Design and fabrication of smart functional hydrogel wound dressing for diabetic foot ulcer

Abstract

Diabetic foot ulcer (DFU) often evolves into chronic wounds that resist healing over an extended period, sometimes necessitating amputation in severe cases. Traditional wound management approaches generally fail to control these chronic sores successfully. Thus, it arouses a huge demand in clinic for a novel wound dressing to treat DFU effectively. Hydrogel as an ideal delivery system exhibits excellent loading capacity and sustainable release behavior. It also boasts tunable physical and chemical properties adaptable to diverse biomedical scenarios, making it a suitable material for fabricating functional wound dressings to treat DFU. The hydrogel dressings are classified into hemostatic, antibacterial and anti-inflammatory, and healing-promoting hydrogel dressings by associating the pathogenesis of DFU in this paper. The design and fabrication strategies for the dressings, as well as their therapeutic effects in treating DFU, are extensively reviewed. Additionally, this paper highlights future perspectives of multifunctional hydrogel dressings in DFU treatment. This review aims to provide valuable references for material scientists to design and develop hydrogel wound dressings with enhanced capabilities for DFU treatment, and to further translate them into the clinic in the future.

Graphical abstract

Keywords

hydrogel dressing / multifunction / design / fabrication / diabetic foot ulcer

References

[1] Narjis M, Noreen M, Safi S Z, . Cross talk between complete blood count and progression of type II diabetes mellitus.Journal of King Saud University Science, 2021, 33(6): 101492

[2] Zhong V W, Yu D, Zhao L, . Achievement of guideline-recommended targets in diabetes care in China: a nationwide cross-sectional study.Annals of Internal Medicine, 2023, 176(8): 1037–1046

[3] Sumpio B J, Mezghani I, Wang E, . Experimental treatments in clinical trials for diabetic foot ulcers: wound healers in the pipeline.Expert Opinion on Investigational Drugs, 2023, 32(2): 95–99

[4] Davis F M, Kimball A, Boniakowski A, . Dysfunctional wound healing in diabetic foot ulcers: new crossroads.Current Diabetes Reports, 2018, 18(1): 2

[5] Schmidt A M . Highlighting diabetes mellitus: the epidemic continues.Arteriosclerosis, Thrombosis, and Vascular Biology, 2018, 38(1): e1–e8

[6] Güiza-Argüello V R, Solarte-David V A, Pinzón-Mora A V, . Current advances in the development of hydrogel-based wound dressings for diabetic foot ulcer treatment.Polymers, 2022, 14(14): 2764

[7] Singer A J . Healing mechanisms in cutaneous wounds: tipping the balance.Tissue Engineering Part B: Reviews, 2022, 28(5): 1151–1167

[8] Li X Y, Jing X, Yu Z, . Diverse antibacterial treatments beyond antibiotics for diabetic foot ulcer therapy.Advanced Healthcare Materials, 2023, 12(23): 2300375

[9] Raghavan J V, Jhunjhunwala S . Role of innate immune cells in chronic diabetic wounds.Journal of the Indian Institute of Science, 2023, 103(1): 249–271

[10] Caturano A, D’Angelo M, Mormone A, . Oxidative stress in Type 2 diabetes: impacts from pathogenesis to lifestyle modifications.Current Issues in Molecular Biology, 2023, 45(8): 6651–6666

[11] Wang H, Xu Z, Zhao M, . Advances of hydrogel dressings in diabetic wounds.Biomaterials Science, 2021, 9(5): 1530–1546

[12] Yang J, Chu Z, Jiang Y, . Multifunctional hyaluronic acid microneedle patch embedded by cerium/zinc-based composites for accelerating diabetes wound healing.Advanced Healthcare Materials, 2023, 12(24): 2300725

[13] Gao S, Zhang W, Zhai X, . An antibacterial and proangiogenic double-layer drug-loaded microneedle patch for accelerating diabetic wound healing.Biomaterials Science, 2023, 11(2): 533–541

