Management Of Diabetic Wounds Research Articles

A Multifunctional Hydrogel Fabricated by Direct Self-Assembly of Natural Herbal Small Molecule Mangiferin for Treating Diabetic Wounds.

Clinical studies have continually referred to the involvement of drug carrier having dramatic negative influences on the biocompatibility, biodegradability, and loading efficacy of hydrogel. To overcome this deficiency, researchers have proposed to directly self-assemble natural herbal small molecules into a hydrogel without any structural modification. However, it is still a formidable challenge due to the high requirements on the structure of natural molecules, leading to a rarity of this type of hydrogel. Mangiferin (MF) is a natural polyphenol of C-glucoside xanthone with various positive health benefits, including the treatment of diabetic wounds, but its poor hydrosolubility and low bioavailability significantly restrict the clinical application. Inspired by these, with heating/cooling treatment, a carrier-free hydrogel (MF-gel) is developed by assembling the natural herbal molecule mangiferin, which is mainly governed through hydrogen bonds and intermolecular π-π stacking interactions. The as-prepared hydrogel has injectable and self-healing properties and shows excellent biocompatibility, continuous release ability, and reversible stimuli-responsive performances. All of the superiorities enable the MF-based hydrogel to serve as a potential wound dressing for treating diabetic wounds, which was further confirmed by both the vitro and vivo studies. In vitro, the MF-gel could promote the migration of healing-related cells from peripheral as well as the angiogenesis and displays the capacity of mediating inflammation response by scavenging the intracellular ROS. In vivo, the MF-gel accelerates wound contraction and healing via inflammatory adjustment, collagen deposition, and angiogenesis. This study provides a facile and effective method for diabetic wound management and emphasizes the direct self-assembly hydrogel from natural herbal small molecule.

Platelet-Rich Plasma/Chitosan/Chondroitin sulfate immunomodulatory hydrogel Co-Networks for diabetic wound Repair: Functions and molecular mechanisms

Diabetic wound healing encounters numerous challenges including bacterial infection, macrophage dysfunction, excessive inflammation, and oxidative stress, causing delays in the overlapping processes of inflammation, proliferation, and remodeling and thus imposing a high burden on patients. Platelet-rich plasma (PRP) has demonstrated significant potential for diabetic wound treatment by promoting granulation tissue formation, collagen deposition, re-epithelialization, and angiogenesis. However, the underlying molecular and cellular mechanisms remain unclear. Here, immunomodulatory hydrogel co-networks based on PRP, with strong hemostatic, antibacterial, and free radical scavenging effects, are developed for diabetic wound treatment. In vitro and in vivo, the hydrogels can reduce endothelial cell apoptosis and promote tube formation by regulating the oxidative stress microenvironment. For anti-inflammatory and tissue repair, the hydrogels can facilitate the M2 macrophage polarization by inhibiting phosphorylation of p-IκBα and p-P65 in the NF-κB signaling pathway. Through increasing the expression of key angiogenic factors (HIF-1α, VEGF, and FGF2), the hydrogels can significantly promote angiogenesis and the formation of endothelial cell tubular structures. These findings offer new insight into the synergistic regulatory contributions of the PRP-based therapy throughout multiple stages of healing, thereby establishing a biomolecular and cellular foundation for advanced diabetic wound management.

Diabetic Wound Healing: Navigating Physiology, Advancements and Research Frontiers

Diabetes, a multifaceted metabolic disorder characterized by inadequate insulin production or resistance, intricately intertwines with the challenging landscape of wound healing, particularly in the context of diabetic wounds. This review embarks on a comprehensive exploration, commencing with an overview of diabetes physiology, setting the stage for understanding its intricate interplay with wound healing complexities. Navigating through the physiology of diabetic wounds, this review encapsulates their classification and the intricate molecular and cellular mechanisms orchestrating the healing process. However, amidst commendable advancements, a discernible research gap remains, urging a more nuanced comprehension of diabetic wound pathophysiology. Examining treatment approaches, this article critically assesses various methods for diabetic wound healing efficacy, rooted in recent studies. It explores advanced therapies and emerging technologies, envisioning possibilities such as 3D printing and smart dressing applications. Nonetheless, integrating these technologies into clinical practice awaits exploration, highlighting a research gap in standardizing these advancements. Infection control and antibiotics are pivotal in diabetic wound management. This review underscores their importance, stressing the need for refined research strategies to optimize antibiotic use and combat evolving bacterial resistance. Furthermore, advocating for patient-centered care and education, this review emphasizes holistic approaches, underscoring a persistent gap in seamlessly integrating patient education into routine wound management protocols. This review offers comprehensive insights into diabetic wound physiology, treatment modalities, and emerging technologies while highlighting persistent research gaps demanding further exploration and refinement.

