Abstract
Diabetic wounds often have a slow healing process and become easily infected owing to hyperglycemia in wound beds. Once planktonic bacterial cells develop into biofilms, the diabetic wound becomes more resistant to treatment. Although it remains challenging to accelerate healing in a diabetic wound due to complex pathology, including bacterial infection, high reactive oxygen species, chronic inflammation, and impaired angiogenesis, the development of multifunctional hydrogels is a promising strategy. Multiple functions, including antibacterial, pro-angiogenesis, and overall pro-healing, are high priorities. Here, design strategies, mechanisms of action, performance, and application of functional hydrogels are systematically discussed. The unique properties of hydrogels, including bactericidal and wound healing promotive effects, are reviewed. Considering the clinical need, stimuli-responsive and multifunctional hydrogels that can accelerate diabetic wound healing are likely to form an important part of future diabetic wound management.
Highlights
Skin, the largest organ of the human body, comprises epidermis, dermis, and hypodermis.[1]
The main goal of this review is to introduce the role of hydrogels in the healing process of diabetic ulcers from the perspective of biomaterial design
This hydrogel had lower than 8% of unspecific protein adsorption in phosphate-buffered saline (PBS) solution containing 1 lg mlÀ1 horseradish peroxidase (HRP)-conjugated anti-IgG for 3 h
Summary
The largest organ of the human body, comprises epidermis, dermis, and hypodermis.[1]. Weight control, and patient education are part of the current clinical treatment for diabetic ulcers.[42] these treatments do not address the issues about bacterial infection, excessive ROS, and impaired angiogenesis, nor do they accelerate wound healing.[43] To solve these problems, new therapeutic approaches, including wound autografts, wound dressings, and tissue engineering scaffolds, have been extensively explored. The main goal of this review is to introduce the role of hydrogels in the healing process of diabetic ulcers from the perspective of biomaterial design. It highlights hydrogel dressings in different aspects during diabetic wound healing, including mitigation of infections and excessive ROS as well as promotion of angiogenesis. Multifunctional hydrogels with antibacterial function and the ability to sense or control topical pH or glucose levels can be fabricated to promote diabetic wound healing (Fig. 1)
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