[14] Chang M, Nguyen T T . Strategy for treatment of infected diabetic foot ulcers.Accounts of Chemical Research, 2021, 54(5): 1080–1093

[15] Glover K, Stratakos A C, Varadi A, . 3D scaffolds in the treatment of diabetic foot ulcers: new trends vs conventional approaches.International Journal of Pharmaceutics, 2021, 599: 120423

[16] Gupta A, Kowalczuk M, Heaselgrave W, . The production and application of hydrogels for wound management: a review.European Polymer Journal, 2019, 111: 134–151

[17] Winter G D . Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig.Nature, 1962, 193(4812): 293–294

[18] Kokabi M, Sirousazar M, Hassan Z M . PVA–clay nanocomposite hydrogels for wound dressing.European Polymer Journal, 2007, 43(3): 773–781

[19] Kim H . Wound dressing materials: the essentials.Journal of Wound Management and Research, 2018, 14(2): 141–142

[20] Bai H, Kyu-Cheol N, Wang Z, . Regulation of inflammatory microenvironment using a self-healing hydrogel loaded with BM-MSCs for advanced wound healing in rat diabetic foot ulcers.Journal of Tissue Engineering, 2020, 11: 2041731420947242

[21] Cascone S, Lamberti G . Hydrogel-based commercial products for biomedical applications: a review.International Journal of Pharmaceutics, 2020, 573: 118803

[22] Ho T C, Chang C C, Chan H P, . Hydrogels: properties and applications in biomedicine.Molecules, 2022, 27(9): 2902

[23] Meleties M, Katyal P, Lin B, . Self-assembly of stimuli-responsive coiled-coil fibrous hydrogels.Soft Matter, 2021, 17(26): 6470–6476

[24] Hiratani T, Kose O, Hamad W Y, . Stable and sensitive stimuli-responsive anisotropic hydrogels for sensing ionic strength and pressure.Materials Horizons, 2018, 5(6): 1076–1081

[25] Yang L, Liang F, Zhang X, . Remodeling microenvironment based on MOFs-hydrogel hybrid system for improving diabetic wound healing.Chemical Engineering Journal, 2022, 427: 131506

[26] Kumar A, Wang X, Nune K C, . Biodegradable hydrogel-based biomaterials with high absorbent properties for non-adherent wound dressing.International Wound Journal, 2017, 14(6): 1076–1087

[27] Zhang M, Qiao X, Han W, . Alginate–chitosan oligosaccharide–ZnO composite hydrogel for accelerating wound healing.Carbohydrate Polymers, 2021, 266: 118100

[28] Liang Y, Li M, Yang Y, . pH/glucose dual responsive metformin release hydrogel dressings with adhesion and self-healing via dual-dynamic bonding for athletic diabetic foot wound healing.ACS Nano, 2022, 16(2): 3194–3207

[29] Huang Y, Mu L, Zhao X, . Bacterial growth-induced tobramycin smart release self-healing hydrogel for Pseudomonas aeruginosa-infected burn wound healing.ACS Nano, 2022, 16(8): 13022–13036

[30] Wang X, Guo Y, Li J, . Tough wet adhesion of hydrogen-bond-based hydrogel with on-demand debonding and efficient hemostasis.ACS Applied Materials & Interfaces, 2022, 14(31): 36166–36177

[31] Fu Y, Ren P, Wang F, . Mussel-inspired hybrid network hydrogel for continuous adhesion in water.Journal of Materials Chemistry B: Materials for Biology and Medicine, 2020, 8(10): 2148–2154

[32] Shin W, Kim J S, Kim H, . Material design for 3D multifunctional hydrogel structure preparation.Macromolecular Materials and Engineering, 2021, 306(5): 2100007

