Abstract Smart textiles have emerged as a transformative class of materials that extend the role of conventional fabrics into personalized health management. This evolution is driven by the seamless integration of textiles with flexible electronics, enabling new paradigms in skin-interfaced systems. In the exploration of novel smart textiles for skin health, microorganisms living in the skin microenvironment necessitate consideration. Skin microbiomes are essential to skin homeostasis and balance the barrier to infection. Moreover, microbes have been extensively explored as functional components in skin health monitoring and therapeutic devices. In this review, the distribution of skin microbes, interactions between host and resident microbiota, and mechanisms of microbial functions in the skin microenvironment are introduced systematically. In addition, recent progress in skin-based flexible devices for health management, and design and fabrication methods for smart textiles are discussed. However, some challenges still exist in association with the integration of microbes into smart textiles, such as the biosafety of microbes, long-term storage, and activation. This review provides a summary of innovative technologies including microencapsulation, synthetic biology, optogenetics, and artificial intelligence for microbe-integrated smart textiles. Next-generation smart textiles will hold significant promise for precision skin disease diagnostics, personalized therapeutics, skin status monitoring, and intelligence regulation. Graphical Abstract

Abstract Panvascular diseases, sharing atherosclerosis as a common pathological basis, pose a significant threat to human health. Flexible fibers combined with sensing elements become implantable and interventional smart fibers with monitoring and intervention capabilities. Due to the prolonged course of panvascular diseases, higher requirements are imposed on the monitoring-intervention closed-loop system of flexible fibers—high suitcordance (a combination of short-term suitability and long-term concordance). Suitcordance implies that novel flexible fibers must meet the traditional concept of compatibility and satisfy the new requirement of long-term co-regulation of fiber-vascular fate. This review introduces emerging flexible fiber electronic devices with exceptional performance related to panvascular diseases. These devices adapt well to the complex panvascular environment and provide ideal technical support for real-time, non-invasive, and continuous health monitoring-treatment. However, existing devices have limitations, and future research should focus on developing novel flexible smart fibers based on the clinical needs of panvascular diseases. Graphical Abstract Flexible fiber technology can revolutionize the panvascular medical paradigm. Flexible fiber technology aids in promptly identifying panvascular disease indicators, enabling better personalized treatment. Further developments include wireless design, miniaturization, multifunction, artificial intelligence-assisted diagnosis, virtual medicine, customized healthcare, etc., and the integration of monitoring-intervention closed-loop functions.