Functional hydrogels for diabetic wound management

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.

Diabetic Wound-Healing Science

“…Wound-healing strategies can fall under standard of care therapies and advanced therapies, with the standard of care treatment involving wound debridement, offloading, and glycemic and infection control, whereas advanced therapies include hyperbaric oxygen therapy (HBOT), wound dressings, negative pressure wound therapy (NPWT), and growth factor therapies including platelet-rich plasma, stem cells, and cell- and tissue-based products [ 2 , 4 ] ( Table 1 ). Considering the clinical need, stimuli-responsive and multifunctional treatment strategies that can accelerate diabetic wound healing are likely to be an important part of future diabetic wound management [ 1 ].…”

“…Currently, close to 500 million people are estimated to be suffering from diabetes mellitus (DM), with a predicted startling increase in the upcoming years. In the US alone, over $300 billion is spent annually on both medical costs and as a result of lost workdays due to DM [ 1 , 2 ]. Moreover, one estimate suggests that between one in three to one in every five patients with DM will develop a chronic non-healing wound in their lifetime, such as a diabetic foot ulcer (DFU), with an alarming recurrence rate (40% within one year and 65% within five years) and no reliable methods available to predict its occurrence [ 3 , 4 ].…”

Progress in Hydrogels for Skin Wound Repair

“…The repair of wound is a long and complex process. [168] During this period, the physiological environment parameters of the injured site are constantly changing. Therefore, the development of smart dressings that can monitor and manage wounds in real time is important for wound healing.…”

Functional biomaterials

“…24 Pan and colleagues then, in another review, discuss polymer-based hydrogel biomaterials utilized towards hemostasis-control and wound-dressing. 25 Gao and colleagues further narrow down the scope by specifically describing stimuli-responsive and multi-functional hydrogels that are suitable for the management of diabetic wounds, 26 concluding the Special Topic.…”