Mechanical biomimetic silk nano fiber-magnesium ion complex/hydroxyethylcellulose/glycerol hydrogel dressing with angiogenic capacity for accelerating scarless diabetic wound healing

Quick scarless healing remains a key issue for diabetic wounds. Here, a stretchable elastomeric hydrogel dressing composed of hydroxyethylcellulose (HEC), silk nano fiber-magnesium ion complex (Mg2+-SNF) and glycerol (Gly) was developed to optimize mechanical niche, anti-inflammatory and angiogenic behavior simultaneously. The composite hydrogel dressing exhibited skin-like elasticity (175.1 ± 23.9 %) and modulus (156.7 ± 2.5 KPa) while Mg2+-SNF complex endowed the dressing with angiogenesis, both favoring quick scarless skin regeneration. In vitro cell studies revealed that the hydrogel dressing stimulated fibroblast proliferation, endothelial cell migration and vessel-like tube formation, and also induced anti-inflammatory behavior of macrophages. In vivo results revealed accelerated healing of diabetic wounds. The improved granulation ingrowth and collagen deposition suggested high quality repair. Both thinner epidermal layer and low collagen I/III ratio of the regenerated skin confirmed scarless tissue formation. This bioactive hydrogel dressing has promising potential to address the multifaceted challenges of diabetic wound management.

Glucose Oxidase Energized Osmium with Dual-Active Centers and Triple Enzyme Activities for Infected Diabetic Wound Management.

Diabetic wounds are susceptible to bacterial infections, largely linked to high blood glucose levels (hyperglycemia). To treat such wounds, enzymes like glucose oxidase (GOx) can be combined with nanozymes (nanomaterials mimic enzymes) to use glucose effectively for purposes. However, there is still room for improvement in these systems, particularly in terms of process simplification, enzyme activity regulation, and treatment effects. Herein, the approach utilizes GOx to directly facilitate the biomineralized growth of osmium (Os) nanozyme (GOx-OsNCs), leading to dual-active centers and remarkable triple enzyme activities. Initially, GOx-OsNCs use vicinal dual-active centers, enabling a self-cascaded mechanism that significantly enhances glucose sensing performance compared to step-by-step reactions, surpassing the capabilities of other metal sources such as gold and platinum. In addition, GOx-OsNCs are integrated into a glucose-sensing gel, enabling instantaneous visual feedback. In the treatment of infected diabetic wounds, GOx-OsNCs exhibit multifaceted benefits by lowering blood glucose levels and exhibiting antibacterial properties through the generation of hydroxyl free radicals, thereby expediting healing by fostering a favorable microenvironment. Furthermore, the catalase-like activity of GOx-OsNCs aids in reducing oxidative stress, inflammation, and hypoxia, culminating in improved healing outcomes. Overall, this synergistic enzyme-nanozyme blend is user-friendly and holds considerable promise for diverse applications.

Resistance Profile of Bacteria Isolated from Diabetic Wounds: Phytochemicals and Antibacterial Studies of Eriosema robustum Leaf Extracts

Resistance Profile of Bacteria Isolated from Diabetic Wounds: Phytochemicals and Antibacterial Studies of Eriosema robustum Leaf Extracts

A one-two punch strategy for diabetic wound management based on an antibiotic-hybrid biomineralized iron sulfide nanoparticle

