Smart Tattoo Sensors 2.0: A Ten-Year Progress Report through a Narrative Review
Abstract
:1. Introduction
1.1. The New Frontiers Offered by Tattoos Used as Sensors
1.1.1. Electronic-Tattoos: Pioneering a Paradigm Shift in the Health Domain
- Rethinking Point-of-Care Testing: Moving away from the historical focus on acute medical issues, there is an imperative to revolutionize our approach to healthcare by embracing proactive, long-term disease management. The emergence of dermal tattoo biosensors, serving as continuous monitoring platforms, not only signifies a leap forward in technology but holds the promise of transforming how we diagnose and treat diseases. A thorough exploration of these biosensors is not just about enhancing medical outcomes; it is a potential game-changer in point-of-care diagnostics. The integration of these innovative technologies not only could improve health outcomes but also has far-reaching economic implications, promising significant cost reductions in the long run.
- Rethinking the Skin as a Diagnostic Platform: The skin, often overlooked as more than a protective barrier, emerges as a fascinating frontier for diagnostics. As the body’s largest organ with complex layers, the skin becomes a canvas for innovation in healthcare. By unlocking the skin’s potential as a diagnostic platform, especially in its role as a host for biosensors, we open doors to a new era of continuous monitoring. This research direction signifies more than just a shift; it is a paradigmatic change in how we view traditional diagnostic approaches. The skin, once seen as a passive organ, now stands as an active and dynamic player in the diagnostic landscape, showcasing its potential to revolutionize healthcare practices and improve patient outcomes.
1.1.2. E-Tattoos: A Promising Frontier for Theragnostic Advancements
- Biological sensing/diagnostics;
- Drug delivery/therapeutics;
- Robust support system.
1.2. The Rationale for a Review Study and the Purpose
1.2.1. The Rationale for a Review
1.2.2. Purpose of the Study
2. Methods
- N1: Clarity of study rationale in the introduction.
- N2: Appropriateness of work’s design.
- N3: Clarity in describing methods.
- N4: Clear presentation of results.
- N5: Justification and alignment of conclusions with results.
- N6: Adequate disclosure of conflicts of interest by authors.
- Initial Screening Process: A meticulous screening process was implemented to validate the authentic emphasis on e-tattoos. This step was crucial in ensuring the precision and relevance of the selected studies.
- Application of Selection Algorithm: Subsequently, in the second step, we applied a rigorous selection algorithm based on the parameters mentioned earlier.
3. Results
3.1. In-Depth Analysis of the Detected Studies: A Comprehensive Overview
3.2. Common Findings and Key Emerging Technological Theragnostic Approach
- Affordability and User-Friendly DesignMinwoo et al. [32] pioneered the field by introducing disposable wearable sensors featuring ultrathin conformable films. Their approach, emphasizing affordability and user-friendly design, involved applying silver nanowire (AgNW) composite films onto glossy paper (GP) with liquid bandages (LB) for stable attachment, enabling continuous recording of electrophysiological signals.
- Noninvasive MonitoringA prevalent theme across various studies is the pursuit of noninvasive monitoring. Wang et al. [33], Lim et al. [34], and Vural et al. [15] explore applications such as venous blood oxygenation, surface electromyography (sEMG) for muscle activity monitoring, and comprehensive health monitoring through noninvasive electrochemical sensors. These studies collectively contribute to technologies prioritizing patient comfort and accessibility.
- Multiplexed Detection and BiosensingHe et al. [37] and Zhao et al. [41] significantly contribute to the realm of multiplexed detection of health-related biomarkers. He et al. propose a colorimetric dermal tattoo biosensor, while Zhao et al. develop highly conductive graphene nanosheet film-based tattoo dry electrodes (TDEs) for electrophysiology and strain sensing, enabling simultaneous and precise detection of multiple biomarkers.
- Skin Conformability and ComfortChen et al. [40] and Jang et al. [63] address challenges related to flexibility, skin biocompatibility, adhesion, and comfort. Chen et al. achieve skin conformity using a dynamic ionic liquid, resulting in electronic tattoos firmly attached to human skin. Jang et al. introduce imperceptible graphene e-tattoos (GET) for unobtrusive electrodermal activity (EDA) sensing, emphasizing minimal strain concentration for enhanced comfort during ambulatory monitoring.
- Advanced Materials and Fabrication TechniquesThe incorporation of advanced materials and fabrication techniques propels e-tattoo development. Gong et al. [59], Wang et al. [62], and Tang et al. [65] exemplify this trend. Gong et al. create highly sensitive, wearable strain sensors using polyaniline microparticles and gold nanowire (AuNW) films. Wang et al. introduce a versatile electronic tattoo (e-tattoo) using MXene nanosheets and cellulose nanofibers/Ag nanowires, while Tang et al. present a groundbreaking electronic tattoo for health and movement sensing with a layer-by-layer approach using metal–polymer conductors and elastomeric block copolymers.
- Functional DiversityStudies such as Gogurla et al. [42], Bandodkar et al. [60,61], and Sempionatto et al. [45] showcase the diversity of functionalities. Gogurla et al. integrate electrically and optically active components onto human skin, Bandodkar et al. develop tattoo-based sensors for noninvasive glycemic and sodium monitoring, and Sempionatto et al. explore wearable chemical sensors for personalized nutrition solutions.
3.3. In-Depth Analysis of the Detected Reviews: A Comprehensive Overview
3.4. Common Findings and Key Emerging Technological Theragnostic Approach in the Reviews
- Health Monitoring Integration
- Focus on Diabetes CareManasa et al. [36], Sharma et al. [38], and Zhang et al. [66] contribute to the growing emphasis on diabetes care. Manasa reviews the evolution of skin glucose monitoring devices, Sharma explores nanostructured ion-selective membranes, and Zhang discusses wearable glucose sensors, collectively aiming to improve diabetes management.
