A highly stretchable, adhesive, and antibacterial hydrogel with chitosan and tobramycin as dynamic cross-linkers for treating the infected diabetic wound

Antibacterial chitosan/organic rectorite nanocomposite-conjugated gelatin/β-cyclodextrin hydrogels with improved hemostasis performance for wound repair

Bacterial infections and severe bleeding continue to pose significant challenges in wound repair. There is an urgent need for innovative, nature-inspired hydrogel dressings with antibacterial and hemostatic properties. A Ge-β-CD-CS-OREC conjugate hydrogel was developed by grafting β-CD and CS-OREC nanocomposites into a Ge matrix using EDC/NHS crosslinking, as confirmed by FT-IR and EDX analyses. Compared to single Ge-β-CD cross-linked hydrogels, the addition of CS-OREC enhanced the hydrogel's properties, including increased pore size (60 ± 14 μm), improved wettability (WCA = 28.82 ± 0.6°), enhanced tensile strength (41.3 ± 3.56 KPa), and strong tissue adhesion. Furthermore, this hydrogel demonstrated excellent cytocompatibility when co-cultured with keratinocytes (Kcs) and vascular endothelial cells (VECs). The incorporation of CS chains into OREC interlayers allowed the hydrogel to specifically target bacteria and increase membrane permeability in Pseudomonas aeruginosa (PA), Klebsiella pneumoniae (KP), and Staphylococcus aureus (SA), effectively reducing the bacterial load in infected wounds by 50.24-73.92 % compared to controls in vivo. Further, the hydrogel exhibited superior hemostatic efficiency (78 ± 10 s) over commercial gauze and other gels by enhancing platelet activation and coagulation factor secretion. The hydrogel accelerated tissue regeneration by promoting epithelial maturation and blood vessel regeneration, indicating its clinical potential as promising wound dressing.

Bioadhesive supramolecular polymer/hyaluronic acid hydrogel with sustained release of zinc ions and dexamethasone for diabetic wound healing

Diabetic patients often struggle with wound healing and are at higher risk of infections, necessitating the development of a stretchable, adhesive hydrogel dressing with antibacterial and angiogenesis-promoting properties. In this study, we synthesized a series of adhesive, antibacterial and anti-inflammatory hydrogels using free radical polymerization with materials including methacrylated hyaluronic acid (HAMA), N-[tris(hydroxymethyl)methyl]acrylamide (THMA), and 3-(bis(pyridin-2-ylmethyl)amino)propyl methacrylate (DPAMA). By leveraging the strong affinity of zinc(II)-dipicolylamine coordination complexes for the phosphorylated groups in dexamethasone sodium phosphate (DMSP), Zn2+ and DMSP were successfully incorporated into the hydrogel. The results demonstrated that the hydrogels possessed excellent adhesiveness and mechanical properties, enabling them to adhere closely to the skin while remaining easily removable without causing trauma. Antibacterial tests demonstrated significant inhibitory effects against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), attributed to the slow release of Zn2+, which effectively suppressed bacterial growth. Additionally, the slow release of DMSP provided strong anti-inflammatory effects. The DHTDZ2 hydrogel, containing 1.5 mg/mL Zn2+ and 4 mg/mL DMSP, significantly accelerated the healing of full-thickness skin wounds. In vitro angiogenesis, immunofluorescence, and immuno-histochemical results further confirmed that the DHTDZ2 hydrogel promoted angiogenesis and reduced the expression of pro-inflammatory factors. In summary, the hydrogel is an effective wound healing dressing that can reduce wound infections and inflammation.

Adhesive and antibacterial guar gum-based nanocomposite hydrogel for remodeling wound healing microenvironment

