<p>Potential Applications of Nanomaterials and Technology for Diabetic Wound Healing</p>

Abstract

Diabetic wound shows delayed and incomplete healing processes, which in turn exposes patients to an environment with a high risk of infection. This article has summarized current developments of nanoparticles/hydrogels and nanotechnology used for promoting the wound healing process in either diabetic animal models or patients with diabetes mellitus. These nanoparticles/hydrogels promote diabetic wound healing by loading bioactive molecules (such as growth factors, genes, proteins/peptides, stem cells/exosomes, etc.) and nonbioactive substances (metal ions, oxygen, nitric oxide, etc.). Among them, smart hydrogels (a very promising method for loading many types of bioactive components) are currently favored by researchers. In addition, nanoparticles/hydrogels can be combined with some technology (including PTT, LBL self-assembly technique and 3D-printing technology) to treat diabetic wound repair. By reviewing the recent literatures, we also proposed new strategies for improving multifunctional treatment of diabetic wounds in the future.

Extracellular Vesicles in Skin Wound Healing

“…Both engineered and naturally derived EVs encapsulated in hydrogels are promising techniques for wound healing because they deliver EVs in the wound site and ensure prolonged and sustained release [ 223 ]. The scaffolding technologies are moving towards developing so-called smart hydrogels that can sense and respond to wound environmental parameters, such as pH, ROS levels, glucose concentrations, and so on [ 224 ]. By improving some properties of liposome-loaded and EV-loaded hydrogels, the release of these nanovesicles can be better controlled [ 225 ].…”

“…In response to specific stimulation (near-infrared laser irradiation or pH), substances in the scaffold are delivered in a tuned manner without instant explosive drug release. Future direction should be precise gradual administration of desired EVs at different stages of wound healing [ 224 ]. It has been shown that the combination of nanomedicine and oxygen-producing materials (such as SPO, CaO 2 , MgO 2 , H 2 O 2 ) relieve wound hypoxia and improve chronic diabetic wound healing [ 226 , 227 ].…”

“…It has been shown that the combination of nanomedicine and oxygen-producing materials (such as SPO, CaO 2 , MgO 2 , H 2 O 2 ) relieve wound hypoxia and improve chronic diabetic wound healing [ 226 , 227 ]. The next step might be developing new multi-functional biomaterials (e.g., improving hypoxia, enhancing angiogenesis, reducing oxidative stress) that would provide a balanced environment and regulate wound healing at all stages [ 224 ]. What is more, there is no data regarding smart hybrid nanovesicles (liposome and EVs hybrids) and their coupling with hydrogel systems [ 225 ].…”

Comparative Evaluation of Different Chitosan Species and Derivatives as Candidate Biomaterials for Oxygen-Loaded Nanodroplet Formulations to Treat Chronic Wounds

“…For these reasons, intensive research has been focused in the recent years on the development of new oxygen carriers, including hemoglobin-based carriers and perfluorocarbon-containing formulations [ 14 ]. Among perfluorocarbon emulsions of the first generation, Fluosol ® is the only medical device approved by the Food and Drugs Administration and unfortunately no perfluorocarbon-based oxygen emulsion of the second generation is currently approved for clinical uses [ 15 ].…”

Therapeutic Role of Nitric Oxide in Diabetic Wound Healing: A Systematic Review

“…Process of healthy wound recovery takes place within 30 days, whereas diabetic wound remains unresolved. Many researchers are focusing on developing effective strategies against diabetes-associated wound (a leading cause of amputations) [5].…”