- Biosensing ApplicationsYetisen et al. [49] and Piro et al. [67] delve into biosensing applications. Yetisen introduces injectable dermal biosensors for monitoring pH, glucose, and albumin concentrations, while Piro explores wearable skin chemical sensors across various applications, indicating a trend toward versatile biosensing capabilities.
- Cultural Heritage and Portable SensorsValentini et al. [52] introduce a unique perspective by focusing on Cultural Heritage fields. The study emphasizes portable tattoo devices for on-the-spot analysis, contributing to non-invasive and non-destructive examination of art objects, suggesting a novel application beyond healthcare.
- Technological Impact on SurgeryMichard et al. [56] explore the use of smartphones and electronic tablets in surgical care. This review identifies the potential of digital applications and connected sensors for real-time monitoring in preoperative, intraoperative, and postoperative phases, indicating a shift toward digital tools in surgical settings.
4. Discussion
4.1. Numerical Trends in the Tattoo-Based Sensoring
4.2. Interpretation of Results: Opportunities, Limitations, and Suggestions for a Broader Investigation
4.2.1. Opportunities
4.2.2. Limitations and Suggestions for a Broader Investigation
4.3. Synoptic Diagram of the Study
4.4. Final Takeaway Message
4.5. Limitations and Future Work
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
- Samadelli, M.; Melis, M.; Miccoli, M.; Vigl, E.E.; Zink, A.R. Complete mapping of the tattoos of the 5300-year-old Tyrolean Iceman. J. Cult. Herit. 2015, 16, 753–758. [Google Scholar] [CrossRef]
- Krutak, L. The cultural heritage of tattooing: A brief history. Curr. Probl. Dermatol. 2015, 48, 1–5. [Google Scholar] [CrossRef] [PubMed]
- Piccinini, P.; Pakalin, S.; Contor, L.; Bianchi, I.; Senaldi, C. JRC. Safety of Tattoos and Permanent Make-Up: Final Report; EUR27947; European Commission: Brussels, Belgium, 2016. [Google Scholar] [CrossRef]
- Giulbudagian, M.; Schreiver, I.; Singh, A.V.; Laux, P.; Luch, A. Safety of tattoos and permanent make-up: A regulatory view. Arch. Toxicol. 2020, 94, 357–369. [Google Scholar] [CrossRef]
- Renzoni, A.; Pirrea, A.; Novello, F.; Lepri, A.; Cammarata, P.; Tarantino, C.; D’Ancona, F.; Perra, A. The tattooed population in Italy: A national survey on demography, characteristics and perception of health risks. Annali dell’Istituto Super. Sanita 2018, 54, 126–136. [Google Scholar]
- Dhond, K.; Hu, Y.; Yetisen, A.K. Dermal tattoo biosensors. Dermatologie 2023, 74, 819–821. [Google Scholar] [CrossRef] [PubMed]
- Scientists Create Tattoo-like Sensors That Reveal Blood Oxygen Levels. Available online: https://now.tufts.edu/2022/05/04/scientists-create-tattoo-sensors-reveal-blood-oxygen-levels (accessed on 3 April 2024).
- Tattoo-like Sensors Reveal Blood Oxygen Levels. Available online: https://healthcare-in-europe.com/en/news/tattoo-like-sensors-reveal-blood-oxygen-levels.html (accessed on 3 April 2024).
- What Is an Electronic Tattoo? Available online: https://builtin.com/hardware/electronic-tattoo (accessed on 3 April 2024).
- Digital Tattoos Make Healthcare More Invisible. Available online: https://medicalfuturist.com/digital-tattoos-make-healthcare-more-invisible/ (accessed on 3 April 2024).
- Graphene Electronic Tattoos. Available online: https://euon.echa.europa.eu/it/nanopinion/-/blogs/graphene-electronic-tattoos (accessed on 3 April 2024).
- Electronic Tattoos. The Future of Wearable Technology. Available online: https://medium.com/@adithya_/electronic-tattoos-4c1055c9f46a (accessed on 3 April 2024).
- Williams, N.X.; Franklin, A.D. Electronic Tattoos: A Promising Approach to Real-time Theragnostics. J. Dermatol. Skin Sci. 2020, 2, 5–16. [Google Scholar]
- van der Schaar, P.J.; Dijksman, J.F.; Broekhuizen-de Gast, H.; Shimizu, J.; van Lelyveld, N.; Zou, H.; Iordanov, V.; Wanke, C.; Siersema, P.D. A novel ingestible electronic drug delivery and monitoring device. Gastrointest. Endosc. 2013, 78, 520–528. [Google Scholar] [CrossRef] [PubMed]
- Bettinger, C.J. Materials Advances for Next-Generation Ingestible Electronic Medical Devices. Trends Biotechnol. 2015, 33, 575–585. [Google Scholar] [CrossRef]
- Wiley Encyclopedia of Biomedical Engineering; John Wiley & Sons Inc.: Hoboken, NJ, USA, 2006. [CrossRef]
- Madhvapathy, S.R. Epidermal Electronic Systems for Measuring the Thermal Properties of Human Skin at Depths of up to Several Millimeters. Adv. Funct. Mater. 2018, 28, 1802083. [Google Scholar] [CrossRef]
- Seo, J.W.; Kim, H.; Kim, K.; Choi, S.Q.; Lee, H.J. Calcium-Modified Silk as a Biocompatible and Strong Adhesive for Epidermal Electronics. Adv. Funct. Mater. 2018, 28, 1800802. [Google Scholar] [CrossRef]
- Wilhelm, K.P.; Cua, A.B.; Maibach, H.I. Skin Aging: Effect on Transepidermal Water Loss, Stratum Corneum Hydration, Skin Surface pH, and Casual Sebum Content. Arch. Dermatol. 1991, 127, 1806–1809. [Google Scholar] [CrossRef] [PubMed]
- Becker, D.P.; Miller, J.D.; Ward, J.D.; Greenberg, R.P.; Young, H.F.; Sakalas, R. The outcome from severe head injury with early diagnosis and intensive management. J. Neurosurg. 1977, 47, 491–502. [Google Scholar] [CrossRef] [PubMed]
- Mueller, C.; Twerenbold, R.; Reichlin, T. Early diagnosis of myocardial infarction with sensitive cardiac troponin assays. Clin. Chem. 2019, 65, 490–491. [Google Scholar] [CrossRef] [PubMed]