[33] Wang M, Hu J, Ou Y, . Shape-recoverable hyaluronic acid–waterborne polyurethane hybrid cryogel accelerates hemostasis and wound healing.ACS Applied Materials & Interfaces, 2022, 14(15): 17093–17108

[34] Sun D, Wang H, Liu J, . An enzyme cross-linked hydrogel as a minimally invasive arterial tissue sealing and anti-adhesion barrier.Nano Today, 2022, 44: 101467

[35] Liang Y, He J, Guo B . Functional hydrogels as wound dressing to enhance wound healing.ACS Nano, 2021, 15(8): 12687–12722

[36] Zhao X, Liang Y, Guo B, . Injectable dry cryogels with excellent blood-sucking expansion and blood clotting to cease hemorrhage for lethal deep-wounds, coagulopathy and tissue regeneration.Chemical Engineering Journal, 2021, 403: 126329

[37] Ávila-Quiroga J E, Pinzón-Mora A V, Solarte-David V A, . Innovation and new technologies in hydrogel wound dressings for treating diabetic foot ulcers: a twenty-year review.Cytotherapy, 2021, 23(5): S184–S188

[38] Cui R W, Zhang L H, Ou R Y, . Polysaccharide-based hydrogels for wound dressing: design considerations and clinical applications.Frontiers in Bioengineering and Biotechnology, 2022, 10: 845735

[39] Jain N, Singh Y, Nouri A, . Assessment of healing capacity of glucose-responsive smart gels on the diabetic wound: a comprehensive review.Journal of Drug Delivery Science and Technology, 2024, 93: 105403

[40] Li Y T, Leng Y X, Liu Y, . Advanced multifunctional hydrogels for diabetic foot ulcer healing: active substances and biological functions.Journal of Diabetes, 2024, 16(4): e13537

[41] Zhang J L, Liu C L, Li X J, . Application of photo-crosslinkable gelatin methacryloyl in wound healing.Frontiers in Bioengineering and Biotechnology, 2023, 11: 1303709

[42] Farokhi M, Mottaghitalab F, Fatahi Y, . Overview of silk fibroin use in wound dressings.Trends in Biotechnology, 2018, 36(9): 907–922

[43] DiPersio C M, Zheng R, Kenney J, . Integrin-mediated regulation of epidermal wound functions.Cell and Tissue Research, 2016, 365(3): 467–482

[44] Butenko S, Miwa H, Liu Y, . Engineering immunomodulatory biomaterials to drive skin wounds toward regenerative healing.Cold Spring Harbor Perspectives in Biology, 2023, 15(5): a041242

[45] Gao Y, Kang Y, Wang T, . Alginate microspheres-collagen hydrogel, as a novel 3D culture system, enhanced skin wound healing of hUCMSCs in rats model.Colloids and Surfaces B: Biointerfaces, 2022, 219: 112799

[46] Oliveira C, Sousa D, Teixeira J A, . Polymeric biomaterials for wound healing.Frontiers in Bioengineering and Biotechnology, 2023, 11: 1136077

[47] Goldberg S R, Diegelmann R F . Wound healing primer.Surgical Clinics of North America, 2010, 90(6): 1133–1146

[48] Guo B, Dong R, Liang Y, . Haemostatic materials for wound healing applications.Nature Reviews: Chemistry, 2021, 5(11): 773–791

[49] Wang J X, He J H, Yang Y T, . Hemostatic, antibacterial, conductive and vascular regenerative integrated cryogel for accelerating the whole wound healing process.Chemical Engineering Journal, 2024, 479: 147577

[50] Gurtner G C, Werner S, Barrandon Y, . Wound repair and regeneration.Nature, 2008, 453(7193): 314–321

[51] Hsu B B, Conway W, Tschabrunn C M, . Clotting mimicry from robust hemostatic bandages based on self-assembling peptides.ACS Nano, 2015, 9(9): 9394–9406