Bacterial infection and immune imbalance are the primary culprits behind chronic wounds in individuals with diabetes, impeding the progression of damaged tissues towards normal healing. To achieve a harmonious balance between pro- and anti-inflammation within these infected areas, herein, we propose a one-two punch strategy for on-demand therapy of diabetes-infected wounds, utilizing an azithromycin (AZM)-hybrid nanocomposite termed GOx@FexSy/AZM. During the infective stage, the nanocomposite facilitates the production of ROS, coupled with the burst release of AZM and H2S gas, effectively dismantling biofilms and achieving rapid sterilization. Subsequently, the hyperinflammatory response induced by antibiosis is significantly mitigated through the synergistic action of tissue H2S and the prolonged half-life of AZM. These components inhibit the activity of pro-inflammatory transcription factors (AP-1 and NF-κB) within macrophages, thereby promoting the polarization of macrophages towards a reparative M2 phenotype and facilitating tissue remodeling. By catering to the diverse requirements of wound healing at different stages, this nanocomposite accelerates a sensible transition from inflammation to the reparative phase. In summary, this one-two punch strategy gives an instructive instance for procedural treatment of diabetes wound infection. Statement of significanceThe treatment of diabetic wound infection presents two major challenges: the diminished antibacterial efficacy arising from biofilm formation and bacterial resistance, as well as the inadequate transition of the wound microenvironment from pro-inflammatory to anti-inflammatory states after bacterial clearance. In this work, a biomineralized iron sulfide nanocomposite was prepared to mediate cascade catalytic (ROS storm) / antibiotic (AZM) / gas (H2S) triple-synergetic antibacterial therapy during the initial stage of bacterial infection, achieving the goal of rapid bactericidal effect; Subsequently, the residual H2S and long half-life AZM would inhibit the key pro-inflammatory transcription factors and promote the macrophages polarization to reparative M2, which effectively mediated tissue repair after hyperinflammatory reactions, leading to orderly treatment of hyperglycemic infected wounds.

Glycopeptide-based multifunctional nanofibrous hydrogel that facilitates the healing of diabetic wounds infected with methicillin-resistant Staphylococcus aureus

Diabetic wound management remains a significant challenge in clinical care due to bacterial infections, excessive inflammation, presence of excessive reactive oxygen species (ROS), and impaired angiogenesis. The use of multifunctional wound dressings has several advantages in diabetic wound healing. Moreover, the balance of macrophage polarization plays a crucial role in promoting skin regeneration. However, few studies have focused on the development of multifunctional wound dressings that can regulate the inflammatory microenvironment and promote diabetic wound healing. In this study, an extracellular matrix-inspired glycopeptide hydrogel composed of glucomannan and polypeptide was proposed for regulating the local microenvironment of diabetic wound sites. The hydrogel network, which was formed via Schiff base and hydrogen bonding interactions, effectively inhibited inflammation and promoted angiogenesis during wound healing. The hydrogels exhibited sufficient self-healing ability and had the potential to scavenge ROS and to activate the mannose receptor (MR), thereby inducing macrophage polarization toward the M2 phenotype. The experimental results confirm that the glycopeptide hydrogel is an effective tool for managing diabetic wounds by showing antibacterial, ROS scavenging, and anti-inflammatory effects, and promoting angiogenesis to facilitate wound repair and skin regeneration in vivo. Statement of Significance•The designed wound dressing combines the advantage of natural polysaccharide and polypeptide.•The hydrogel promotes M2-polarized macrophages, antibacterial, scavenges ROS, and angiogenesis.•The multifunctional glycopeptide hydrogel dressing could accelerating diabetic wound healing in vivo.

Hybrid Hydrogels for Immunoregulation and Proangiogenesis through Mild Heat Stimulation to Accelerate Whole-Process Diabetic Wound Healing.

