Diverse Antibacterial Treatments beyond Antibiotics for Diabetic Foot Ulcer Therapy

Abstract

Diabetic foot ulcer (DFU), a common complication of diabetes, has become a great burden to both patients and the society. The delayed wound closure of ulcer sites resulting from vascular damage and neutrophil dysfunction facilitates bacterial infection. Once drug resistance occurs or bacterial biofilm is formed, conventional therapy tends to fail and amputation is unavoidable. Therefore, effective antibacterial treatment beyond antibiotics is of utmost importance to accelerate the wound healing process and prevent amputation. Considering the complexity of multidrug resistance, biofilm formation, and special microenvironments (such as hyperglycemia, hypoxia, and abnormal pH value) at the infected site of DFU, several antibacterial agents and different mechanisms have been explored to achieve the desired outcome. The present review focuses on the recent progress of antibacterial treatments, including metal‐based medications, natural and synthesized antimicrobial peptides, antibacterial polymers, and sensitizer‐based therapy. This review provides a valuable reference for the innovation of antibacterial material design for DFU therapy.

Recent advances of hydrogels as smart dressings for diabetic wounds

“…How to prevent microbial infection and protect the wound surface is a must-consider issue when designing smart hydrogels. 119 Currently, various strategies have been adopted to enable smart hydrogels to acquire antibacterial capabilities, such as introducing antibacterial agents (traditional antibiotics, inorganic metal antibacterial agents, natural extracts, antimicrobial peptides (AMPs), etc. ) into smart hydrogels, preparing hydrogels with inherent antibacterial capabilities, and photodynamic antibacterial properties.…”

Gases and gas-releasing materials for the treatment of chronic diabetic wounds

“…The molecular mechanism of diabetic wound healing is complex, involving a variety of damage repair and metabolic process dysfunction. 10–13 These include high glucose, advanced glycosylation end products, vascular disease, neuropathy, infection, long-term inflammation, and abnormal protein metabolism.…”

Photopolymerized Multifunctional Hydrogel Loaded with Asiaticoside and Growth Factor for Accelerating Diabetic Wound Healing

“…Hydrogel dressing, as the closest biological functional material to living tissue, has attracted much attention due to the fact that it can provide a good moist microenvironment, keep the wound clean, and effectively prevent bacterial infection to promote wound healing. , Moreover, the hydrogel has been used as an excellent carrier for loading therapeutic drugs or active growth factors because of its special three-dimensional network and porous structure. , Antibiotics have been widely used to promote wound healing due to their effective antibacterial and anti-inflammatory properties. , However, the use of antibiotics may lead to bacterial resistance in chronic wounds. Notably, asiaticoside (AS) is a natural Chinese herbal compound that rarely causes bacterial resistance.…”