[52] Hickman D A, Pawlowski C L, Sekhon U D S, . Biomaterials and advanced technologies for hemostatic management of bleeding.Advanced Materials, 2018, 30(4): 1700859

[53] Ayudhya C C N, Roy S, Thapaliya M, . Roles of a mast cell–specific receptor MRGPRX2 in host defense and inflammation.Journal of Dental Research, 2020, 99(8): 882–890

[54] Jere S W, Abrahamse H, Houreld N N . Interaction of the AKT and β-catenin signalling pathways and the influence of photobiomodulation on cellular signalling proteins in diabetic wound healing.Journal of Biomedical Science, 2023, 30(1): 81

[55] Pan H, Fan D, Duan Z, . Non-stick hemostasis hydrogels as dressings with bacterial barrier activity for cutaneous wound healing.Materials Science and Engineering C, 2019, 105: 110118

[56] Grice E A, Kong H H, Conlan S, . Topographical and temporal diversity of the human skin microbiome.Science, 2009, 324(5931): 1190–1192

[57] Li S Q, Dong S J, Xu W G, . Antibacterial hydrogels.Advanced Science, 2018, 5(5): 1700527

[58] Poplimont H, Georgantzoglou A, Boulch M, . Neutrophil swarming in damaged tissue is orchestrated by connexins and cooperative calcium alarm signals.Current Biology, 2020, 30(14): 2761–2776

[59] Liang Y, Liang Y, Zhang H, . Antibacterial biomaterials for skin wound dressing.Asian Journal of Pharmaceutical Sciences, 2022, 17(3): 353–384

[60] Musaie K, Abbaszadeh S, Nosrati-Siahmazgi V, . Metal-coordination synthesis of a natural injectable photoactive hydrogel with antibacterial and blood-aggregating functions for cancer thermotherapy and mild-heating wound repair.Biomaterials Science, 2023, 11(7): 2486–2503

[61] Xu X, Zeng Y, Chen Z, . Chitosan-based multifunctional hydrogel for sequential wound inflammation elimination, infection inhibition, and wound healing.International Journal of Biological Macromolecules, 2023, 235: 123847

[62] Soliman A M, Das S, Abd Ghafar N, . Role of microRNA in proliferation phase of wound healing.Frontiers in Genetics, 2018, 9: 38

[63] Stevens L J, Page-McCaw A . A secreted MMP is required for reepithelialization during wound healing.Molecular Biology of the Cell, 2012, 23(6): 1068–1079

[64] Zhang R, Tian Y, Pang L, . Wound microenvironment-responsive protein hydrogel drug-loaded system with accelerating healing and antibacterial property.ACS Applied Materials & Interfaces, 2022, 14(8): 10187–10199

[65] Maione A G, Smith A, Kashpur O, . Altered ECM deposition by diabetic foot ulcer-derived fibroblasts implicates fibronectin in chronic wound repair.Wound Repair and Regeneration, 2016, 24(4): 630–643

[66] Yang Y, Xia T, Zhi W, . Promotion of skin regeneration in diabetic rats by electrospun core–sheath fibers loaded with basic fibroblast growth factor.Biomaterials, 2011, 32(18): 4243–4254

[67] Martin P, Nunan R . Cellular and molecular mechanisms of repair in acute and chronic wound healing.British Journal of Dermatology, 2015, 173(2): 370–378

[68] Yadav J P . Based on clinical research matrix metalloprotease (MMP) inhibitors to promote diabetic wound healing.Hormone and Metabolic Research, 2023, 55(11): 752–757

[69] Berlanga-Acosta J A, Guillén-Nieto G E, Rodríguez-Rodríguez N, . Cellular senescence as the pathogenic hub of diabetes-related wound chronicity.Frontiers in Endocrinology, 2020, 11: 573032

[70] Liu D, Yang P, Gao M, . NLRP3 activation induced by neutrophil extracellular traps sustains inflammatory response in the diabetic wound.Clinical Science, 2019, 133(4): 565–582

