On the basis transduction systems, wearable pH sensors are becoming the applied form in real world applications based on the following techniques:
4.1. Wearable pH sensors in real life applications
The evolutionary phases in computer technology have served the scientific community to develop algorithmic tools and analyze them in various fields. The computational toolboxes have started a new era of interdisciplinary sciences and gave rise to internet-of-things (IoT) to explore innovative designs and applications. Thus, the synergy of material science and bio-electronics has played a vital role to address the diverse problems in healthcare applications by interlinking the blend of enabling technologies, providing integrated platforms to foreseen wearable devices in POC systems. In the current era, wearable-technologies are revolutionizing biochemical sensors design and remarkably, more in applied form to better help and manage biomedical applications [
16,
17,
18,
36,
38,
113,
114,
115,
116,
117,
118]. A comprehensive overview is provided somewhere else describing the latest updates regarding the advances in wearable pH sensors
. Of them, wound management is becoming clinically an exciting area, and wearable technology is promising to provide cutting-edge solutions in clinical diagnostics and surgical wounds by exploiting various physical, chemical and biological sensors [
42,
119,
120]
.
Wound management is another clinical complication growing fast world-wide. Monitoring of wounds by means of elevated levels of various indicators, including temperature (T), pH, uric acid (UA), and ammonium in wound exudate provide very useful information that can be translated to understand wound physiology to deal with it more professionally. Thanks to IoT in the biomedical field, this has been providing more sophisticated and wirelessly distant platform to manage biological complications very effectively. Additionally, the developed systems also performed combinative therapies by means of controlled drug release as well as produced electrical pulses for tissue regeneration in the wound area [
42,
43,
44,
45,
46]. In this regard,
Figure 9 depicts an NFC-enabled smart bioelectronics platform consisting interdisciplinary capabilities, including temperature and pH sensing, drug delivery, acquisition of results, and most importantly, the device was wirelessly powered, wound dressing, multiple sensors and antibiotic coated on polypyrrole (PPy) substrate [
44]. While bottom of the system containing polyimide substrate with fabrication and integration of disposable Conductive pads were provided to electrically connect the both layers. All the data regarding change in pH, uric acid, temperature, and infected wound were successfully recorded and wirelessly transmitted and translated by smartphone for analysis. The all-in-one design provided satisfactory outcomes for wound management in terms of drug delivery and sensing various parameters.
Similarly,
Figure 10 (A) depicts the construction of smart bandage comprising various compartments such as pH and temperature sensors, microheater, hydrogel patch encapsulating drug, and IoT to read the data and treat the wound [
45]. Here, PANI led to potential output used for further pH translation. The entire system was embedded in bandage, where the sensing and thermo-responsive drug delivery data were obtained via the wireless module in electronic patch. Other parameters, such thermoresponse, drug release, pH and temperature measurements were performed (B-D), where the responses were up to the mark.
Ehsan Shirzaei et al. [
46] developed another smart wearable system to treat and monitor the wound with the help of an integrated multimodal sensor array as shown in
Figure 11. The smart wearable patch was comprehensively evaluated for the monitoring of metabolic indicators and antibacterial/ inflammatory activities. with carbon composite constructed as positive exchange membrane while provided. Furthermore, the physical parameters such as mechanical flexibility, stretchability, and adherence to the skin wound were tested in a rodent model, demonstrating that the bioelectronics patch is fully biocompatible and a valuable addition in cutting-edge chronic wound management.
Other than detection, pH responsive hydrogels employed in wound dressings also show a great promise in wound management and regeneration. Because, hydrogels are bioactive materials that encapsulate antimicrobial agents to promote wound healing subjected to pH variations. pH-controlled environment is responsible for antibacterial activities of hydrogel materials by releasing drug to kills proliferated bacteria [
121].