Hydrogels are promising wound dressings due to their extracellular matrix-like properties and tunable structure-function characteristics. Besides the physical isolation effect, hydrogel dressings are highly expected to possess tissue-adhesive performance and antibacterial capacity, which are beneficial for their clinical translations. Herein, a guar gum (GG)-based nanocomposite hydrogel was fabricated by mixing methacrylated GG (GGMA), acrylic acid, acrylated 3-aminophenylboronic acid, mangiferin (MF)-loaded cetyltrimethyl ammonium chloride (CTAC) micelles (MF@CTAC) and radical initiator. This hydrogel exhibited stable and tunable mechanical property as well as excellent biocompatibility. Borate crosslinking and physical interactions of the hydrogel produced a certain degree of self-healing ability, good tissue adhesive and hemostatic capacity. MF endowed the hydrogel with good antioxidant ability and excellent synergistic antibacterial ability with CATC. In vivo experiments indicated that the hydrogel significantly accelerated wound healing with a narrower wound edge, thicker granulation tissue, maturer epidermis and dermis tissue, higher collagen deposition level, milder inflammatory response, and enhanced angiogenesis. The hydrogel without adding antibiotics and other exogenous active ingredients showed great application potential as a versatile wound dressing material.

RGDSP-functionalized peptide hydrogel stimulates growth factor secretion via integrin αv/PI3K/AKT axis for improved wound healing by human amniotic mesenchymal stem cells

The wound healing process involves communication among growth factors, cytokines, signaling pathways, and cells in the extracellular matrix, with growth factors acting as key regulators. Although stem cells can promote wound healing by secreting diverse growth factors, their therapeutic potential is hindered by poor survival and engraftment. Mimicking the stem cell-matrix interactions can improve stem cell survival, regulate their fate, and even enhance their paracrine effects. This study investigated the use of composite RGDmix hydrogel, which can support the survival and proliferation of human amniotic mesenchymal stem cells (hAMSCs), and effectively increase the expression of various growth factors, thereby promoting wound re-epithelialization, angiogenesis, and epidermal maturation. At last, the specific role of integrin αv and PI3K/AKT signaling pathways in the secretion of growth factors were examined by silencing them in vitro and in vivo. Results suggested that the RGDmix hydrogel improved the secretion of growth factors by hAMSCs through the RGDSP/integrin αv/PI3K/AKT axis, thereby enhancing the therapeutic effect in wound healing.

A Janus Adhesive Hydrogel with Integrated Attack and Defense for Bacteria Killing and Antifouling

Objective: Skin wound exposed to complex external environment for a long time is highly susceptible to bacterial infection. Impact Statement: This work designs a Janus adhesive dual-layer hydrogel containing in situ silver nanoparticles (named PSAP/DXP@AgNPs) with integrated attack and defense to simultaneously kill the existing bacteria and prevent foreign bacterial contamination. Introduction: The current gauze dressing fixed by tape fails to well fit at skin wound and lacks intrinsic antibacterial property, making it highly prone to causing secondary infection. Moreover, foreign bacteria may contaminate the wound dressing during use, further increasing the risk of secondary infection. Methods: In this work, a Janus adhesive dual-layer PSAP/DXP@AgNPs hydrogel is prepared by sequentially building the PSAP gel layer containing zwitterionic poly(sulfobetaine methacrylamide) (PSBMA) on the DXP@AgNPs gel layer containing in situ catechol-reduced AgNPs. Results: The flexible PSAP/DXP@AgNPs can adapt shape change of skin and adhere to skin tissue with interfacial toughness of 153.38 J m-2 relying on its DXP@AgNPs layer, which is beneficial to build favorable fit. The in situ reduced AgNPs released from the DXP@AgNPs layer of PSAP/DXP@AgNPs exhibit obvious antibacterial effects against Escherichia coli and Staphylococcus aureus, with antibacterial rates of 99% and 88%, respectively. Meanwhile, the hydrated PSAP layer of PSAP/DXP@AgNPs containing PSBMA is able to prevent the bacterial contamination, decreasing the risk of secondary infection. Besides, cell experiments demonstrate that PSAP/DXP@AgNPs is biocompatible. Conclusion: The PSAP/DXP@AgNPs hydrogel with integrated attack and defense simultaneously possessing bacteria-killing and bacteria-antifouling properties is a potential alternative in treating infected skin wound.