[71] Bannon P, Wood S, Restivo T, . Diabetes induces stable intrinsic changes to myeloid cells that contribute to chronic inflammation during wound healing in mice.Disease Models & Mechanisms, 2013, 6(6): 1434–1447

[72] Teh H X, Phang S J, Looi M L, . Molecular pathways of NF-ĸB and NLRP3 inflammasome as potential targets in the treatment of inflammation in diabetic wounds: a review.Life Sciences, 2023, 334: 122228

[73] Yang Y T, Liang Y P, Chen J Y, . Mussel-inspired adhesive antioxidant antibacterial hemostatic composite hydrogel wound dressing via photo-polymerization for infected skin wound healing.Bioactive Materials, 2022, 8: 341–354

[74] Zhang L, Zhang Y, Ma F, . A low-swelling and toughened adhesive hydrogel with anti-microbial and hemostatic capacities for wound healing.Journal of Materials Chemistry B: Materials for Biology and Medicine, 2022, 10(6): 915–926

[75] Smithmyer M E, Sawicki L A, Kloxin A M . Hydrogel scaffolds as in vitro models to study fibroblast activation in wound healing and disease.Biomaterials Science, 2014, 2(5): 634–650

[76] Thangavel P, Ramachandran B, Kannan R, . Biomimetic hydrogel loaded with silk and l-proline for tissue engineering and wound healing applications.Journal of Biomedical Materials Research Part B: Applied Biomaterials, 2017, 105(6): 1401–1408

[77] Smithmyer M E, Sawicki L A, Kloxin A M . Hydrogel scaffolds as in vitro models to study fibroblast activation in wound healing and disease.Biomaterials Science, 2014, 2(5): 634–650

[78] Malone-Povolny M J, Maloney S E, Schoenfisch M H . Nitric oxide therapy for diabetic wound healing.Advanced Healthcare Materials, 2019, 8(12): 1801210

[79] Wang N, Zhao S, Tian X, . Fabrication of microspheres containing coagulation factors by reverse microemulsion method for rapid hemostasis and wound healing.Colloids and Surfaces B: Biointerfaces, 2022, 218: 112742

[80] Xu J Y, Su M, Jin Z M, . Effects of natural brown cotton bleached gauze on wound healing.Materials, 2022, 15(6): 2070

[81] Cheng J, Liu J, Li M, . Hydrogel-based biomaterials engineered from natural-derived polysaccharides and proteins for hemostasis and wound healing.Frontiers in Bioengineering and Biotechnology, 2021, 9: 780187

[82] Liu J, Li J, Yu F, . In situ forming hydrogel of natural polysaccharides through Schiff base reaction for soft tissue adhesive and hemostasis.International Journal of Biological Macromolecules, 2020, 147: 653–666

[83] Qiao L, Liang Y, Chen J, . Antibacterial conductive self-healing hydrogel wound dressing with dual dynamic bonds promotes infected wound healing.Bioactive Materials, 2023, 30: 129–141

[84] Ouyang Y, Zhao Y, Zheng X, . Rapidly degrading and mussel-inspired multifunctional carboxymethyl chitosan/montmorillonite hydrogel for wound hemostasis.International Journal of Biological Macromolecules, 2023, 242: 124960

[85] Khan M A, Mujahid M . A review on recent advances in chitosan based composite for hemostatic dressings.International Journal of Biological Macromolecules, 2019, 124: 138–147

[86] Meldawati K P, Syafruddin I, Tamrin T, . Bioactive bacterial cellulose wound dressings for burns with collagen in-situ and chitosan ex-situ impregnation.International Journal of Biological Macromolecules, 2023, 230: 123118

[87] Chou T C, Fu E, Wu C J, . Chitosan enhances platelet adhesion and aggregation.Biochemical and Biophysical Research Communications, 2003, 302(3): 480–483