- European Diabetes Policy Group. A desktop guide to Type 2 diabetes mellitus. European Diabetes Policy Group 1999. Diabet. Med. 1999, 16, 716–730. [Google Scholar]
- Alharbi, M.; Bauman, A.; Neubeck, L.; Gallagher, R. Validation of Fitbit-Flex as a measure of free-living physical activity in a community-based phase III cardiac rehabilitation population. Eur. J. Prev. Cardiol. 2016, 23, 1476–1485. [Google Scholar] [CrossRef]
- Moreno-Pino, F.; Porras-Segovia, A.; López-Esteban, P.; Artés, A.; Baca-García, E. Validation of Fitbit Charge 2 and Fitbit Alta HR Against Polysomnography for Assessing Sleep in Adults with Obstructive Sleep Apnea. J. Clin. Sleep. Med. 2019, 15, 1645–1653. [Google Scholar] [CrossRef] [PubMed]
- Wong, C.K.; Mentis, H.M.; Kuber, R. The bit doesn’t fit: Evaluation of a commercial activity-tracker at slower walking speeds. Gait Posture 2018, 59, 177–181. [Google Scholar] [CrossRef]
- O’Connell, S.; ÓLaighin, G.; Quinlan, L.R. When a step is not a step! Specificity analysis of five physical activity monitors. PLoS ONE 2017, 12, e0169616. [Google Scholar] [CrossRef]
- van der Bent, S.A.S.; Rauwerdink, D.; Oyen, E.M.M.; Maijer, K.I.; Rustemeyer, T.; Wolkerstorfer, A. Complications of tattoos and permanent makeup: Overview and analysis of 308 cases. J. Cosmet. Dermatol. 2021, 20, 3630–3641. [Google Scholar] [CrossRef]
- Laux, P.; Tralau, T.; Tentschert, J.; Blume, A.; Dahouk, S.A.; Bäumler, W.; Bernstein, E.; Bocca, B.; Alimonti, A.; Colebrook, H.; et al. A medical-toxicological view of tattooing. Lancet 2016, 387, 395–402. [Google Scholar] [CrossRef]
- ANDJ Checklist. Available online: https://www.elsevier.com/__data/promis_misc/ANDJ%20Narrative%20Review%20Checklist.pdf (accessed on 3 June 2023).
- Giansanti, D. An Umbrella Review of the Fusion of fMRI and AI in Autism. Diagnostics 2023, 13, 3552. [Google Scholar] [CrossRef]
- Makhinia, A.; Beni, V.; Andersson Ersman, P. Screen-Printed Piezoelectric Sensors on Tattoo Paper Combined with All-Printed High-Performance Organic Electrochemical Transistors for Electrophysiological Signal Monitoring. ACS Appl. Mater. Interfaces 2023. epub ahead of print. [Google Scholar] [CrossRef] [PubMed]
- Lee, M.; Kim, J.; Khine, M.T.; Kim, S.; Gandla, S. Facile Transfer of Spray-Coated Ultrathin AgNWs Composite onto the Skin for Electrophysiological Sensors. Nanomaterials 2023, 13, 2467. [Google Scholar] [CrossRef] [PubMed]
- Tan, P.; Wang, E.; Tamma, S.; Bhattacharya, S.; Lu, N. Towards Simultaneous Noninvasive Arterial and Venous Oxygenation Monitoring with Wearable E-Tattoo. In Proceedings of the International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC), Sydney, Australia, 24–27 July 2023; pp. 1–4. [Google Scholar] [CrossRef]
- Lim, J.; Sun, M.; Liu, J.Z.; Tan, Y. A Preliminary Usability Study of Integrated Electronic Tattoo Surface Electromyography (sEMG) Sensors. In Proceedings of the 2023 45th Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC), Sydney, Australia, 24–27 July 2023; pp. 1–4. [Google Scholar] [CrossRef]
- Vural, B.; Uludağ, İ.; Ince, B.; Özyurt, C.; Öztürk, F.; Sezgintürk, M.K. Fluid-based wearable sensors: A turning point in personalized healthcare. Turk. J. Chem. 2023, 47, 944–967. [Google Scholar] [CrossRef]
- Manasa, G.; Mascarenhas, R.J.; Shetti, N.P.; Malode, S.J.; Mishra, A.; Basu, S.; Aminabhavi, T.M. Skin Patchable Sensor Surveillance for Continuous Glucose Monitoring. ACS Appl. Bio Mater. 2022, 5, 945–970. [Google Scholar] [CrossRef]
- He, R.; Liu, H.; Fang, T.; Niu, Y.; Zhang, H.; Han, F.; Gao, B.; Li, F.; Xu, F. A Colorimetric Dermal Tattoo Biosensor Fabricated by Microneedle Patch for Multiplexed Detection of Health-Related Biomarkers. Adv. Sci. 2021, 8, e2103030. [Google Scholar] [CrossRef]
- Sharma, R.; Geranpayehvaghei, M.; Ejeian, F.; Razmjou, A.; Asadnia, M. Recent advances in polymeric nanostructured ion selective membranes for biomedical applications. Talanta 2021, 235, 122815. [Google Scholar] [CrossRef] [PubMed]
- Pazos, M.D.; Hu, Y.; Elani, Y.; Browning, K.L.; Jiang, N.; Yetisen, A.K. Tattoo Inks for Optical Biosensing in Interstitial Fluid. Adv. Healthc. Mater. 2021, 10, e2101238. [Google Scholar] [CrossRef]
- Chen, Z.; Gao, N.; Chu, Y.; He, Y.; Wang, Y. Ionic Network Based on Dynamic Ionic Liquids for Electronic Tattoo Application. ACS Appl. Mater. Interfaces 2021, 13, 33557–33565. [Google Scholar] [CrossRef]
- Zhao, Q.L.; Wang, Z.M.; Chen, J.H.; Liu, S.Q.; Wang, Y.K.; Zhang, M.Y.; Di, J.J.; He, G.P.; Zhao, L.; Su, T.T.; et al. A highly conductiveself-assembled multilayer graphene nanosheet film for electronic tattoos in the applications of human electrophysiology and strain sensing. Nanoscale 2021, 13, 10798–10806. [Google Scholar] [CrossRef]
- Gogurla, N.; Kim, Y.; Cho, S.; Kim, J.; Kim, S. Multifunctional and Ultrathin Electronic Tattoo for On-Skin Diagnostic and Therapeutic Applications. Adv. Mater. 2021, 33, e2008308. [Google Scholar] [CrossRef] [PubMed]
- Taccola, S.; Poliziani, A.; Santonocito, D.; Mondini, A.; Denk, C.; Ide, A.N.; Oberparleiter, M.; Greco, F.; Mattoli, V. Toward the Use of Temporary TattooElectrodes for Impedancemetric Respiration Monitoring and Other Electrophysiological Recordings on Skin. Sensors 2021, 21, 1197. [Google Scholar] [CrossRef] [PubMed]