Accelerated healing of intractable biofilm-infected diabetic wounds by trypsin-loaded quaternized chitosan hydrogels that disrupt extracellular polymeric substances and eradicate bacteria

Complex and stubborn bacterial biofilm infections significantly hinder diabetic wound healing and threaten public health. Therefore, a dressing material that effectively clears biofilms and promotes wound healing is urgently required. Herein, we introduce a novel strategy for simultaneously dispersing extracellular polymeric substances and eradicating drug-resistant bacteria. We prepared an ultrabroad-spectrum and injectable quaternized chitosan (QCS) hydrogel loaded with trypsin, which degrades biofilm extracellular proteins. Increased temperature initiated QCS gelation to form the hydrogel, enabling the sustained release of trypsin and effective adherence of the hydrogel to irregularly shaped wounds. To reproduce clinical scenarios, biofilms formed by a mixture of Staphylococcus aureus (S. aureus), Methicillin-resistant S. aureus, and Pseudomonas aeruginosa were administered to the wounds of rats with streptozotocin-induced diabetes. Under these severe infection conditions, the hydrogel efficiently suppressed inflammation, promoted angiogenesis, and enhanced collagen deposition, resulting in accelerated healing of diabetic wounds. Notably, the hydrogel demonstrates excellent biocompatibility without cytotoxicity. In summary, we present a trypsin-loaded QCS hydrogel with tremendous clinical applications potential for the treatment of chronic infected wounds.

Development and characterization of ferulic acid-loaded chitosan nanoparticle embedded- hydrogel for diabetic wound delivery

Diabetic wounds present a significant global health challenge exacerbated by chronic hyperglycemia-induced oxidative stress, impeding the natural healing process. Despite various treatment strategies, diabetic foot ulceration lacks standardized therapy. Ferulic acid (FA), known for its potent antidiabetic and antioxidant properties, holds promise for diabetic wound management. However, oral administration of FA faces limitations due to rapid oxidation, stability issues, and low bioavailability. The topical application of FA-loaded chitosan nanoparticles (FA-CSNPs) has emerged as a promising approach to overcome these challenges. Here, we report the development of a sustained-release formulation of FA-CSNPs within a hydrogel matrix composed of Chitosan and gelatin. The FA-CSNPs were synthesized using the ionic gelation method andoptimized through a Central Composite Design (CCD) approach. Characterization of the optimized nanoparticles revealed spherical morphology, a particle size of 56.9 ± 2.5 nm, and an impressive entrapment efficiency of 90.3 ± 2.4 %. Subsequently, an FA-CSNPs-loaded hydrogel was formulated, incorporating chitosan as a gelling agent, gelatin to enhance mechanical properties and cell permeation, and glutaraldehyde as a cross-linker. Comprehensive characterization of the hydrogel included pH, moisture loss, porosity, swelling index, rheology, water vapor transmission rate (WVTR), SEM, TEM, invitro drug release studies, antioxidant activity, antibacterial efficacy, cell cytotoxicity, cell migration studies on L929 fibroblast cell line, and stability studies. The stability study demonstrated negligible variations in particle size, zeta potential, and entrapment efficiency over 60 days, ensuring the stable nature of nanoparticles and hydrogel. This innovative delivery approach embedded within a hydrogel matrix holds significant promise for enhancing the therapeutic efficacy of FA-CSNPs-hydrogel in diabetic wound healing applications.

Overview of Dynamic Bond Based Hydrogels for Reversible Adhesion Processes

Polymeric hydrogels are soft materials with a three-dimensional (3D) hydrophilic network capable of retaining and absorbing large amounts of water or biological fluids. Due to their customizable properties, these materials are extensively studied for developing matrices for 3D cell culture scaffolds, drug delivery systems, and tissue engineering. However, conventional hydrogels still exhibit many drawbacks; thus, significant efforts have been directed towards developing dynamic hydrogels that draw inspiration from organisms' natural self-repair abilities after injury. The self-healing properties of these hydrogels are closely associated with their ability to form, break, and heal dynamic bonds in response to various stimuli. The primary objective of this review is to provide a comprehensive overview of dynamic hydrogels by examining the types of chemical bonds associated with them and the biopolymers utilized, and to elucidate the chemical nature of dynamic bonds that enable the modulation of hydrogels' properties. While dynamic bonds ensure the self-healing behavior of hydrogels, they do not inherently confer adhesive properties. Therefore, we also highlight emerging approaches that enable dynamic hydrogels to acquire adhesive properties.