[88] Liu W S, Yang C F, Gao R, . Polymer composite sponges with inherent antibacterial, hemostatic, inflammation-modulating and proregenerative performances for methicillin-resistant Staphylococcus aureus-infected wound healing.Advanced Healthcare Materials, 2021, 10(22): 2101247

[89] Song F, Kong Y, Shao C, . Chitosan-based multifunctional flexible hemostatic bio-hydrogel.Acta Biomaterialia, 2021, 136: 170–183

[90] Fan L, Yang H, Yang J, . Preparation and characterization of chitosan/gelatin/PVA hydrogel for wound dressings.Carbohydrate Polymers, 2016, 146: 427–434

[91] Ye H, Cheng J, Yu K . In situ reduction of silver nanoparticles by gelatin to obtain porous silver nanoparticle/chitosan composites with enhanced antimicrobial and wound-healing activity.International Journal of Biological Macromolecules, 2019, 121: 633–642

[92] Yu X S, Cheng C, Peng X, . A self-healing and injectable oxidized quaternized guar gum/carboxymethyl chitosan hydrogel with efficient hemostatic and antibacterial properties for wound dressing.Colloids and Surfaces B: Biointerfaces, 2022, 209: 112207

[93] Zheng Z, Bian S, Li Z, . Catechol modified quaternized chitosan enhanced wet adhesive and antibacterial properties of injectable thermo-sensitive hydrogel for wound healing.Carbohydrate Polymers, 2020, 249: 116826

[94] Dragostin O M, Samal S K, Dash M, . New antimicrobial chitosan derivatives for wound dressing applications.Carbohydrate Polymers, 2016, 141: 28–40

[95] Cheng C, Zhong H, Zhang Y, . Bacterial responsive hydrogels based on quaternized chitosan and GQDs-ε-PL for chemo-photothermal synergistic anti-infection in diabetic wounds.International Journal of Biological Macromolecules, 2022, 210: 377–393

[96] Qiao L, Liang Y, Chen J, . Antibacterial conductive self-healing hydrogel wound dressing with dual dynamic bonds promotes infected wound healing.Bioactive Materials, 2023, 30: 129–141

[97] Ren Y, Ma S, Zhang D, . Functionalized injectable hyaluronic acid hydrogel with antioxidative and photothermal antibacterial activity for infected wound healing.International Journal of Biological Macromolecules, 2022, 210: 218–232

[98] Jiang Y, Wang J, Zhang H, . Bio-inspired natural platelet hydrogels for wound healing.Science Bulletin, 2022, 67(17): 1776–1784

[99] Silva V, Almeida F, Carvalho J A, . Emergence of community-acquired methicillin-resistant Staphylococcus aureus EMRSA-15 clone as the predominant cause of diabetic foot ulcer infections in Portugal.European Journal of Clinical Microbiology & Infectious Diseases, 2020, 39(1): 179–186

[100] Wang L, Li X, Sun T, . Dual-functional dextran-PEG hydrogel as an antimicrobial biomedical material.Macromolecular Bioscience, 2018, 18(2): 1700325

[101] Masood N, Ahmed R, Tariq M, . Silver nanoparticle impregnated chitosan-PEG hydrogel enhances wound healing in diabetes induced rabbits.International Journal of Pharmaceutics, 2019, 559: 23–36

[102] Uppu D S S M, Haldar J . Lipopolysaccharide neutralization by cationic–amphiphilic polymers through pseudoaggregate formation.Biomacromolecules, 2016, 17(3): 862–873

[103] Wang X, Song R, Johnson M, . An injectable chitosan-based self-healable hydrogel system as an antibacterial wound dressing.Materials, 2021, 14(20): 5956

[104] Liu H, Li Z, Zhao Y, . Novel diabetic foot wound dressing based on multifunctional hydrogels with extensive temperature-tolerant, durable, adhesive, and intrinsic antibacterial properties.ACS Applied Materials & Interfaces, 2021, 13(23): 26770–26781