Intense and persistent oxidative stress, excessive inflammation, and impaired angiogenesis severely hinder diabetic wound healing. Bioactive hydrogel dressings with immunoregulatory and proangiogenic properties have great promise in treating diabetic wounds. However, the therapeutic effects of dressings always depend on drugs with side effects, expensive cytokines, and cell therapies. Herein, a novel dynamic borate-bonds crosslinked hybrid multifunctional hydrogel dressings with photothermal properties are developed to regulate the microenvironment of diabetic wound sites and accelerate the whole process of its healing without additional medication. The hydrogel is composed of phenylboronic acid-modified chitosan and hyaluronic acid (HA) crosslinked by tannic acid (TA) through borate bonds and Prussian blue nanoparticles (PBNPs) with photothermal response characteristics are embedded in the polymer networks. The results indicate hydrogels show inherent broad-spectrum antioxidative activities through the integrated interaction of borate bonds, TA, and PBNPs. Meanwhile, combined with the regulation of macrophage phenotype by HA, the inflammatory microenvironment of diabetic wounds is transformed. Moreover, the angiogenesis is then enhanced by the mild photothermal effect of PBNPs, followed by promoted epithelialization and collagen deposition. In summary, this hybrid hydrogel system accelerates all stages of wound repair through antioxidative stress, immunomodulation, and proangiogenesis, showing great potential applications in diabetic wound management.

Evaluation of Interleukin-1β, Interleukin-6 and Interleukin-10 Profiles in Serum and Surgically Created Wound Exudates of Alloxan-Induced Diabetic Rabbits

The knowledge of immune-modulatory actions of interleukins could be of immense value in the management of diabetic wounds. This study evaluated the interleukin profiles of diabetic wounded rabbits. Sixteen New Zealand White rabbits of mean weight 2.5 ± 0.7 kg used for this study were divided into four groups; A, B, C and D, of four rabbits each; A (non-diabetic and non-wounded) as control, B (diabetic and non-wounded, C (wounded and non-diabetic) and D (wounded and diabetic). Three (3) cm2 skin wounds were created in a standard aseptic procedure while diabetes was induced by administration of alloxan monohydrate. Serum and wound exudate were harvested on days 0, 3, 7, 14, 21 and 28 for Interleukin-1β, Interleukine-6 and Interleukine-10 assays. The increases in the serum concentration of Interleukin-1β and Interleukine-6 in the C rabbit group between days 3 and 7 (Interleukin-1β) and between days 3 and 28 (Interleukine-6) were relatively higher than the corresponding day 0 and control values. The decrease in the serum concentration of IL-10 (ng /mL) in B rabbit group from days 7 (36.96 ± 8.7) to 14 (128.12 ± 12.05) were significantly lower (P˂0.05) than the corresponding values in groups A and C rabbits. The values of Interleukine-10 in wound exudate of C rabbit group from days 7 (160.57 ± 23.76 ng /mL) to 21 (177.30 ± 8.60 ng /mL) were significantly higher (P<0.05) than the corresponding group D values. The evidence shows that, the values of Interleukin-1β and Interleukine-6 are up regulated in the inflammatory phase of wound healing in normoglycaemic and diabetic rabbits while the values of Interleukine-10 is down regulated during wound healing in diabetic rabbits. Therefore, the knowledge of interleukin markers shall be of significant roles in proffering solution for management of normoglycaemic and diabetic wounds.

Promoting Diabetic Wound Healing through a Hydrogel-Based Cascade Regulation Strategy of Fibroblast-Macrophage.

The management of diabetic wounds (DWs) continues to pose a significant challenge in the field of medicine. DWs are primarily prevented from healing due to damage to macrophage efferocytosis and fibroblast dysfunction. Consequently, a treatment strategy that involves both immunoregulation and the promotion of extracellular matrix (ECM) formation holds promise for healing DWs. Nevertheless, existing treatment methods necessitate complex interventions and are associated with increased costs, for example, the use of cytokines and cell therapy, both of which have limited effectiveness. In this study, a new type of ruthenium (IV) oxide nanoparticles (RNPs)-laden hybrid hydrogel dressing with a double network of Pluronic F127 and F68 has been developed. Notably, the hybrid hydrogel demonstrates remarkable thermosensitivity, injectability, immunoregulatory characteristics, and healing capability. RNPs in hydrogel effectively regulate both fibroblasts and macrophages in a cascade manner, stimulating fibroblast differentiation while synergistically enhancing the efferocytosis of macrophage. The immunoregulatory character of the hydrogel aids in restoring the intrinsic stability of the immune microenvironment in the wound and facilitates essential remodeling of the ECM. This hydrogel therefore offers a novel approach for treating DWs through intercellular communication.

Turmeric-Derived Nanoparticles Functionalized Aerogel Regulates Multicellular Networks to Promote Diabetic Wound Healing.