A hyaluronic acid hydrogel as a mild photothermal antibacterial, antioxidant, and nitric oxide release platform for diabetic wound healing

Hyaluronic acid (HA)-based biopolymer hydrogels are promising therapeutic dressings for various wounds but still underperform in treating diabetic wounds. These wounds are extremely difficult to heal and undergo a prolonged and severe inflammatory process due to bacterial infection, overexpression of reactive oxygen species (ROS), and insufficient synthesis of NO. In this study, a dynamic crosslinked hyaluronic acid (HA) hydrogel dressing (Gel-HAB) loaded with allomelanin (AMNP)-N, N'-dis-sec-butyl-N, N'-dinitroso-1, 4-phenylenediamine (BNN6) nanoparticles (AMNP-BNN6) was developed for healing diabetic wounds. The dynamic acylhydrazone bond formed between hydrazide-modified HA (HA-ADH) and oxidized HA (OHA) makes the hydrogel injectable, self-healing, and biocompatible. The hydrogel, loaded with AMNP-BNN6 nanoparticles, exhibits promising ROS scavenging ability and on-demand release of nitric oxide (NO) under near-infrared (NIR) laser irradiation to achieve mild photothermal antibacterial therapy (PTAT) (∼ 48 °C). Notably, the Gel-HAB hydrogel effectively reduced the oxidative stress level, controlled infections, accelerated vascular regeneration, and promoted angiogenesis, thereby achieving rapid healing of diabetic wounds. The injectable self-healing nanocomposite hydrogel could serve as a mild photothermal-enhanced antibacterial, antioxidant, and nitric oxide release platform for the treatment of diabetic wounds.

Multifunctional biomimetic hydrogel dressing provides anti-infection treatment and improves immunotherapy by reprogramming the infection-related wound microenvironment

The advancement of biomaterials with antimicrobial and wound healing properties continues to present challenges. Macrophages are recognized for their significant role in the repair of infection-related wounds. However, the interaction between biomaterials and macrophages remains complex and requires further investigation. In this research, we propose a new sequential immunomodulation method to enhance and expedite wound healing by leveraging the immune properties of bacteria-related wounds, utilizing a novel mixed hydrogel dressing. The hydrogel matrix is derived from porcine acellular dermal matrix (PADM) and is loaded with a new type of bioactive glass nanoparticles (MBG) doped with magnesium (Mg-MBG) and loaded with Curcumin (Cur). This hybrid hydrogel demonstrates controlled release of Cur, effectively eradicating bacterial infection in the early stage of wound infection, and the subsequent release of Mg ions (Mg2+) synergistically inhibits the activation of inflammation-related pathways (such as MAPK pathway, NF-κB pathway, TNF-α pathway, etc.), suppressing the inflammatory response caused by infection. Therefore, this innovative hydrogel can safely and effectively expedite wound healing during infection. Our design strategy explores novel immunomodulatory biomaterials, offering a fresh approach to tackle current clinical challenges associated with wound infection treatment.

Microenvironmental dynamics of diabetic wounds and insights for hydrogel-based therapeutics

The rising prevalence of diabetes has underscored concerns surrounding diabetic wounds and their potential to induce disability. The intricate healing mechanisms of diabetic wounds are multifaceted, influenced by ambient microenvironment, including prolonged hyperglycemia, severe infection, inflammation, elevated levels of reactive oxygen species (ROS), ischemia, impaired vascularization, and altered wound physicochemical properties. In recent years, hydrogels have emerged as promising candidates for diabetic wound treatment owing to their exceptional biocompatibility and resemblance to the extracellular matrix (ECM) through a three-dimensional (3D) porous network. This review will first summarize the microenvironment alterations occurring in the diabetic wounds, aiming to provide a comprehensive understanding of its pathogenesis, then a comprehensive classification of recently developed hydrogels will be presented, encompassing properties such as hypoglycemic effects, anti-inflammatory capabilities, antibacterial attributes, ROS scavenging abilities, promotion of angiogenesis, pH responsiveness, and more. The primary objective is to offer a valuable reference for repairing diabetic wounds based on their unique microenvironment. Moreover, this paper outlines potential avenues for future advancements in hydrogel dressings to facilitate and expedite the healing process of diabetic wounds.