- Kedambaimoole, V.; Kumar, N.; Shirhatti, V.; Nuthalapati, S.; Sen, P.; Nayak, M.M.; Rajanna, K.; Kumar, S. Laser-Induced Direct Patterning of Free-standing Ti3C2-MXene Films for Skin Conformal Tattoo Sensors. ACS Sens. 2020, 5, 2086–2095. [Google Scholar] [CrossRef]
- Sempionatto, J.R.; Khorshed, A.A.; Ahmed, A.; De Loyola ESilva, A.N.; Barfidokht, A.; Yin, L.; Goud, K.Y.; Mohamed, M.A.; Bailey, E.; May, J.; et al. Epidermal Enzymatic Biosensors for Sweat Vitamin C: Toward Personalized Nutrition. ACS Sens. 2020, 5, 1804–1813. [Google Scholar] [CrossRef] [PubMed]
- LaRochelle, E.P.M.; Soter, J.; Barrios, L.; Guzmán, M.; Streeter, S.S.; Gunn, J.R.; Bejarano, S.; Pogue, B.W. Imaging luminescent tattoo inks for direct visualization of linac and cobalt irradiation. Med. Phys. 2020, 47, 1807–1812. [Google Scholar] [CrossRef] [PubMed]
- Chen, Y.; Jamshidi, R.; Montazami, R. Study of Partially Transient Organic Epidermal Sensors. Materials 2020, 13, 1112. [Google Scholar] [CrossRef] [PubMed]
- Kim, M.; Park, S.; Lee, H.U.; Kang, H.W. Quantitative Monitoring of Tattoo Contrast Variations after 755-nm Laser Treatments in In Vivo Tattoo Models. Sensors 2020, 20, 285. [Google Scholar] [CrossRef] [PubMed]
- Yetisen, A.K.; Moreddu, R.; Seifi, S.; Jiang, N.; Vega, K.; Dong, X.; Dong, J.; Butt, H.; Jakobi, M.; Elsner, M.; et al. Dermal Tattoo Biosensors for Colorimetric Metabolite Detection. Angew. Chem. Int. Ed. Engl. 2019, 58, 10506–10513. [Google Scholar] [CrossRef] [PubMed]
- Ha, T.; Tran, J.; Liu, S.; Jang, H.; Jeong, H.; Mitbander, R.; Huh, H.; Qiu, Y.; Duong, J.; Wang, R.L.; et al. A Chest-Laminated Ultrathin and Stretchable E-Tattoo for the Measurement of Electrocardiogram, Seismocardiogram, and Cardiac Time Intervals. Adv. Sci. 2019, 6, 1900290. [Google Scholar] [CrossRef]
- Kim, J.; Sempionatto, J.R.; Imani, S.; Hartel, M.C.; Barfidokht, A.; Tang, G.; Campbell, A.S.; Mercier, P.P.; Wang, J. Simultaneous Monitoring of Sweat and Interstitial Fluid Using a Single Wearable Biosensor Platform. Adv. Sci. 2018, 5, 1800880. [Google Scholar] [CrossRef]
- Valentini, F.; Calcaterra, A.; Antonaroli, S.; Talamo, M. Smart Portable Devices Suitable for Cultural Heritage: A Review. Sensors 2018, 18, 2434. [Google Scholar] [CrossRef] [PubMed]
- Park, R.; Kim, H.; Lone, S.; Jeon, S.; Kwon, Y.W.; Shin, B.; Hong, S.W. One-Step Laser Patterned Highly Uniform Reduced Graphene Oxide Thin Films for Circuit-Enabled Tattoo and Flexible Humidity Sensor Application. Sensors 2018, 18, 1857. [Google Scholar] [CrossRef] [PubMed]
- Stier, A.; Halekote, E.; Mark, A.; Qiao, S.; Yang, S.; Diller, K.; Lu, N. Stretchable Tattoo-Like Heater with On-Site Temperature Feedback Control. Micromachines 2018, 9, 170. [Google Scholar] [CrossRef] [PubMed]
- Mishra, R.K.; Martín, A.; Nakagawa, T.; Barfidokht, A.; Lu, X.; Sempionatto, J.R.; Lyu, K.M.; Karajic, A.; Musameh, M.M.; Kyratzis, I.L.; et al. Detection of vapor-phase organophosphate threats using wearable conformable integrated epidermal and textile wireless biosensor systems. Biosens. Bioelectron. 2018, 101, 227–234. [Google Scholar] [CrossRef] [PubMed]
- Michard, F. Smartphones and e-tablets in perioperative medicine. Korean J. Anesthesiol. 2017, 70, 493–499. [Google Scholar] [CrossRef] [PubMed]
- Kabiri Ameri, S.; Ho, R.; Jang, H.; Tao, L.; Wang, Y.; Wang, L.; Schnyer, D.M.; Akinwande, D.; Lu, N. Graphene Electronic Tattoo Sensors. ACS Nano 2017, 11, 7634–7641. [Google Scholar] [CrossRef] [PubMed]
- Jeong, H.; Ha, T.; Kuang, I.; Shen, L.; Dai, Z.; Sun, N.; Lu, N. NFC-enabled, tattoo-like stretchable biosensor manufactured by “cut- and-paste” method. In Proceedings of the 2017 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Jeju, Republic of Korea, 11–15 July 2017; pp. 4094–4097. [Google Scholar] [CrossRef]
- Gong, S.; Lai, D.T.; Wang, Y.; Yap, L.W.; Si, K.J.; Shi, Q.; Jason, N.N.; Sridhar, T.; Uddin, H.; Cheng, W. Tattoolike Polyaniline Microparticle-Doped Gold Nanowire Patches as Highly Durable Wearable Sensors. ACS Appl. Mater. Interfaces 2015, 7, 19700–19708. [Google Scholar] [CrossRef]
- Bandodkar, A.J.; Jia, W.; Yardımcı, C.; Wang, X.; Ramirez, J.; Wang, J. Tattoo-based noninvasive glucose monitoring: A proof-of-concept study. Anal. Chem. 2015, 87, 394–398. [Google Scholar] [CrossRef]
- Bandodkar, A.J.; Molinnus, D.; Mirza, O.; Guinovart, T.; Windmiller, J.R.; Valdés-Ramírez, G.; Andrade, F.J.; Schöning, M.J.; Wang, J. Epidermal tattoo potentiometric sodium sensors with wireless signal transduction for continuous non-invasive sweat monitoring. Biosens. Bioelectron. 2014, 54, 603–609. [Google Scholar] [CrossRef]
- Wang, Z.; Zhou, Z.; Li, C.L.; Liu, X.H.; Zhang, Y.; Pei, M.M.; Zhou, Z.; Cui, D.X.; Hu, D.; Chen, F.; et al. A Single Electronic Tattoo for Multisensory Integration. Small Methods 2023, 7, e2201566. [Google Scholar] [CrossRef]
- Jang, H.; Sel, K.; Kim, E.; Kim, S.; Yang, X.; Kang, S.; Ha, K.H.; Wang, R.; Rao, Y.; Jafari, R.; et al. Graphene e-tattoos for unobstructive ambulatory electrodermal activity sensing on the palm enabled by heterogeneous serpentine ribbons. Nat. Commun. 2022, 13, 6604. [Google Scholar] [CrossRef] [PubMed]
- Galliani, M.; Ferrari, L.M.; Ismailova, E. Conformable Wearable Electrodes: From Fabrication to Electrophysiological Assessment. J. Vis. Exp. 2022, e63204. [Google Scholar] [CrossRef]