Regulation of excessive inflammation and impaired cell proliferation is crucial for healing diabetic wounds. Although plant-to-mammalian regulation offers effective approaches for chronic wound management, the development of a potent plant-based therapeutic presents challenges. This study aims to validate the efficacy of turmeric-derived nanoparticles (TDNPs) loaded with natural bioactive compounds. TDNPs can alleviate oxidative stress, promote fibroblast proliferation and migration, and reprogram macrophage polarization. Restoration of the fibroblast-macrophage communication network by TDNPs stimulates cellular regeneration, in turn enhancing diabetic wound healing. To address diabetic wound management, TDNPs are loaded in an ultralight-weight, high swelling ratio, breathable aerogel (AG) constructed with cellulose nanofibers and sodium alginate backbones to obtain TDNPs@AG (TAG). TAG features wound shape-customized accessibility, water-adaptable tissue adhesiveness, and capacity for sustained release of TDNPs, exhibiting outstanding performance in facilitating in vivo diabetic wound healing. This study highlights the potential of TDNPs in regenerative medicine and their applicability as a promising solution for wound healing in clinical settings.

Bioinspired wet adhesive carboxymethyl cellulose-based hydrogel with rapid shape adaptability and antioxidant activity for diabetic wound repair

Currently, adhesive hydrogels have shown promising effect in chronic diabetic wound repair. However, there are issues and challenges in treating diabetic wounds due to inadequate wet adhesion, unable to fill irregular and deep wounds, and oxidative stress. Herein, a mussel-inspired naturally hydrogel dressing with rapid shape adaptability, wet adhesion and antioxidant abilities for irregular, deep and frequently movement diabetic wounds repair was constructed by comprising catechol modified carboxymethyl cellulose (CMC-DA) and tannic acid. Benefiting from the reversible hydrogen bonding, the resulting hydrogels exhibited injectability, remarkable self-healing ability, rapid shape adaptability and strong tissue adhesion (45.9 kPa), thereby contributing to self-adaptive irregular-shaped wounds or moving joint parts. Especially, the adhesion strength of the hydrogel on wet tissue still remained at 14.9 kPa. Besides, the hydrogels could be easily detached from the skin by ice-cooling that avoided secondary damage caused by dressing change. Remarkably, the hydrogels possessed excellent antioxidant, satisfactory biocompatibility, efficient hemostasis and antibacterial properties. The in vivo evaluation further demonstrated that the hydrogel possessed considerable wound-healing promotion effect by regulating diabetic microenvironment, attributed to that the hydrogel could significantly reduce inflammatory response, alleviate oxidative stress and regulate neovascularization. Overall, this biosafe adhesive hydrogel had great potentials for diabetic wound management.

Assessment of wound healing activity in diabetic mice treated with a novel therapeutic combination of selenium nanoparticles and platelets rich plasma

Diabetic wound healing is sluggish, often ending in amputations. This study tested a novel, two-punch therapy in mice—Selenium nanoparticles (Se NPs) and platelet-rich plasma (PRP)—to boost healing. First, a mouse model of diabetes was created. Then, Se NPs were crafted for their impressive antioxidant and antimicrobial powers. PRP, packed with growth factors, was extracted from the mice's blood. Wound healing was tracked for 28 days through photos, scoring tools, and tissue analysis. Se NPs alone spurred healing, and PRP added extra fuel. Furthermore, when used in combination with PRP, the healing process was accelerated due to the higher concentration of growth factors in PRP. Notably, the combination of Se NPs and PRP exhibited a synergistic effect, significantly enhancing wound healing in diabetic mice. These findings hold promise for the treatment of diabetic wounds and have the potential to reduce the need for lower limb amputations associated with diabetic foot ulcers. The innovative combination therapy using Se NPs and PRP shows great potential in expediting the healing process and addressing the challenges of impaired wound healing in individuals with diabetes. This exciting finding suggests this therapy could change diabetic wound management, potentially saving limbs and improving lives.

Diabetic Wound: Pathophysiology, Complications and Treatment Strategies.