Sweat – is believed to be very useful biological matrix to obtain physiological information and pH is an important parameter to be monitored in sweat [
47]. Therefore, wearable technology is rapidly adoptable area due to its promising features in sports health, healthcare and diagnostic applications. From last few years, enormous research is presented in healthcare to target pH along with some other vital parameters to monitor health indications [
39,
40,
41]. For instance, Yitian Tang et al. [
41] proposed organic materials – free pH wearable sensor-based on WO
3 as an active material. They discovered and exploited the intercalation phenomenon between lattice H
+ ions and WO
3, which increased the ion-exchange capacity due to the monoclinic to cubic phasal
.transitions. This phenomenon was further translated as pH measuring matrix. The typical electrochromic process led to the reduction of W
6+ to W
5+ subjected to the protons insertion, which turned WO
3 into cubic hydrogen tungsten bronze (HxWO
3), causing to increase in conductivity as well.
Then, HxWO
3-based sensing matrix was used to fabricate miniaturized electrode and used as wearable sweat pH monitoring (
Figure 12). As shown, the HxWO
3-based matrix produced revocable pH responses vs. time in the pH range of ~ 1 to 11, where the electromotive force (EMF) signal decreased with the increase in pH values as WO
3 is dependent on the double injection/extraction of electrons and proton to the structure. The developed sensor showed an excellent behavior towards pH sensing, when used in wearable configurations [
41]
.
Composites of organic – inorganic materials are also a fruitful substrate choice for such modes of technology, where, textile chemical sensing is another wearable beneficiary in healthcare industry by collecting the vital parameters [
122]. IrOx-based composites have been explored in many studies, because these NMs composites possess a high sensitivity to pH in terms of their electrochemistry. Moreover, PANI is used as positive exchange membrane for pH sensitive applications and thus, it provides sufficient analytical performance when composited with metal/metal-oxides. For instance, Federica and colleagues developed smart bandages for the real-time monitoring of wound pH, correlating it with the wound-healing[
123]. They fabricated two-terminal pH-sensing devices with the help of polymer and IrO
2 NPs, then integrating with the absorbent layer to ensure the continuous delivery of wound exudate flow across the sensor area. Potentiometric transduction against an open-circuit potential (OCP) provided a satisfactory data of 59 ± 4 μA pH
−1. In further evaluations, it was found that there was a peak potential shift in Ir
-III/Ir
-IV redox couple, responsibly enabling the sensor for pH transduction. Later, they developed a two terminal solid-state electrode to elaborate the pH sensing mechanism. BY utilizing IrOx/ PEDOT:PSS electrochemistry, as acidic environment promoted the reduction of Ir
-IV sites to Ir
-III, causing the associated withdrawal of electrons from the PEDOT:PSS film, leading to current flow across the film. Thus, sensing layer was embedded in absorbent layer to construct a wound bandage, which successfully interpreted as pH range of 6-9, sufficiently monitoring wound with unaffected performance from potential interferences as well as workable in temperature range of 22 to 40 °C.
A flexible pH sensor was reported using IrOx as the sensing film deposited on a PET substrate in a roll-to-roll (R2R) process (
Figure 13 (A)). The fabricated electrodes demonstrated a good linear range of pH sensing between 2-13 with a Nernstian response of −60.6 mVpH
-1. Other characterizations such as hysteresis, drift, fluctuation, and deviation test were performed to evaluate the stability as well as the repeatability of IrOx-based pH sensor. Further, the fabricated electrodes presented a suitable data from pH 4 to 9 when tested against a synthetic sweat [
124].
Similarly, PEDOT:PSS and IrOx NMs provided the pH sensing matrix due to the redox chemistry of IrOx-complex as it exhibited Ir
-III/Ir
-IV redox couple, which ultimately triggered PEDOT:PSS chain that extracted electrons from the polymeric (PEDOT:PSS) film, causing to current flow across the film (
Figure 13 (B)). The developed sensor possessed flexible nature, where it was further fabricated as a fully textile pH sensor embedded in a bandage. Additionally, the sensing evaluations were carried out in simulated wound liquid (exudate) using dynamic flow analysis to validate its performance [
125]
.