- Tang, L.; Shang, J.; Jiang, X. Multilayered electronic transfer tattoo that can enable the crease amplification effect. Sci. Adv. 2021, 7, eabe3778. [Google Scholar] [CrossRef] [PubMed]
- Zhang, J.; Xu, J.; Lim, J.; Nolan, J.K.; Lee, H.; Lee, C.H. Wearable Glucose Monitoring and Implantable Drug Delivery Systems for Diabetes Management. Adv. Healthc. Mater. 2021, 10, e2100194. [Google Scholar] [CrossRef] [PubMed]
- Piro, B.; Mattana, G.; Noël, V. Recent Advances in Skin Chemical Sensors. Sensors 2019, 19, 4376. [Google Scholar] [CrossRef] [PubMed]
- Regulation (EU) 2017/745 of the European Parliament and of the Council. Available online: https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A32017R0745 (accessed on 3 April 2024).
- Beck, A.; Retèl, V.P.; Bhairosing, P.A.; van den Brekel, M.; van Harten, W.H. Barriers and facilitators of patient access to medical devices in Europe: A systematic literature review. Health Policy 2019, 123, 1185–1198. [Google Scholar] [CrossRef]
- Kramer, D.B.; Xu, S.; Kesselheim, A.S. How does medical device regulation perform in the United States and the European? A Systematic Review. PLoS Med. 2012, 9, e1001276. [Google Scholar] [CrossRef]
- Pycroft, L.; Aziz, T.Z. Security of implantable medical devices with wireless connections: The dangers of cyber-attacks. Expert Rev. Med. Devices 2018, 15, 403–406. [Google Scholar] [CrossRef] [PubMed]
- Zhang, B.; Guo, J.; Zhang, H. Design and analysis of crossover trials for investigating high-risk medical devices: A review. Contemp. Clin. Trials Commun. 2022, 30, 101004. [Google Scholar] [CrossRef]
- Aaron, R.E.; Tian, T.; Yeung, A.M.; Huang, J.; Arreaza-Rubín, G.A.; Ginsberg, B.H.; Kompala, T.; Lee, W.A.; Kerr, D.; Colmegna, P.; et al. NIH Fifth Artificial Pancreas Workshop 2023: Meeting Report: The Fifth Artificial Pancreas Workshop: Enabling Fully Automation, Access, and Adoption. J. Diabetes Sci. Technol. 2024, 18, 215–239. [Google Scholar] [CrossRef]
- O’Keeffe, D.T.; Maraka, S.; Basu, A.; Keith-Hynes, P.; Kudva, Y.C. Cybersecurity in Artificial Pancreas Experiments. Diabetes Technol. Ther. 2015, 17, 664–666. [Google Scholar] [CrossRef] [PubMed]
Technology/ Technological Process Faced in the Study | Description | Type of Study, Associated Study |
---|---|---|
Ultrathin conformable films transferred onto human skin using glossy paper (GP) and liquid bandages (LBs). Spray-coating of silver nanowire (AgNW) composite films onto GP | Enables continuous recording of electrophysiological signals (EMG, ECG, EOG). LB ensures stable attachment, promoting rapid adhesion and environmental stability. AgNW composite offers high breathability, suitable for extended use in creating affordable tattoo-like sensors. | Article, [32] |
Soft wearable e-tattoo sensor | Simultaneously measures arterial and venous pulses from the wrist. Addresses crosstalk between arterial and venous signals by proposing spatial filtering. Aims to enhance clinical diagnoses of conditions like sepsis and shock by providing simultaneous measurements of arterial and venous blood oxygenation. | Article, [33] |
Flexible Electronic Tattoo | Wearable, flexible epidermal sensor intimately attaches electrodes to the skin, improving long-term comfort. Demonstrates effectiveness in monitoring muscle activities, providing comparable signal quality to commercial products with enhanced comfort and signal-to-motion artifact ratio during active movements. | Article, [34] |
Non-invasive electrochemical sensors | Emphasizes the importance of electrochemical sensors in detecting biomarkers in body fluids (tears, saliva, perspiration, and skin interstitial fluid). Reviews recent articles, examining wearable sensors for various biofluids, and discusses implementation challenges and future prospects. | Article, [35] |
Segmented microneedle patch | Multiplexed detection of health-related biomarkers in skin interstitial fluid. Exhibits color changes in response to biomarker concentration changes (pH, glucose, uric acid, and temperature). Shows potential for simultaneous detection of multiple biomarkers in vitro, ex vivo, and in vivo, offering long-term health monitoring capabilities. | Article, [37] |
Dynamic ionic liquid | Lightweight and noninvasive wearable electronics firmly attached to human skin. Demonstrates excellent sensing performance in response to temperature variation and tensile strain. Intelligently monitors body temperature, pulse, and movement. | Article, [40] |
Highly conductive graphene nanosheet film | Developed for human electrophysiology and strain sensing. Provides support for fabricating low-cost, customizable, and high-performance electronic tattoos. Exhibits lower skin–electrode contact impedance, enabling accurate detection of electrocardiogram and electromyogram during 24 h wearing. | Article, [41] |
Natural silk protein with carbon nanotubes | Multifunctional electronic tattoo integrating electrically and optically active heaters, a temperature sensor, a stimulator for drug delivery, and real-time electrophysiological signal detectors onto human skin. Offers a next-generation electronic platform for wearable and epidermal applications in healthcare. | Article, [42] |
Ink-jet printing of PEDOT:PSS on temporary tattoo paper | Developed for electrophysiological recordings, enabling real-time monitoring of respiration through transthoracic impedance measurements. Proposed interconnection strategy ensures stability and re-positionability, making them suitable for large-scale production and diverse bio-electric signal monitoring. | Article, [43] |
