Zhao Ying, Zhao Yulan, Xu Bing, Liu Hongwei, Chang Qiang
Department of Plastic Surgery, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China.
Department of Burn and Plastic surgery, Jinan University Affiliated Shunde Hospital, Jinan University, Foshan, China.
J Tissue Eng. 2024 May 29;15:20417314241253290. doi: 10.1177/20417314241253290. eCollection 2024 Jan-Dec.
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.
糖尿病患病率的不断上升凸显了对糖尿病伤口及其导致残疾可能性的担忧。糖尿病伤口复杂的愈合机制是多方面的,受周围微环境影响,包括长期高血糖、严重感染、炎症、活性氧(ROS)水平升高、缺血、血管生成受损以及伤口物理化学性质改变。近年来,水凝胶因其卓越的生物相容性以及通过三维(3D)多孔网络与细胞外基质(ECM)相似而成为糖尿病伤口治疗的有前景的候选材料。本综述首先将总结糖尿病伤口中发生的微环境变化,旨在全面了解其发病机制,然后将对最近开发的水凝胶进行全面分类,包括降血糖作用、抗炎能力、抗菌特性、ROS清除能力、促进血管生成、pH响应性等特性。主要目的是根据糖尿病伤口独特的微环境为修复提供有价值的参考。此外,本文概述了水凝胶敷料未来进展的潜在途径,以促进和加速糖尿病伤口的愈合过程。