management with sustainable pH sensing and dynamic electrotherapy.

Smart wound management remains a significant challenge, necessitating real-time monitoring and dynamic treatment. Herein, an innovative multifunctional Janus dressing is designed to enable sustainable pH sensing, and provide dynamic drug delivery and electrical therapy at infected wounds. Specifically, the hydrophilic side is a pH-sensing layer with phenol red grafted onto amino-modified poly (2-hydroxyethyl methacrylate) via Mannich reaction, while the hydrophobic side contains drug-loaded piezoelectric particles semi-embedded in a polydimethylsiloxane matrix for therapeutic delivery. The dressing exhibits high flexibility (156 % elongation), strong water absorption (123 %), rapid pH sensing (∼1.5 min), and controllable piezoelectricity. Upon application, wound exudates are autonomously pumped through micropores to the hydrophilic layer, signaling infection, triggering drug release and "high electric field" treatment via external ultrasound, achieving an antibacterial treatment with a rate of up to 97.5 %. Following antimicrobial treatment, natural body movements and skin tension exert mechanical loading on the dressing, facilitating self-powered "low electric field" stimulation for tissue repair. The smart wound management effectively detects wound infection and delivers dynamic, adaptive electrotherapy, reducing inflammatory responses, accelerating collagen deposition, and enhancing tissue regeneration. This study presents a promising approach for advancing integrated wound dressings that unify diagnosis and therapy. STATEMENT OF SIGNIFICANCE: A multifunctional Janus dressing was developed to benefit sustainable pH sensing, and enable drug delivery alongside dynamic electrotherapy. Upon application, wound exudate was automatically drawn through micropores into the hydrophilic layer, triggering the release of an infection signal that initiates drug release. Subsequently, antibacterial treatment was administered via a high electric field facilitated by external ultrasound. Following antibacterial therapy, a self-powered low electric field promoted tissue regeneration. The dressing exhibited 156 % elongation, 123 % water absorption, and a rapid pH response (∼1.5 min). Both in vitro and in vivo studies demonstrated that this strategy significantly accelerated wound healing, establishing a smart system for personalized wound management.