Ti3C2-MXene resistor | Ultrathin skin-mountable temporary tattoo for highly sensitive strain sensing. Skin conformability allows inconspicuous monitoring of vital health parameters such as pulse rate, respiration rate, and surface electromyography. High sensitivity attributed to nanocrack development upon strain, offering a fast, repeatable, and easily patternable sensor. | Article, [44] |
Epidermal biosensor with ascorbate oxidase on flexible printable tattoo electrodes | Explores wearable chemical sensors for personalized nutrition solutions. Enables noninvasive electrochemical detection of sweat vitamin C, showcasing selective response, mechanical resiliency, and potential for personalized nutrition assessments by monitoring vitamin C dynamics in sweat. | Article, [45] |
UV-excited luminescent tattoo inks | Cost-effective fiducial markers in radiotherapy patient alignment. Demonstrates the feasibility of visualizing these inks under megavoltage (MV) radiation, providing direct visualization of field position during beam delivery. UV-sensitive tattoo inks exhibit peak fluorescence emission between 440 and 600 nm, with lifetimes around 11–16 μs. Despite some challenges, such as a six-fold increase in luminescence intensity during the x-ray pulse, the study achieved a spatial resolution of 1.6 mm accuracy in skin test phantoms, offering potential real-time field verification during MV dose delivery. | Article, [46] |
Water-soluble polyethylene oxide (PEO) substrate and poly (3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) conjugated polymer | Development of a transient epidermal sensor with stable electronic properties under static stress, dynamic load, and transient conditions. Maintains electrode resistance up to 2% strain, gradually increases within 6.5% strain under static stress, and demonstrates a fast response to dynamic loads. The PEO substrate dissolves in water, leaving the PEDOT:PSS electrode intact, forming a soft, Van der Waals force-attached, tattoo-like epidermal sensor. | Article, [47] |
755 nm laser treatment on Sprague Dawley rat models tattooed with various ink concentrations | Proposes a quantitative imaging method to monitor tattoo removal using laser treatment. Accurately quantifies tattoo contrast variations post-laser treatment. Histological analysis confirms significant ink removal without thermal injury, showcasing the potential of this monitoring technique for objective assessment in clinical settings. | Article, [48] |
28 µm thick piezoelectric polymer (PVDF) | Introduction of a stretchable, ultrathin seismocardiography (SCG) sensing e-tattoo. Integrated with gold electrodes, forming an electro-mechano-acoustic cardiovascular (EMAC) sensing tattoo. Allows synchronous ECG and SCG measurements, correlating systolic time interval (STI) with blood pressure. Demonstrates reduced motion artifacts and potential for continuous, noninvasive blood pressure estimation. | Article, [50] |
Screen-printing technique with temporary tattoo materials | Presentation of a wearable epidermal platform for simultaneous, noninvasive sampling and analysis of sweat and interstitial fluid (ISF) using a single device. Enables real-time measurement of biomarkers (sweat-alcohol and ISF-glucose) in human subjects. Showcases promising applications in next-generation noninvasive epidermal biosensing. | Article, [51] |
Flow-enabled self-assembly approach | Development of a method for cost-effective, large-area fabrication of reduced graphene oxide (rGO) films on flexible polymer substrates. Utilizes a flow-enabled self-assembly approach with laser direct writing. The resulting rGO-based electrical circuit boards exhibit compatibility with electronic module chips and flexible humidity sensors. | Article, [53] |
“Cut-and-paste” method with a stretchable aluminum heater and a stretchable gold resistance temperature detector | Introduction of a large-area, ultra-thin, ultra-soft tattoo-like heater with autonomous PID temperature control. Demonstrates the ability to maintain a target temperature, adjust to new set points, and conform to skin deformation without imposing constraints. Suitable for long-term wearability in medical applications. | Article, [54] |
Stretchable organophosphorus hydrolase (OPH) enzyme electrodes | Development of flexible epidermal tattoo and textile-based electrochemical biosensors for vapor-phase detection of organophosphorus nerve agents. Offers rapid and selective square-wave voltametric detection of OP vapors. Stress-enduring inks used for printing the electrodes ensure resilience against mechanical deformations, providing potential applications in decentralized security for rapid warning of personal exposure to OP nerve-agent vapors. | Article, [55] |
Sub-micrometer thick graphene electronic tattoos (GET) fabricated through a “wet transfer, dry patterning” method | GET functions as dry electrodes with high transparency, stretchability, and breathability. Matches medically used silver/silver-chloride (Ag/AgCl) gel electrodes but offers superior comfort, mobility, and reliability. Demonstrates successful application in measuring various physiological parameters, including ECG, EMG, EEG, skin temperature, and hydration. | Article, [57] |