Diabetic wound healing is expected to affect 25% of all diabetics, resulting in less severe external factors, economic costs, and less trauma. Topical formulations have been continually improved to achieve a range of amazing properties and have had a significant impact on the management of diabetic wounds. Topical insulin has become one of the most attractive and convenient wound healing techniques due to its excellent biocompatibility, water retention, and therapeutic properties. Multiple versatile topical insulins have been identified and have shown promise over the past few years as they greatly facilitate the management of diabetic wounds as we understand their etiology. The physiological wound healing process repairs damaged tissue and restores skin integrity. For about a century, insulin, a powerful healing agent, and it has been utilized in several clinical and experimental researches research studies to accelerate the healing of various injuries.

The Mechanism of Pyroptosis and Its Application Prospect in Diabetic Wound Healing.

Pyroptosis defines a form of pro-inflammatory-dependent programmed cell death triggered by gasdermin proteins, which creates cytoplasmic pores and promotes the activation and accumulation of immune cells by releasing several pro-inflammatory mediators and immunogenic substances upon cell rupture. Pyroptosis comprises canonical (mediated by Caspase-1) and non-canonical (mediated by Caspase-4/5/11) molecular signaling pathways. Numerous studies have explored the contributory roles of inflammasome and pyroptosis in the progression of multiple pathological conditions such as tumors, nerve injury, inflammatory diseases and metabolic disorders. Accumulating evidence indicates that the activation of the NOD-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasome results in the activation of pyroptosis and inflammation. Current evidence suggests that pyroptosis-dependent cell death plays a progressive role in the development of diabetic complications including diabetic wound healing (DWH) and diabetic foot ulcers (DFUs). This review presents a brief overview of the molecular mechanisms underlying pyroptosis and addresses the current research on pyroptosis-dependent signaling pathways in the context of DWH. In this review, we also present some prospective therapeutic compounds/agents that can target pyroptotic signaling pathways, which may serve as new strategies for the effective treatment and management of diabetic wounds.

Design, Development and In-Vitro Characterization of Insulin Loaded Topical Pluronic-Lecithin Based Organogel Formulation for the Management of Diabetic Wound.

To develop and characterize the topical insulin-loaded organogel formulation for the management of diabetic wounds. To formulate and evaluate organogel of insulin that can serve as a topical administration for promoting enhanced wound healing in diabetic patients by providing sustained and localized delivery of drug to the wound site. The insulin organogel formulated by the micro-emulsion method involves mixing the "aqueous and oil phases" at high shear. Physical and chemical properties, as well as an in vitro study with a Franz diffusion chamber, were used to evaluate the prepared organogel. All formulations proved to be off-white, homogeneous, washable, and had a pH between 6 and 6.5; moreover, they were non-irritating and skin-compatible. Formulations F1-F6 had viscosity ranging from 2058 to 3168 cps, spreadability ranges of 0.35 to 0.52 g*cm/s, and gel transition ranges of 28.33 to 35.33 °C. In formulations F1-F3, the concentration of lecithin was gradually increased, and in formulations F4-F6, the concentration of PF-127 was increased, resulting in a decrease in gel transition temperature, an increase in viscosity, and a gradual change in spreadability. The higher-viscosity formulations were much more stable and had better drug release. All formulations were fitted to a kinetic model belonging to first-order kinetics. However, after examining the parameter evaluation, it was found that the formulations F2 and F6 were better suited to the kinetic model and were consistent with the first-order and Higuchi models in Korsmeyer-Peppas F2 (r2 = 0.9544 and n = 1.0412); F6 (r2 = 0.9019 and n = 1.0822), which was a confirmation of the sustainability of the release system with matrix diffusion and drug delivery mechanisms that were based on the Super-Case II transport. Further research and clinical trials are needed to validate its efficacy, optimize the formulation, and establish its long-term safety. Topical insulin organogel has the potential to revolutionize diabetic wound management by improving healing outcomes, reducing complications, and raising the standard of living for those who have diabetes.