[105] Xiong Y H, Zhang L J, Xiu Z P, . Derma-like antibacterial polysaccharide gel dressings for wound care.Acta Biomaterialia, 2022, 148: 119–132

[106] Qi X L, Ge X X, Chen X J, . An immunoregulation hydrogel with controlled hyperthermia-augmented oxygenation and ROS scavenging for treating diabetic foot ulcers.Advanced Functional Materials, 2024, 34: 2400289

[107] Fujii J, Osaki T . Involvement of nitric oxide in protecting against radical species and autoregulation of M1-polarized macrophages through metabolic remodeling.Molecules, 2023, 28(2): 814

[108] Zhao H, Lou Z, Chen Y, . Tea polyphenols (TPP) as a promising wound healing agent: TPP exerts multiple and distinct mechanisms at different phases of wound healing in a mouse model.Biomedicine and Pharmacotherapy, 2023, 166: 115437

[109] Bi M, Qin Y, Wang L, . The protective role of resveratrol in diabetic wound healing.Phytotherapy Research, 2023, 37(11): 5193–5204

[110] Farhat F, Sohail S S, Siddiqui F, . Curcumin in wound healing — a bibliometric analysis.Life, 2023, 13(1): 143

[111] Tekin G G, Deveci B . Effects of gallic acid on gingival wounds.European Review for Medical and Pharmacological Sciences, 2023, 27(7): 2739–2744

[112] Liu Z J, Zhang S L, Ran Y Y, . Nanoarchitectonics of tannic acid based injectable hydrogel regulate the microglial phenotype to enhance neuroplasticity for poststroke rehabilitation.Biomaterials Research, 2023, 27: 108

[113] Liu Z J, Ye L, Xi J N, . Cyclodextrin polymers: structure, synthesis, and use as drug carriers.Progress in Polymer Science, 2021, 118: 101408

[114] Zhu W, Dong Y, Xu P, . A composite hydrogel containing resveratrol-laden nanoparticles and platelet-derived extracellular vesicles promotes wound healing in diabetic mice.Acta Biomaterialia, 2022, 154: 212–230

[115] Zhao B, Zhu S, Liu Y W, . Enriching and smart releasing curcumin via phenylboronic acid-anchored bioinspired hydrogel for diabetic wound healing.Advanced NanoBiomed Research, 2023, 3(5): 2200177

[116] Cai X, He Y, Cai L, . An injectable elastic hydrogel crosslinked with curcumin–gelatin nanoparticles as a multifunctional dressing for the rapid repair of bacterially infected wounds.Biomaterials Science, 2023, 11(9): 3227–3240

[117] Zong Q, Zhou S, Ye J, . Aliphatic polycarbonate-based hydrogel dressing for wound healing.Journal of Drug Delivery Science and Technology, 2023, 79: 104083

[118] Chen T, Guo X, Huang Y, . Bletilla striata polysaccharide–waterborne polyurethane hydrogel as a wound dressing.Journal of Biomaterials Science: Polymer Edition, 2023, 34(9): 1157–1170

[119] Lu Y, Jia C, Gong C, . A hydrogel system containing molybdenum-based nanomaterials for wound healing.Nano Research, 2023, 16(4): 5368–5375

[120] Peng J, Zhao H, Tu C, . In situ hydrogel dressing loaded with heparin and basic fibroblast growth factor for accelerating wound healing in rat.Materials Science and Engineering C, 2020, 116: 111169

[121] Xiao Y, Zhao H, Ma X, . Hydrogel dressing containing basic fibroblast growth factor accelerating chronic wound healing in aged mouse model.Molecules, 2022, 27(19): 6361

[122] Jing X D, Sun Y, Liu Y, . Alginate/chitosan-based hydrogel loaded with gene vectors to deliver polydeoxyribonucleotide for effective wound healing.Biomaterials Science, 2021, 9(16): 5533–5541