“Cut-and-paste” method | Introduction of a low-cost, wireless, stretchable biosensor integrating temperature sensor, light source/sensor, NFC chip, and antenna. Imperceptible, adheres to skin without mechanical failure. Demonstrates high-fidelity sensing, suitable for applications like skin thermography and photometry. | Article, [58] |
Polyaniline microparticles and gold nanowire (AuNW) films | Development of highly sensitive, wearable strain sensors with enhanced conductivity and sensitivity. Stretchability improved by designing curved tattoos with different radii of curvature. Roller coating encapsulation ensures water resistibility and durability. Directly interfaces with wireless circuitry, enabling applications in human finger-controlled robotic arm systems. | Article, [59] |
Reverse iontophoretic extraction of interstitial glucose combined with an enzyme-based amperometric biosensor | Demonstration of an all-printed temporary tattoo-based glucose sensor for noninvasive glycemic monitoring. Exhibits a linear response to glucose levels. In vivo testing on human subjects shows promising results, indicating the potential of this tattoo sensor for efficient diabetes management. | Article, [60] |
Potentiometric tattoo sensor | Epidermal Potentiometric Sodium Sensor embedded in a temporary-transfer tattoo on the skin. | Article, [61] |
Mixed-dimensional matrix network with MXene nanosheets and cellulose nanofibers/Ag nanowires | Introduction of a versatile electronic tattoo (e-tattoo) that utilizes a unique mixed-dimensional matrix network. It offers exceptional sensing capabilities for temperature, humidity, strain, proximity, and material identification. Multidimensional design enables easy fabrication on diverse substrates using hybrid inks and various methods. Triboelectric properties make it a potential power source for a small electronic device. | Article, [62] |
Imperceptible graphene e-tattoos (GET) on the palm with heterogeneous serpentine ribbons (HSPR) | Solution for unobtrusive electrodermal activity (EDA) sensing for mental stress. HSPR minimizes strain concentration at interfaces, allowing effective ambulatory EDA monitoring on the palm in real-life conditions. Novel EDA event selection policy introduced and validated against established gold standards. | Article, [63] |
Conformable thin sensors created using cutaneous electrode patterning with PEDOT:PSS on wearable substrates | Focuses on the integration of wearable electronic devices for monitoring physiological signals, particularly in healthcare applications. Introduces a method for creating conformable thin sensors using cost-effective and scalable processes. Emphasis on achieving high-quality recordings and long-term functionality on the human body. The protocol provided enables biosignal recordings in various configurations using a portable electronic setup. | Article, [64] |
Metal–polymer conductors and elastomeric block copolymers in a layer-by-layer approach | Introduction of a groundbreaking electronic tattoo for health and movement sensing on the skin. Achieves remarkable characteristics like high stretchability, conformality, and adhesion. Incorporates the crease amplification effect, tripling the output signal from strain sensors. Effortlessly transferred to various surfaces, ensuring secure attachment without solvents or heat. Practical application includes a three-layered tattoo with a heater and 15 strain sensors, enabling functions like temperature adjustment, movement monitoring, and remote control of robots. | Article, [65] |
Piezoelectric Sensors with Organic Electrochemical Transistors (OECTs) | The review introduced sensitive and cost-effective skin piezoelectric sensors integrated with organic electrochemical transistors (OECTs) for real-time monitoring of electrophysiological signals. The fully screen-printed piezoelectric sensors are manufactured on tattoo paper substrates, enabling radial pulse monitoring. | Review, [31] |
Skin Glucose Monitoring Devices | The study focused on diabetes mellitus, exploring the evolution of skin glucose monitoring devices. Emphasis is placed on real-time continuous glucose monitoring systems (rt-CGMs), particularly microneedle (MN) array sensory and delivery systems. | Review, [36] |
Nanostructured Ion-Selective Membranes | The overview delved into nanostructured ion-selective membranes (ISMs) for biomedical applications, emphasizing miniaturization for implantable or wearable devices like smartwatches, tattoos, sweatbands, and fabric patches. | Review, [38] |
Optical Biosensors with Traditional Tattoo Inks | The study explored the potential of traditional tattoo inks for continuous health monitoring using optical biosensors. The study discusses replacing tattoo pigments with optical biosensors for diagnostic capabilities. | Review, [39] |
Injectable Dermal Biosensors for pH, Glucose, and Albumin Monitoring | The overview investigated minimally invasive, injectable dermal biosensors for monitoring pH, glucose, and albumin concentrations in interstitial fluid, showcasing multiplexing capabilities for managing various health aspects. | Review, [49] |
