Poorly healing and nonhealing diabetic wounds are challenging
to
treat as the rapid growth of bacteria due to the high local glucose
content can lead to persistent inflammation and poor angiogenesis.
Herein, a smart hydrogel dressing composed of 3,3′,5,5′-tetramethylbenzidine/ferrous
ion/Pluronic F-127/glucose oxidase (TMB/Fe2+/PF127/GOx)
is designed and demonstrated to consume blood glucose while accelerating
wound healing by generating antibacterial agents in situ. The loaded GOx degrades blood glucose to provide hydrogen peroxide
(H2O2) and gluconic acid to support the Fe2+-based Fenton reaction, and the generated hydroxyl radical
(·OH) facilitates the oxidation of TMB. The color change from
colorless to green caused by the oxidation of TMB in the blood glucose
range between 1 and 10 mM can be monitored visually. Simultaneously,
this process induced chemodynamic therapy (CDT) by the specific generation
of hydroxyl radical (·OH) for killing bacteria. Moreover, the
oxidized TMB shows strong absorption in the near infrared (NIR) region
so that NIR light can be converted into heat efficiently for photothermal
therapy (PTT). As a result, nearly 100% of Staphylococcus
aureus and Escherichia coli are killed by
synergistic PTT/CDT, and the infected skin wounds undergo complete
repair along with downregulation of interleukin-6 (IL-6) and upregulation
of the vascular endothelial growth factor (VEGF) and matrix metallopeptidase-2
(MMP-2). Different from traditional wound dressings that can give
rise to secondary injury, the excellent thermosensitive properties
arising from the sol/gel phase transition render the hydrogel dressing
materials injectable, self-reparable, and removable on demand. The
multifunctional hydrogel with hypoglycemic, chemodynamic, photothermal,
antibacterial, and on-demand thermosensitive properties has immense
potential in the treatment of diabetic wounds.