[123] Yang J, Zeng W N, Xu P, . Glucose-responsive multifunctional metal–organic drug-loaded hydrogel for diabetic wound healing.Acta Biomaterialia, 2022, 140: 206–218

[124] Zhang B, Lv Y J, Yu C G, . Au–Pt nanozyme-based multifunctional hydrogel dressing for diabetic wound healing.Biomaterials Advances, 2022, 137: 212869

[125] Wang L, Zhou M, Xu T, . Multifunctional hydrogel as wound dressing for intelligent wound monitoring.Chemical Engineering Journal, 2022, 433: 134625

[126] Jiang Y, Trotsyuk A A, Niu S, . Wireless, closed-loop, smart bandage with integrated sensors and stimulators for advanced wound care and accelerated healing.Nature Biotechnology, 2023, 41(5): 652–662

[127] Cardinal M, Eisenbud D E, Armstrong D G . Wound shape geometry measurements correlate to eventual wound healing.Wound Repair and Regeneration, 2009, 17(2): 173–178

[128] Li G C, Li S J, Zhang L L, . Construction of biofunctionalized anisotropic hydrogel micropatterns and their effect on Schwann cell behavior in peripheral nerve regeneration.ACS Applied Materials & Interfaces, 2019, 11(41): 37397–37410

[129] Chen S Y, Zhao Y X, Yan X L, . PAM/GO/gel/SA composite hydrogel conduit with bioactivity for repairing peripheral nerve injury.Journal of Biomedical Materials Research Part A, 2019, 107(6): 1273–1283

[130] Zhao L, Niu L, Liang H, . pH and glucose dual-responsive injectable hydrogels with insulin and fibroblasts as bioactive dressings for diabetic wound healing.ACS Applied Materials & Interfaces, 2017, 9(43): 37563–37574

[131] Lei X X, Hu J J, Zou C Y, . Multifunctional two-component in-situ hydrogel for esophageal submucosal dissection for mucosa uplift, postoperative wound closure and rapid healing.Bioactive Materials, 2023, 27: 461–473

[132] Zhang J X, Dong H F, Jing X Z, . Injectable in situ photocrosslinked hydrogel dressing for infected wound healing.ACS Applied Bio Materials, 2023, 6(5): 1992–2002

[133] Yayehrad A T, Siraj E A, Matsabisa M, . 3D printed drug loaded nanomaterials for wound healing applications.Regenerative Therapy, 2023, 24: 361–376

[134] Ma X, Gao F, Su W, . Multifunctional injectable hydrogel promotes functional recovery after stroke by modulating microglial polarization, angiogenesis and neuroplasticity.Chemical Engineering Journal, 2023, 464: 142520

[135] Teoh J H, Tay S M, Fuh J, . Fabricating scalable, personalized wound dressings with customizable drug loadings via 3D printing.Journal of Controlled Release, 2022, 341: 80–94

[136] Alizadehgiashi M, Nemr C R, Chekini M, . Multifunctional 3D-printed wound dressings.ACS Nano, 2021, 15(7): 12375–12387

Authors’ contributions

Conceptualization: Y.W., Z.L., and L.Y.; data curation: Y.W., X.G., and D.H.; writing — original draft preparation: Y.W. and X.W.; writing — review and editing: Y.W., L.Y., and X.G.; supervision: X.W. and Z.F.; funding acquisition: H.Z., Z.F., and Z.L. All authors have read and agreed to the published version of the manuscript.

Declaration of competing interests

The authors declare that they have no competing interests.

Acknowledgements

This research was funded by the Science and Technology Innovation Project, China Academy of Chinese Medical Sciences, clinical study on the effect of modified Bu yang Huan wu decoction combined with early anticoagulant intervention on the prevention of lower extremity deep vein thrombosis syndrome (CI2021A01905).

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