Portable Sensor Technologies in Cultural Heritage (CH) Fields | The study focused on Cultural Heritage fields, reviewing advancements in portable sensor technologies. The study introduces portable tattoo devices designed for on-the-spot analysis, especially relevant for immovable and intangible art objects. | Review, [52] |
Smartphones and Electronic Tablets in Surgical Care | The overview explored the role of smartphones and electronic tablets in surgical care. The review highlights the potential of digital applications and connected sensors for real-time monitoring in various phases of surgical care. | Review, [56] |
Wearable Glucose Sensors and Closed-Loop Diabetes Care | The study emphasized the global cost of diabetes care and presented wearable glucose sensors embedded in various platforms like skin or on-tooth tattoos, patches, eyeglasses, contact lenses, fabrics, mouth guards, and pacifiers for noninvasive and real-time glucose analysis. | Review, [66] |
Advancements in Wearable Skin Chemical Sensors | The study extensively explored advancements in wearable skin chemical sensors across applications such as sweat analysis, skin hydration, skin wounds, perspiration of volatile organic compounds, and general skin conditions. | Review, [67] |
Category | Description | Associated Study |
---|---|---|
Health Monitoring and Diagnostics | Disposable Wearable Sensors for Electrophysiological Signal Monitoring [32] Noninvasive Venous Blood Oxygenation Monitoring [33] Colorimetric Dermal Tattoo Biosensor for Biomarker Detection [37] Wearable Devices for Comprehensive Health Monitoring [35] Electronic Tattoos for Noninvasive Wearable Electronics [40] | [31,32,33,35,37,40] |
Multipurpose and Multifunctional Devices | Epidermal Electronic Tattoo (E-Tattoo) System [42] Ultra-Conformable Temporary Tattoo Electrodes (TTEs) [43] Ti3C2-MXene Resistor for Highly Sensitive Strain Sensing [44] Wearable Chemical Sensors for Personalized Nutrition [45] | [42,43,44,45] |
Sensing and Monitoring Techniques | Quantitative Imaging Method for Tattoo Removal Monitoring [48] Stretchable Seismocardiography (SCG) Sensing E-Tattoo [50] Simultaneous Sampling and Analysis of Sweat and Interstitial Fluid (ISF) [51] Cost-Effective Fabrication of Reduced Graphene Oxide (rGO) Films [53] Large-Area, Ultra-Thin, Ultra-Soft Tattoo-Like Heater [54] Flexible Epidermal Tattoo for Vapor-Phase Detection of Nerve Agents [55] | [48,50,51,53,54,55] |
Wearable Electronics and Biosensors | Graphene Electronic Tattoos (GET) for Physiological Parameter Monitoring [57] Low-Cost, Wireless, Stretchable Biosensor [58] Wearable Strain Sensors with Polyaniline Microparticles and AuNW Films [59] All-Printed Temporary Tattoo-Based Glucose Sensor [60] Epidermal Potentiometric Sodium Sensor in a Temporary-Transfer Tattoo [61] Versatile Electronic Tattoo (E-Tattoo) with MXene Nanosheets [62] Unobtrusive Electrodermal Activity (EDA) Sensing with Graphene E-Tattoos [63] | [57,58,59,60,61,62,63] |
Miscellaneous | Large-Area Fabrication of rGO Films with Laser Direct Writing [53] Monitoring Physiological Signals with Conformable Thin Sensors [64] Electronic Tattoo for Health and Movement Sensing with Crease Amplification [65] | [53,64,65] |
Thematic Areas | Opportunity/ Limitation | Description | References |
---|---|---|---|
Affordability | Opportunity | [31,32,33,41,60] | |
Affordability | Limitation | [31,33,41,60] | |
User-Friendly Design | Opportunity | [31,32,40,60] | |
User-Friendly Design | Limitation | [31,32,40,47,60] | |
Diverse Sensorization Solutions | Opportunity |
| [31,33,41,49,67] |
Diverse Sensorization Solutions | Limitation | [31,33,41,49,67] | |
Materials Focus | Opportunity | [31,38,49,52,67] | |
Materials Focus | Limitation | [31,38,49,52,67] | |
Comfortable Design | Opportunity | [38,46,47,52] | |
Comfortable Design | Limitation | [38,46,47,52] | |
Seamless Integration | Opportunity | [33,38,52,56] | |
Seamless Integration | Limitation | [33,38,52,56] | |
Non-Invasive Health Monitoring | Opportunity |
| [33,38,47,50,52,56,66] |
Non-Invasive Health Monitoring | Limitation | [33,38,47,50,52,56,66] | |
Imaging and Multiplexed Detection | Opportunity | [38,46,52,67] | |
Imaging and Multiplexed Detection | Limitation | [38,46,52,67] | |
Wearable Chemical Sensors | Opportunity | [38,45,52,59] | |
Wearable Chemical Sensors | Limitation | [38,45,52,59] | |
Cost-Effective Fabrication Methods | Opportunity |
| [38,52,61,62] |
Cost-Effective Fabrication Methods | Limitation | [38,52,61,62] | |
Security Applications | Opportunity | [38,46,52,67] | |
Security Applications | Limitation | [38,46,52,67] |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Pirrera, A.; Giansanti, D. Smart Tattoo Sensors 2.0: A Ten-Year Progress Report through a Narrative Review. Bioengineering 2024, 11, 376. https://doi.org/10.3390/bioengineering11040376
Pirrera A, Giansanti D. Smart Tattoo Sensors 2.0: A Ten-Year Progress Report through a Narrative Review. Bioengineering. 2024; 11(4):376. https://doi.org/10.3390/bioengineering11040376
Chicago/Turabian StylePirrera, Antonia, and Daniele Giansanti. 2024. "Smart Tattoo Sensors 2.0: A Ten-Year Progress Report through a Narrative Review" Bioengineering 11, no. 4: 376. https://doi.org/10.3390/bioengineering11040376
APA StylePirrera, A., & Giansanti, D. (2024). Smart Tattoo Sensors 2.0: A Ten-Year Progress Report through a Narrative Review. Bioengineering, 11(4), 376. https://doi.org/10.3390/bioengineering11040376