Polymer Hydrogel‐Based Multifunctional Theranostics for Managing Diabetic Wounds

AbstractChronic, non‐healing wounds pose significant challenges for public health, particularly in the context of diabetes, and carry significant economic consequences. This article introduces a new solution in the form of a wireless theranostic patch, developed to meet the critical need for real‐time monitoring and targeted treatments to facilitate optimal healing. The patch incorporates advanced materials that are both multifunctional and electro‐responsive, leveraging a sophisticated blend of smart hydrogels and wearable bioelectronics to support diabetic wound management with unparalleled efficacy. With electro‐responsive multifunctional polymer hydrogels at its core, the patch delivers a stretchable, antimicrobial, and moist environment for the wound, with added benefits such as conductivity and visibility. The materials also allow for continuous and autonomous monitoring of glucose and pH levels, providing precise and personalized treatments like insulin delivery via iontophoresis and electrical stimulation. Animal models have demonstrated that this integrated system is highly adaptable, effectively promoting wound closure and healing. Overall, the wireless theranostic system offers an exciting prospect for personalized healthcare solutions, adopting a patient‐centric approach that prioritizes real‐time, targeted care for chronic wounds. Its incorporation of advanced materials and electro‐controlled treatments paves the way for new and innovative approaches to wound management.

Self‐Healing, Injectable Hydrogel Dressing for Monitoring and Therapy of Diabetic Wound

AbstractChronic diabetic wound repair is a global medical challenge. Developing a hydrogel dressing to effectively promote angiogenesis and detect wound state in diabetic wound management is an unmet medical requirement. Herein, a facile and efficient strategy to prepare self‐healing hydrogel with enhanced angiogenesis and real‐time monitoring for diabetic wounds is presented, by cross‐linking carboxymethyl cellulose (CMC) with precoordinated europium‐ethylenediaminetetraacetic acid (Eu‐EDTA) complexes. Benefiting from the dynamic and reversible coordination interaction formation, the hydrogel exhibits remarkable injectability and self‐healing properties, thus forming efficient coverage in irregular and deep wounds with minimally invasive procedures. Furthermore, the fluorescence of the hydrogel changes linearly with pH value in the range of 4.5–7.5 and enables real‐time pH measurement to monitor the wound state. More importantly, the hydrogel can effectively promote the proliferation and migration of endothelial cells and enhance tube formation ability, demonstrating great angiogenesis capacity in tissue remodeling. The in vivo experiments manifested that the hydrogel can enhance angiogenesis by upregulating the expression of angiogenesis‐related factors and downregulating matrix metalloproteinase‐9 (MMP‐9), contributing to granulation tissue formation, collagen deposition, and diabetic wound repair. This work can provide a promising strategy for diagnosis and therapy in clinical diabetic wounds.

Tailored gelatin methacryloyl-based hydrogel with near-infrared responsive delivery of Qiai essential oils boosting reactive oxygen species scavenging, antimicrobial, and anti-inflammatory activities for diabetic wound healing

The management of diabetic wounds poses a substantial economic and medical burden for diabetic patients. Oxidative stress and persistent bacterial infections are considered to be the primary factors. Qiai essential oil (QEO) exhibits various pharmacological characteristics, including inflammatory-reducing, antibacterial, and antioxidant properties. Nevertheless, the hydrophobic nature and propensity for explosive release of this substance present constraints on its potential for future applications. Here, we developed a stimulus-responsive hydrogel to overcome the multiple limitations of QEO-based wound dressings. The QEO was encapsulated within graphene oxide (GO) through repeated extrusion using an extruder. Subsequently, QEO@GO nanoparticles were incorporated into a Gelatin-methacryloyl (GelMA) hydrogel. The QEO@GO-GelMA hydrogel demonstrated controlled release ablation, photothermal antibacterial effects, and contact ablation against two representative bacterial strains. It effectively reduced reactive oxygen species (ROS) generation, promoted angiogenesis, and decreased levels of the pro-inflammatory cytokine interleukin-6 (IL-6), thereby accelerating the healing process of diabetic wounds. In addition, in vitro and in vivo tests provided further evidence of the favorable biocompatibility of this multifunctional hydrogel dressing. Overall, the QEO@GO-GelMA hydrogel provides numerous benefits, encompassing antimicrobial properties, ROS-scavenging abilities, anti-inflammatory effects, and the capacity to expedite diabetic wound healing. These attributes make it an optimal choice for diabetic wound management.