Various composites of organic/inorganic (NMs), metal/metal-oxide such as titanium dioxide or titania-carbon (TiO
2-carbon), and 2D-NMs (graphene/MXenes/CNTs) play a pivotal role in advancing nanotechnology. Also, the blend of 2D-NMs with PANI retains potentials for pH sensing and capable enough to be adopted in wearable technology. Further doping or laser treatments of these NMs with organic moieties provide wearable gadgets with improved environmental stability, responsiveness and reversibility [
47,
126,
127,
128,
129]. Hydrogel formulation of such above said composites is another facile approach to obtain the desired outcomes in wearable domain.
Recently [
126], tannic acid-Ag-carbon nanotube-polyaniline (TA-Ag-CNT-PANI)-based hydrogel was used to prepare sweat sensing platform, and employed to detect noninvasively pH and tyrosine as shown in
Figure 14 (A-E). Where, a pilocarpine-based iontophoretic system was also embedded into the sensing patch to stimulate sweat secretion from human body. Being sensitive and stable for pH and Tyrosine sensing, the integrated patch was capable enough to successfully detect both the analyzing analytes, simultaneously in sweat matrix. The detected pH results were further correlated to determine Tyr concentrations in various sweat samples, thus providing a reliable mechanism to evaluate the device performance in terms of concerned biomarkers.
It was concluded by the authors that the designed wearable sensing mechanism could be a great addition in healthcare applications.
In another study [
127] multiwall carbon nanotubes (MWCNTs)-based hydrogel was prepared by compositing Poly(N-isopropylacrylamide) (PNIPAM), carboxymethyl chitosan (CMCS) and PANI (
Figure 14 (F-I)). The resultant CMCS/ MWCNT/PANI hydrogel (F-inset is the magnified image) was thermosensitive as well as efficient in terms of pH sensing. CMCS and MWCNTs provided not only the mechanical properties but also with the better conductivity and temperature sensitivity (G-H). As shown in
Figure 14 (I)
, the pH sensing was performed and the prepared hydrogel offered great response due to the outstanding reversible or doping/de-doping nature of PANI in the matrix, which is known as the best material for pH determinations. The increase in pH values produced doping effects in the PANI matrix and vice versa, thus provided an excellent performance of the hydrogel in terms of pH determinations.
Recently, organic electrochemical transistors (OECTs)-based pH sensors also became the choice in cutting-edge technology owing to their promising capabilities, such as inherent signal amplification and miniaturization ability [
130,
131,
132,
133]. Moreover, the modifications with highly pH sensitive materials in gate and channel electrodes provide OECTs an edge to be more sensitive wearable device. However, the proper functioning of OECTs devices solely depend on the availability of enough electrolyte when using in wearable configurations. The probability of human skin not providing enough sweat for OEC working may lead to false results, which limit their broader applications. To mitigate this hinderance, researchers are exploiting the use if ion-gel.
Figure 15 shows the pictorial representation of the developed (OECT-based flexible) pH sensor, where PEDOT:PSS was used to modify the gate electrode. The blend of bromothymol blue (BTB), polymeric network ([EMIM][TFSI]) comprising lithium salts (LiTFSI) [BMIM][TFSI]/PVDF-HFP were used to prepare pH sensitive materials for the channel modifications. Further, it was characterized employing electrochemical technique that anionic/ cationic transportation due to the [BMIM]
+/[TFSI]
-, respectively caused de-doping of the PEDOT:PSS, thus providing pH sensitivity of up to 91 mA dec at -0.4 V gate biasing; which was translated as the pH changes measurements from 2 to 9 [
132]
.
Contrary to electrochemical and optical techniques, piezoelectric mass biosensors are another emerging class to monitor pH. As, the frequency of conducting materials can also be affected subject to pH change in sweat, which could be a facile way to analyze the pH in sweat. However, due to their rigidity, these devices are limited to lab-scale pH detection. Scarpa and colleagues developed a pH responsive sensor based on PEG-DA/CEA hydrogel, demonstrating swelling/shrinking capability at several pH corresponding to resonant frequency shift. The proposed device retained pH range 3–8 in artificial sweat formulation with satisfactory response with 12 kHz/pH unit. Such kinds of devices are rare and could have a great potential to be integrated in modest form, such as wearable devices for the desired applications [
134].